0933 Sleep Specialists in Federally Qualified Health Centers: A Gap in Sleep Health Care Potentially Contributing to Sleep Disparities

Abstract

Abstract Introduction Poor sleep is associated with adverse cardiometabolic health outcomes and increased risk of mortality. Although primary care providers recognize the importance of sleep, they report low comfort levels in diagnosing, treating, and managing sleep disorders; lack of clinical knowledge and skills is the most common barrier to recognizing insomnia in family practice. Furthermore, minoritized racial/ethnic groups are disproportionately affected by poor sleep health, likely due in part to structural and other forms of racism that result in limited access to sleep healthcare. Health Resources & Services Administration (HRSA) has a variety of awards that support scholarships and loan repayment programs at colleges and universities to meet critical workforce shortages and diversify the health professions. We assessed the distribution of sleep specialists among clinicians who participated in a HRSA grant program because they tend to work for health care organizations that serve persons from lower socioeconomic and diverse racial-ethnic backgrounds. Methods Publicly available data were obtained from the HRSA data warehouse. Data were available for 44,199 clinicians (49% MD/DO and 16% Nurse Practitioner) who participated in a HRSA grant program between 2011 and 2021. We report data for those clinicians who endorsed sleep medicine as their subspecialty. Results Of the 44,199 clinicians, 27 (0.06%) physicians trained in a medical subspecialty of sleep medicine, and the majority (52%) were in Michigan. The remainder of sleep medicine specialists completed their program in Pennsylvania (33%), Ohio (7%), Minnesota (4%), and California (4%). Only the participants in the Children's Hospital Graduate Medical Education program designated their subspecialty as sleep medicine. None of the sleep medicine specialists currently practice in Health Professional Shortage Areas (HPSAs) or Medically Underserved Areas/Populations (MUA/P), and 1 physician currently practices in a rural area. Conclusion A marked paucity of trained sleep specialists in HRSA grant programs and an absence of such practitioners in HSPAs underscores the disparities in access to sleep specialty care. Initiatives are needed to incentivize sleep specialists to serve in under-resourced communities as well as to implement programs training primary care practitioners working in these areas to deliver sleep health care, supported by sleep specialists. Support (if any) Divisions of Intramural Research: NIMHD/NIEHS, NIH