In the journal Chiropractic & Manual Therapies, a study was published on July 24, 2019, that reviewed the availability of chiropractic world-wide. The study titled; “The chiropractic workforce: a global review”, also looked at the number of chiropractors, and the legality in various countries.
The authors of the report start by noting that there is a global shortage of health care workers. “Health workers are the engine of our health care systems. Yet, the world is faced with a chronic shortage of health workers. In 2013, the World Health Organization (WHO) estimated a global shortage of 7.2 million health workers, with 83 countries facing a health worker crisis.”
This study points out that there is a growing number of “careseeking elderly people.” This increase in the elderly population leads to an increase of disability, particularly as it relates to musculoskeletal conditions. They estimate that the rate of disability ranges from the average of 11.8% in high income countries to 18.0% in lower income countries. This translates to about one billion people world-wide.
To help meet the challenge of a population in need, this study looked at the number of chiropractors and distribution in 193 United Nations countries. The research looked at factors such as the total number of chiropractors in each region or country, the level of education needed to practice, licensing and legality of practice, and the scope of practice for chiropractic.
The data for this study was collected from a number of sources including chiropractic organizations that were members of the World Federation of Chiropractic, as well as government websites and online data searches.
The study found that there was at least one practicing chiropractor in 90 out of 193 countries. Worldwide, the total number of chiropractors according to this study was 103,469. Not surprisingly, since chiropractic began in the U.S., 77,000 of the total number are in the United States. This translates into 23.7 chiropractors for every 100,000 people, which is the highest density in the world.
There 48 chiropractic educational programs currently in 19 countries, predominantly located in English-speaking and/or high-income countries. Again, the U.S. leads in the number of chiropractic schools having 18 of the total number. Australia has the second highest number of schools with four.
There are 81 countries where their populations have direct access to chiropractic care. In two countries, the Bahamas and Saudi Arabia, a medical referral is needed to see a chiropractor. In 46 countries, just slightly over half of the countries that have chiropractic, the care was partially or fully covered by governmental health programs or private health insurance.
Chiropractic is legally recognized in 68 (75.6%) of the 90 countries. In 12 countries, chiropractic is illegal. Those countries include Egypt, Argentina, Columbia, Austria, Estonia, Greece, Hungary, Lebanon, Republic of Korea, Taiwan, Turkey, and Ukraine. In 10 countries, chiropractic does not fall under the law, leaving chiropractic neither legal or illegal.
In their conclusion, the authors note that chiropractic services are not evenly distributed throughout the world. “The profession is represented in 90 countries, but the distribution, chiropractic educational institutions, and governing legislations and regulations largely favour high-income countries. There is a large under-representation in low- and middle-income countries in terms of provision of services, education and legislative and regulatory frameworks, and the available data from these countries are limited.”