So I ran across some interesting statistics on pharmaceutical usage.
Yeah, I’m a nerd.
No, seriously, in 2001 Express-Scripts, a major pharmaceutical vendor, did a study to determine patterns of pharmaceutical usage across the US. Here’s part of the executive summary:
We found substantial variation in the number of prescriptions per member per year across the states for adults even after adjusting for differences in age and gender. The greatest use was among those living in Kentucky and West Virginia, with an average of 11.9 and 11.3 prescriptions per person per year in 2000, respectively. In contrast, New York state, had the lowest utilization at 7.65, followed closely by Colorado, Massachusetts, and California. Geographic patterns fluctuated across the therapy classes studied. Notable findings included:
- a higher age-gender adjusted rate of antidepressant use in Utah, Maine, Oregon, and Washington
- higher cardiovascular use in the South, including West Virginia, Kentucky, Tennessee, South Carolina, Mississippi, and Louisiana
- greater rate of antidiabetic medication use in West Virginia, Texas, North Carolina, Utah, and Ohio
- a lower rate of asthma medication use in the South (Mississippi, Arkansas, Louisiana, and South Carolina)
- a lower rate of use of antihyperlipidemics in New Mexico, Colorado, Idaho, Alabama, Montana, and California
- a lower rate of estrogen use among women in Northeastern states such as New Jersey, New York, and Massachusetts.
If you’re like me, you had to look up “antihyperlipidemics”. It’s drugs which reduce the fatty content of blood — in other words, blood-thinners. I guess they stave off heart attacks.
Many of us have lived in the states mentioned. The main reason I was interested was because this is the study which documents that Utah uses an order of magnitude more antidepressants per capita, particularly among women, than any other state.
So if you were to randomly speculate as to why usage varies so widely in different areas, why would that be?
Anti-Depressants & Utah
Not to malign the fine state of Utah or the city of Salt Lake, but crazy people migrate there.
I have, in my life, met one truly crazy person. I’m talking midway through the conversation you start thinking “what color is the sky in YOUR world?”. And she was sober. So the state kept trying to take her kids, but she’d pull it togther in front of ther judge.
So she decides to outrun the law. She packs up the kids, a bunch of peanut butter & jelly sandwiches, and heads out west. To Salt Lake.
Now when I say packs up the kids and some PBJs, I’m not leaving out furniture, clothes, essentials. I’m telling you what she packed: the kids and PBJs.
So her and her kids lived on the streets of Salt Lake for a while, before they sent some of the kids to the institution, and others out here to live with fsmily.
The girl that came out here to live ran away at 15 to…Salt Lake.
And then there was the girl when I coached wrestling at the local high school, and she was a few fries short of a happy meal herself. She ran off at 16 to…
yep
Salt Lake.
Now I’m sure there’s hundreds of others who didn’t go to Salt Lake, but it seems everyone I run into has a crazy-person-runs-off-to-Salt-Lake story.
My $.02 Weed
Exactly!
That’s exactly the kind of stereotypical overrepresentation based on anecdotes that I’m looking for 🙂 Here’s what I figure is the reason for excessive antidepressant usage in various states:
A psychology PhD wrote paper regarding the possible causes of over-antidepressant usage among Mormon women. It’s an opinion piece which, however, has been fairly controversial, and the best thing which I came away with out of it is that some of the Utah cultural norms are great for many women. Just not all women.
Regarding a lower rate of asthma medication use in the South: I think it’s because kids in the south have dogs. Seriously. Regular exposure to pet dander as a youth reduces the likelihood of adult asthma. Kids in a condominium don’t have the space for a dog.
Antidiabetic medication in West Virginia, Texas, North Carolina, Utah, and Ohio? I’ve lived several of those places. Diet’s a large factor, but I suspect that at least for West Virginia, diabetes is part of the genetic heritage of generations of inbreeding among English/Irish immigrants. I’m one of them 🙂 In Utah, I’d also say it’s diet. As a sample point, the other day, my wife and I attended a dinner together, and there wasn’t a single dish which wasn’t full of sugars and starches. It was kind of depressing. We refrained from eating entirely, and went home and cooked a steak.
I don’t even know enough to speculate on the reasons for less blood-pressure medication in certain states, though. A total mystery to me.
So that’s my total stereotype for the day 🙂 The diabetes one, in particular, is poignant for me since it’s totally my family, and I’m 100% West Virginian in genetic makeup…
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Matthew P. Barnson
Antidepressants
I’ve heard Mormon women joke that it’s either antidepressants or alcohol. And since drinking is against our religion, legal drugs it is. Maybe I should get some of that stuff! I have those days when four kids truly puts me over the top.–
Christy
Compelling!
That’s actually a compelling argument. Rather than self-medicating using alcohol, they compensate using prescription methods.
Makes sense, good point!
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Matthew P. Barnson
Plus…
From what I’ve heard LDS Social Services is also handing out Zoloft like candy as a first line of defense for depression. ——– Visit my blog, eh! The Murphy Maphia
Some explanations…
The use of cardiac meds and antihyperlipidemics.. (or just antilipidemics) will be almost exclusively determined by activity and excercise.
Look at typical southern food vs. food in the west.. lots more fat and cholesterol.. lots fewer hearty grains..
Likewise, there is most likely an incresaed level of education mixed with a more active lifestyle (especially in the summer).
As for antidiabetic meds.. it depends which ones.. (glucophage or glucotrol vs. straight insulin) – Type 1 Diabetes is almost exclusively genetic.. type 2 is overwhelmingly lifestyle based.
Estrogen use? You got me.. although you do have a much higher income level in the states you mentioned..
Follow-up
So there was a follow-up to this: Men’s Health Magazine figured out the happiest and most depressed cities in the US. Salt Lake was number twelve for the most depressed city in the US…
http://www.sltrib.com/ci_2687511
The suicide rate in Utah is also dramatically higher than the national average.
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Matthew P. Barnson