Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Sep;100(9):1758-64.
doi: 10.2105/AJPH.2009.165019. Epub 2009 Dec 17.

The relative health burden of selected social and behavioral risk factors in the United States: implications for policy

Peter Muennig  1 , Kevin Fiscella, Daniel Tancredi, Peter Franks
Affiliations

The relative health burden of selected social and behavioral risk factors in the United States: implications for policy

Peter Muennig et al. Am J Public Health. 2010 Sep.

Abstract

Objectives: We sought to quantify the potential health impact of selected medical and nonmedical policy changes within the United States.

Methods: Using data from the 1997-2000 National Health Interview Surveys (linked to mortality data through 2002) and the 1996-2002 Medical Expenditure Panel Surveys, we calculated age-specific health-related quality-of-life scores and mortality probabilities for 8 social and behavioral risk factors. We then used Markov models to estimate the quality-adjusted life years lost.

Results: Ranked quality-adjusted life years lost were income less than 200% of the poverty line versus 200% or greater (464 million; 95% confidence interval [CI]=368, 564); current-smoker versus never-smoker (329 million; 95% CI=226, 382); body mass index 30 or higher versus 20 to less than 25 (205 million; 95% CI=159, 269); non-Hispanic Black versus non-Hispanic White (120 million; 95% CI=83, 163); and less than 12 years of school relative to 12 or more (74 million; 95% CI=52, 101). Binge drinking, overweight, and health insurance have relatively less influence on population health.

Conclusions: Poverty, smoking, and high-school dropouts impose the greatest burden of disease in the United States.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270(18):2207–2212 - PubMed
    1. Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;35:80–94 - PubMed
    1. Adler NE, Ostrove JM. Socioeconomic status and health: what we know and what we don't. Ann N Y Acad Sci. 1999;896:3–15 - PubMed
    1. Virchow R. Notes on the typhoid epidemic prevailing in Upper Silesia. Arch Pathologische Anatomie Physiologic Klinische Medizin. 1849;2:143–322
    1. World Health Organization Commission on the social determinants of health. Available at: http://www.who.int/social_determinants/en. Accessed October 19, 2008