Tuesday, August 12, 2008
Prescribe us a solution!
I like rankings. Maybe it's because I'm a college sports fan and it always leads to good natured bitching, but even non-sports fans like rankings. I love those top-50 lists at the end of every year. I don't like the shows much, but anytime I run across those VH1 lists I always find it intriguing. Rankings are fun. So I'm making a category called Rankings, and now I've got a reason to share just about any ranking I come across.
TPS officemate extraordinaire Joab Corey sends along this list showing the top ten states in terms of retail prescriptions filled per capita. (Click the left arrow to go back and see #2, #3, etc.) And who's #1? Country roads, take me home. West Virginia is the "most medicated state." I have to admit, sight unseen, I thought Florida would take it, being the popular retirement locale and all, but the denominator (population) is pretty large...I think that hurt them. (They didn't make the top 10.) A brief glance at the list reveals, for the most part, the low end of the income per capita rankings populating the top 10 retail prescription per capita list. Explanations?
1) Lower income leads to worse health outcomes. This is a result usually used to compare first and third world countries, but perhaps discrepancies even in high income countries have tangible effects.
2) States with more prescriptions have more generous public health care provision, and larger public sectors make for poorer states.
3) Most of these states are low population as well; a lot of prescriptions OR a low population will get you to the top of the list. Of course, population could well be a function of income as well; the Laffer study I linked to last week speaks of states being winners and losers in the migration battle.
Causality gets tangled pretty quickly; I'd say #2 is probably closest. I'm not convinced that #1 can be drawn out within the U.S., or at least not that simple and definite of a link between the two.