In the United States, the rates of infectious diseases are much higher
where the most people are packed together.

In United Health Care rankings there are differences by population
concentrations that impact the state rankings and sometimes the associated
relationships with a specialty choice, such as family medicine.

For example, the most densely populated states have the most care delivered
in major medical centers, the fewest family physicians, and the worst
levels of TB, hepatis B, and STDs. They have the best rates of screening
for cholesterol.

The least densely populated have the opposite in all groups.

Now it could be that FPs do not screen or it could be that those most
interested in screening are those with bachelors degrees and professional
school diplomas, the ones more likely to be found in the most densely
populated states.

Immunization rates and access to prenatal care do no vary by state level
analysis, suggesting some success in these areas, but with poor results in
most other areas. Of course we continue to pour more funding into
immunizations and less than the most useful immunizations and more funding
into prenatal care and less than effective prenatal care, when we should be
diverting funding into areas more likely to result in better health.

With concentrations of people, especially those with less healthy behaviors
and lower income levels, there will be higher rates of a number of
different morbidities and mortalities.

Robert C. Bowman, M.D.
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