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Published on: January 8, 2020
An explanation of the persistent doctor-mortality association
1Department of Rural Sociology, Cornell University, Ithaca, NY 14853, USA. Fwy1@cornell.edu
Journal of Epidemiology and Community Health
|January 12, 2001
Summary
The positive correlation between physicians per capita and mortality rates is spurious. Social and economic factors, not specialist availability, significantly impact mortality rates.
Area of Science:
- Public Health
- Sociology
- Health Economics
Background:
- A persistent positive correlation between physicians per capita and mortality rates, even when controlling for income, has been observed since 1978.
- This counterintuitive finding requires explanation beyond conventional biomedical models.
Purpose of the Study:
- To investigate the hypothesis that an oversupply of physicians in urban-industrial areas, driven by migration, contributes to higher mortality rates.
- To examine the independent effect of rural-to-urban migration and associated adaptation stress on mortality.
Main Methods:
- Analysis of data from Japanese prefectures, US counties, and European countries.
- Inclusion of test variables in regression models to assess their impact on the physicians per capita-mortality correlation, controlling for income.
Main Results:
- Test variables reduced or eliminated the positive correlation in two of three samples, indicating it is spurious.
- The direction of the correlation did not reverse as predicted by some theories.
- Refugee status did not consistently reduce the correlation across all country samples.
Conclusions:
- The positive correlation between physicians per capita and mortality is spurious.
- Social and economic variables, rather than the availability of medical specialists, are more influential in determining mortality rates.
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