We examine the effect of canal gradients on agricultural production and health of Hohokam irrigation farmers on the lower Salt River valley of central Arizona. Given otherwise comparable canals, differences in canal gradient will affect the amount of water discharged per unit of time (Caseldine 2020:38-44; Howard, 1991,1993; Woodson, 2010; 2016), the effort required to maintain the canals (Howard, 1991:32; Huckleberry 1991:66-67), and the pathogen load in the water (Fink 1991; Fink and Merbs, 1991). We compare six irrigation villages (13th and 14th century) in the Lower Salt River valley of Arizona and find that canal gradient was positively associated with increased maize production and inversely associated with health conditions related to physical stress on the body and consumption of contaminated water. We discuss how the social responses to these differences contributed to social inequality among neighboring villages.