Geographical analysis of the distribution of certified genetic counselors in the United States

The number of certified genetic counselors (CGCs) in the genetic counseling workforce has increased over the past few decades as the number of training programs increases and CGCs expand into new patient-facing and non-patient-facing roles. Few studies have explored the distribution of CGCs across the United States. We sought to identify the U.S. geographical regions with the highest number of CGCs and those regions where the physical presence of CGCs is sparser. Deidentified city, state, and ZIP code information for each CGC in the United States were obtained from the American Board of Genetic Counseling (ABGC) database. A countrywide analysis of the distribution of CGCs was completed using geographic information system (GIS) mapping software. The data were organized into U.S. metropolitan or micropolitan statistical areas, if applicable, and analyzed by CGC per capita. We included a total of 4,554 data points (92.2%) in the analysis. Results showed there is one CGC for every 71,842 people nationwide. Of 3,141 total counties (or county equivalents) in the United States, 535 counties had at least one CGC (17.0%). The majority (98.7%) of CGCs live or work within metropolitan statistical areas (MSAs), which are defined by this study as geographical areas with greater than 50,000 people. Of the MSAs with a CGC, approximately half have more than one CGC per 100,000 people. These results are consistent with the overall distribution of the U.S. population. We believe that the MSAs with the most CGCs per capita are due to associations with specific institutions, that is, genetic counseling training programs, health system headquarters, or genetic laboratories. Although the present study cannot draw definite conclusions regarding direct patient care services provided by CGCs, it does provide a snapshot of current CGC distribution within the country. Knowing the distribution of CGCs provides a tool to conduct further workforce analyses to determine the number of CGCs needed to serve the U.S. population.