title: Trends in the rehabilitation therapist workforce in underserved areas: 1980-2000.
abstract: BACKGROUND
  There is little information about how increases in the rehabilitation therapist workforce have been distributed over the nation. There is evidence that rural areas continue to face a shortage of trained rehabilitation providers. There has also been little attention to therapist distribution in non-rural settings where health professionals are in short supply.
  
  
  OBJECTIVE
  To assess the change in the distribution of rehabilitation therapists in 1980, 1990, and 2000 across counties with different levels of health professional shortages and the difference between metropolitan and non-metropolitan counties.
  
  
  METHODS
  A trend analysis of cross-sectional data of employment of physical therapists, occupational therapists, and speech-language pathologists from 1980 to 2000 by county, relative to population, was done. The groups were stratified by shortage area, partial shortage area, and non-shortage counties and metropolitan and non-metropolitan counties.
  
  
  RESULTS
  There is a maldistribution of rehabilitation therapists in the United States. Although the absolute differences have remained the same or, in most instances, have increased, the relative change was greatest in the shortage areas and non-metropolitan areas. If the trends in the relative changes continue, the absolute differences may begin to narrow.
  
  
  CONCLUSIONS
  This study provides evidence that there are maldistributions of rehabilitation therapists in traditionally underserved areas. It is unclear if these maldistributions represent a shortage of rehabilitation therapists. Continued monitoring of the rehabilitation therapist workforce and the determination of the optimal supply should be undertaken in the future.
authors.affiliation: Case Western Reserve University/MetroHealth Medical Center, Center for Health Care Research and Policy, Cleveland, Ohio 44109, USA. rwilson@metrohealth.org.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Wilson
authors.forename: Steven A
authors.initials: SA
authors.lastname: Lewis
authors.forename: Patrick K
authors.initials: PK
authors.lastname: Murray
mesh_terms: D000488:Allied Health Personnel / Q000145:classification / Q000600:supply & distribution*; D003430:Cross-Sectional Studies; D004651:Employment; D019538:Health Care Surveys; D006280:Health Workforce / Q000639:trends*; D006801:Humans; D008507:Medically Underserved Area; D009788:Occupational Therapy; D026761:Physical Therapy Specialty; D011365:Professional Practice Location / Q000639:trends*; D012046:Rehabilitation; D019035:Rural Health Services; D013066:Speech-Language Pathology; D014481:United States; D019037:Urban Health Services