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Am J Public Health. 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.

Author information

  • 1Department of Health Policy and Management, Mailman School of Public Health, Columbia University, 600 W 168th St, 6th Floor, New York, NY 10032, USA. pm124@columbia.edu

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.

PMID:
20019300
[PubMed - indexed for MEDLINE]
PMCID:
PMC2920959
Free PMC Article
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