Original Investigation
Physician Work Environment and Well-Being
February 24, 2025
Mortality Among US Physicians and Other Health Care Workers
Vishal R. Patel, Michael Liu, Christopher M. Worsham, et al
JAMA Intern Med. Published online February 24, 2025. doi:10.1001/jamainternmed.2024.8432
Question How do mortality rates differ by sex, race, and ethnicity among physicians and other health care workers in the US?
Findings In this population-based cross-sectional study of 3 606 791 US workers aged 25 to 74 years, age-adjusted and sex-adjusted mortality rates per 100 000 were lower for most health care workers compared with non–health care workers. While female individuals had lower mortality rates compared with male workers in non–health care occupations (male-to-female rate ratio, 0.55), this advantage was not present for several health care occupations, including among physicians, and while Black workers had the highest mortality rates across all occupations, the largest disparity between Black and White workers was observed among physicians (Black to White rate ratio, 2.13).
Meaning The study results suggest that although most health care occupations experience low mortality rates, significant disparities based on sex, race, and ethnicity exist among health care workers, particularly physicians; these findings underscore the need for targeted interventions to address health inequities within the health care workforce.
Abstract
Importance National estimates of mortality among physicians and other health care workers are lacking. It is also unknown if distinct patterns exist across sex, race, and ethnicity.
Objective To compare all-cause and cause-specific mortality rates among physicians, health care workers, and non–health care workers by sex, race, and ethnicity.
Design, Setting, and Participants The National Vital Statistics System, a population-based registry of US death certificates, was used to obtain data on deaths among adults aged 25 to 74 years from January 2020 to December 2022 by usual occupation. Data were analyzed from January 2024 to December 2024.
Exposures Usual occupation, sex, race, and ethnicity.
Main Outcomes and Measures Overall and cause-specific mortality rates were calculated for each occupation, as well as sex, race, and ethnicity subgroups, and compared using mortality rate ratios. Mortality estimates were age-adjusted and sex-adjusted, and health care occupations were compared with non–health care occupations with similar income levels (categorized as low income, medium income, and high income based on US Census income terciles).
Results Most health care workers had lower age-adjusted and sex-adjusted annual mortality rates per 100 000 population than non–health care workers (eg, physicians [269.3], high-income non–health care workers [499.2], and non–health care workers overall [730.6]). While female individuals had lower mortality than male individuals in non–health care occupations overall (female to male ratio, 0.55; 95% CI, 0.55-0.55) and high-income non–health care occupations specifically (0.60; 95% CI, 0.60-0.60), this advantage was absent for several health care occupations, including physicians (0.97; 95% CI, 0.93-1.01). In particular, female physicians experienced higher mortality than male physicians of neoplasms and chronic lower respiratory diseases, despite lower mortality of these causes among female individuals in high-income non–health care occupations. Black workers had higher mortality than White workers across all occupations, although the Black to White mortality ratio was largest for physicians (2.13; 95% CI, 1.99-2.29), with the largest differences due to neoplasms, heart disease, and COVID-19. Black female physicians had higher mortality rates than all other physician subgroups and White female individuals in non–health care occupations. While Hispanic workers had lower mortality than White workers in non–health care occupations overall (Hispanic to White ratio, 0.83; 95% CI, 0.83-0.83) and high-income non–health care occupations specifically (0.90; 95% CI, 0.90-0.91), this pattern was reversed for several health care occupations, including physicians (1.18; 95% CI, 1.09-1.27).
Conclusions and Relevance The results of this cross-sectional study suggest that although physicians and most health care workers experienced lower mortality rates compared with the general population, this benefit did not fully extend to female individuals or racial and ethnic minority groups. Renewed efforts are needed to address health inequities within the health care workforce.
