• Hart J

• Delivery of Health Care / economics
• Delivery of Health Care / United States
• Outcome Assessment, Health Care
• Socioeconomic Factors

Purpose: The news that Minnesota ranks first in health and Louisiana last, suggests that their connecting medium, the Mississippi River, or some other north-to-south phenomenon might be a factor. Consequently, correlations were assessed for various outcomes for states along the Mississippi River in an effort to better understand possible mechanisms for the health disparity along the River. Doctor ratios were also correlated with the outcomes.

Methods: Each state along the Mississippi River was ranked according to its north-to-south position. The position ranks were correlated with various outcomes in the areas of health, education, and socioeconomics. Doctor (physician [medical and osteopathic] and chiropractor) ratios for these river states were also correlated with these outcomes.

Results: Except for generosity index, the outcomes had a tendency to worsen from north-to-south but tended to improve with increased doctor ratios. Chiropractors had stronger correlations for improved outcomes in 20 of the 25 outcomes compared to physicians, whereas physicians had stronger correlations in four of the 25 outcomes compared to chiropractors. The correlation was the same for both doctor types for one of the 25 outcomes.

Discussion: Decreased health along the Mississippi River, from north-to-south, is likely a multi-factorial phenomenon, i.e., a decrease in income, educational attainment, and quality of health care. The ratios for both doctor types (physician and chiropractor) were correlated with improved outcomes, especially for chiropractor ratios.

Conclusion: Correlation does not necessarily show causation but it can give clues. Except for generosity index, the outcomes tended to worsen when proceeding south along the Mississippi River. Chiropractors had stronger correlations for improved health outcomes when compared to physicians. Further study is indicated into other possible causative mechanisms such as the quality of drinking water and health care delivery.

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