How Physician Mortality Stacks Up Against the General Population

Physicians in the U.S. had lower mortality rates than the general population, but this applied only to men and not women or racial and ethnic minorities, a cross-sectional study showed.

Among over 3.6 million U.S. workers, physicians had lower age- and sex-adjusted annual mortality rates per 100,000 compared with non-healthcare workers:

• Physicians: 269.3
• High-income non-healthcare workers: 499.2
• Non-healthcare workers overall: 730.6

“While this finding may be reassuring for healthcare professionals, it overlies concerning inequities across sex, race, and ethnicity,” wrote Anupam B. Jena, MD, PhD, of Harvard Medical School in Boston, and colleagues in JAMA Internal Medicine.

While women had lower mortality rates than men in non-healthcare occupations overall (female to male mortality rate ratio [MRR] 0.55, 95% CI 0.55-0.55) and men in high-income non-healthcare occupations specifically (MRR 0.60, 95% CI 0.60-0.60), this was not the case for several healthcare occupations, including female physicians (MRR 0.97, 95% CI 0.93-1.01) and female physician assistants (MRR 1.02, 95% CI 0.91-1.14).

Black workers had the highest mortality rates for all occupations, and 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.

In addition, the Black to white mortality ratio was significantly greater in female physicians compared with male physicians (2.23 vs 2.08, respectively), and Black female physicians had a higher mortality rate compared with white women in the general population of non-healthcare workers (616.1 vs 537.4 per 100,000, respectively).

Finally, mortality in Hispanic healthcare workers varied greatly by occupation group, but the Hispanic to white mortality ratio was higher for physicians (1.18, 95% CI 1.09-1.27) compared with high-income non-healthcare workers (0.90, 95% CI 0.90-0.91) and non-healthcare workers overall (0.83, 95% CI 0.83-0.83).

“While physicians generally have lower mortality rates than the general population, this advantage is not shared equally. The striking disparities by sex, race, and ethnicity — particularly among physicians — underscore the need for targeted efforts to address workplace conditions, systemic inequities, and the broader social determinants that impact the health of healthcare workers themselves,” co-author Vishal Patel, MD, MPH, of Harvard Medical School and Brigham and Women’s Hospital in Boston, told MedPage Today.

“Physicians and healthcare workers dedicate their lives to patient care, yet their own health has not been well studied at a national level,” Patel explained. “Prior research suggested physicians live longer than their peers, but much of it was outdated and lacked insight into racial, ethnic, and sex-based differences. With newly available national data, we aimed to provide a more comprehensive picture of mortality patterns in healthcare workers.”

When asked to comment on their finding that only male physicians and male healthcare workers had lower mortality rates compared with the general population, Patel noted that “this suggests that the lower mortality seen in male physicians and male healthcare workers may not be a true advantage, but rather the loss of a disadvantage. In most professions, men have higher mortality rates than women, so the fact that male physicians have lower mortality than the general population may simply reflect a leveling effect.”

For this study, Jena and colleagues used data on deaths among adults ages 25 to 74 years from January 2020 to December 2022 by usual occupation in the National Vital Statistics System, a U.S. registry of death certificates. Physicians comprised 0.3% of the sample, while other healthcare workers, including dentists, health services managers, nurses, nurse practitioners, optometrists, chiropractors, pharmacists, physician assistants, and healthcare support workers including home health aides, comprised 8.5%.

The researchers also included lawyers, engineers, and scientists as a comparator for physicians based on their similar education and income levels, and found that female lawyers, engineers, and scientists had lower mortality compared with their male counterparts (MRR 0.59, 95% CI 0.58-0.60) and the Black to white mortality rate ratio was higher for physicians than lawyers, engineers, and scientists (1.74, 95% CI 1.69-1.78).

Study limitations included the use of cross-sectional data, the fact that death certificates recorded usual occupation rather than current occupation, possible misclassification of specific causes of death, and the lack of demographic information in the mortality data.

“While our study provides a national snapshot of mortality patterns, it does not establish causation,” Patel noted. “While we adjusted for age and sex, other individual-level health factors (differences in lifestyle, work schedules, or unmeasured social determinants) remain unaccounted for, and so further research is needed to understand the underlying drivers.”

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