Social factors like poverty, low levels of education, poor social support, job stress and other factors contribute to deaths in the US as such familiar as heart attacks, strokes and lung cancer, say researchers at Columbia University.
The research team, led by Sandro Galea, chair of the Mailman School Department of Epidemiology, estimated the number of U.S. deaths attributable to social factors using a systematic review of the available literature combined with vital statistics data. They 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.
Ultimately they considered 47 studies for meta-analysis. After calculating for the relative risks of mortality from social factors, researchers obtained prevalence estimates for each social factor using primarily Census Bureau data.
Individual social factors included education, poverty, health insurance status, employment status and job stress, social support, racism or discrimination, housing conditions and early childhood stressors. Area-level social factors included area-level poverty, income inequality, deteriorating built environment, racial segregation, crime and violence, social capital and availability of open or green spaces.
The investigators found that approximately 245,000 deaths in the United States in the year 2000 were attributable to low levels of 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.
Overall, 4.5 pc of U.S. deaths were found to be attributable to poverty-midway between previous estimates of 6 pc and 2.3 pc. However the risks associated with both poverty and low education were higher for individuals aged 25 to 64 than for those 65 or older.
"Social causes can be linked to death as readily as can pathophysiological and behavioral causes," said Dr. Galea, who is also Gelman Professor of Epidemiology.
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," added Galea. (ANI)
The study has been published online ahead of print in the American Journal of Public Health.