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. 2011 Aug;101(8):1456-65.
doi: 10.2105/AJPH.2010.300086. Epub 2011 Jun 16.

Estimated Deaths Attributable to Social Factors in the United States

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Free PMC article

Estimated Deaths Attributable to Social Factors in the United States

Sandro Galea et al. Am J Public Health. .
Free PMC article

Abstract

Objectives: We estimated the number of deaths attributable to social factors in the United States.

Methods: We conducted a MEDLINE search for all English-language articles published between 1980 and 2007 with estimates of the relation between social factors and adult all-cause mortality. We calculated summary relative risk estimates of mortality, and we obtained and used prevalence estimates for each social factor to calculate the population-attributable fraction for each factor. We then calculated the number of deaths attributable to each social factor in the United States in 2000.

Results: Approximately 245,000 deaths in the United States in 2000 were attributable to low education, 176,000 to racial segregation, 162,000 to low social support, 133,000 to individual-level poverty, 119,000 to income inequality, and 39,000 to area-level poverty.

Conclusions: The estimated number of deaths attributable to social factors in the United States is comparable to the number attributed to pathophysiological and behavioral causes. These findings argue for a broader public health conceptualization of the causes of mortality and an expansive policy approach that considers how social factors can be addressed to improve the health of populations.

Figures

FIGURE 1
FIGURE 1
Flow diagram of studies considered for meta-analyses to derive summary relative risk (RR) estimates for each social factor in relation to mortality. Note. SES = socioeconomic status.

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