Steven H Woolf
Datos Biográficos
| ID | 282557 |
|---|---|
| NOMBRE | Steven H Woolf |
| NOMBRES | Steven H |
| APELLIDO | Woolf |
| FIRMA | WOOLF S H |
| AFILIACIONES | Virginia Commonwealth University |
| ORCID | 0000-0001-9384-033X |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAS | 95 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1999 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 4 |
The Plight of Marginalized Populations in 2025
Malignant Neglect
Malignant Neglect: Accounting for Public Disinterest in Deteriorating Health Outcomes in the United States Steven H. Woolf MD, MPH Affiliation Steven H. Woolf is with the Center on Society and Health and Department of Family Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA. CopyRightCorrespondence should be sent to Steven H. Woolf, MD, MPH, Center on Society and Health, Virginia Commonwealth University School of Medicin…
Excess Death Rates by State During the Covid-19 Pandemic
Objectives. To estimate state-level excess death rates during 2020 to 2023 and examine differences by region and partisan orientation. Methods. We modeled death and population counts from the Centers for Disease Control and Prevention to estimate excess death rates for the United States, 9 census divisions, and 50 states. We compared excess death rates for states with different partisan orientations, measured by the party of the seated governor a…
Neighborhood Predictors of Poor Prenatal Care and Well-Child Visit Attendance
Neighborhood-level factors performed well in predicting inadequate PCV and WCV attendance. The disproportionate impact impact of inadequate PCV and WCV in neighborhoods where higher proportions of Black people lived highlights the potential influence of systemic racism and segregation on healthcare utilization
Policies Have Consequences
Hurricane Maria, a category 5 hurricane, swept through Puerto Rico.Official reports claimed that 67 people had died, but experts worried that the storm might have claimed far more lives.Researchers turned to an established epidemiologic tool, the measurement of excess deaths, to address these concerns.The term excess deaths refers to the difference between observed deaths from all causes and the number that would be expected under normal circumst…
Falling Behind
Objectives. To document the evolution of the US life expectancy disadvantage and regional variation across the US states. Methods. I obtained life expectancy estimates in 2022 from the United Nations, the Human Mortality Database, and the US Mortality Database, and calculated changes in growth rates, US global position (rank), and state-level trends. Results. Increases in US life expectancy slowed from 1950 to 1954 (0.21 years/annum) and 1955 to …
Age-Specific Mortality During the 2020 Covid-19 Pandemic and Life Expectancy Changes in the United States and Peer Countries, 1980–2020
U.S. life expectancy declines in 2020 were larger than in peer countries and involved deaths across a broader age range, particularly among young and middle-aged adults. Both the longstanding U.S. e0 disadvantage and acute losses of life in 2020 signal the need for systemic policy changes in the United States
US State Policies, Politics, and Life Expectancy
Policy Points Changes in US state policies since the 1970s, particularly after 2010, have played an important role in the stagnation and recent decline in US life expectancy. Some US state policies appear to be key levers for improving life expectancy, such as policies on tobacco, labor, immigration, civil rights, and the environment. US life expectancy is estimated to be 2.8 years longer among women and 2.1 years longer among men if all US state…
Life Expectancy and Mortality Rates in the United States, 1959-2017
Importance: US life expectancy has not kept pace with that of other wealthy countries and is now decreasing. Objective: To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends. Evidence: Life expectancy data for 1959-2016 and cause-specific mortality rates for 19…
Educational Disparities in Adult Mortality Across U.S. States
Adult mortality varies greatly by educational attainment. Explanations have focused on actions and choices made by individuals, neglecting contextual factors such as economic and policy environments. This study takes an important step toward explaining educational disparities in U.S. adult mortality and their growth since the mid-1980s by examining them across U.S. states. We analyzed data on adults aged 45–89 in the 1985–2011 National Health Int…
The Case for Considering Education and Health
Awareness of the impact of education on health remains relatively low among the public, professionals, and policy makers. Virginia Commonwealth University’s Center on Society and Health sought to raise awareness among key decision makers about the impact of education on health outcomes through its Education and Health Initiative (EHI). EHI utilized four key strategies to raise awareness: user-oriented research, strategic communication, local and …
Where Health Disparities Begin
Health disparities by racial or ethnic group or by income or education are only partly explained by disparities in medical care. Inadequate education and living conditions-ranging from low income to the unhealthy characteristics of neighborhoods and communities-can harm health through complex pathways. Meaningful progress in narrowing health disparities is unlikely without addressing these root causes. Policies on education, child care, jobs, com…
Avertable Deaths Associated With Household Income in Virginia
Objectives. We estimated how many deaths would be averted if the entire population of Virginia experienced the mortality rates of the 5 most affluent counties or cities. Methods. Using census data and vital statistics for the years 1990 through 2006, we applied the mortality rates of the 5 counties/cities with the highest median household income to the populations of all counties and cities in the state. Results. If the mortality rates of the ref…
The Priority Is Screening, Not Colonoscopy
Like Neugut and Lebwohl,1 we welcome the recent successes in promoting colorectal cancer screening. We also agree that offering too many testing options can dampen enthusiasm for screening, but we disagree with their solution: to promote a “preferred” test. Setting aside the question of whether colonoscopy is the “best” test—Neugut and Lebwohl themselves acknowledge that only fecal occult blood testing (FOBT) has been proven to lower mortality ra…
The Meaning of Translational Research and Why It Matters
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archiv…
The Health Impact of Resolving Racial Disparities
The US health system spends far more on the “technology” of care (e.g., drugs, devices) than on achieving equity in its delivery. For 1991 to 2000, we contrasted the number of lives saved by medical advances with the number of deaths attributable to excess mortality among African Americans. Medical advances averted 176 633 deaths, but equalizing the mortality rates of Whites and African Americans would have averted 886202 deaths. Achieving equity…
Giving Everyone the Health of the Educated
Objectives. Social determinants of health, such as inadequate education, contribute greatly to mortality rates. We examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). Methods. Using US vital statistics data for 1996 through 2002, we applied indirect standardization techniques to estimate the maximum n…
Health and Economic Benefits of Reducing the Number of Students per Classroom in US Primary Schools
Objectives. We estimated the costs associated with reducing class sizes in kindergarten through grade 3 as well as the effects of small class sizes on selected outcomes such as quality-adjusted life-years and future earnings. Methods. We used multiple data sets to predict changes in the outcomes assessed according to level of educational attainment. We then used a Markov model to estimate future costs and benefits incurred and quality-adjusted li…
Inattention to the Fidelity of Health Care Delivery Is Costing Lives
Leroy et al.1 examined what we call the fidelity of health care delivery, the extent to which the system provides patients with the interventions they need, delivered properly and precisely when they need them.2 According to their analysis of interventions for children in 42 low-income countries, improving fidelity rather than the technology of care (e.g., new drugs) would save almost 3 times as many lives. They reported that research on child mo…
What If We Were Equal? A Comparison Of The Black-White Mortality Gap In 1960 And 2000
The United States has made progress in decreasing the black-white gap in civil rights, housing, education, and income since 1960, but health inequalities persist. We examined trends in black-white standardized mortality ratios (SMRs) for each age-sex group from 1960 to 2000. The black-white gap measured by SMR changed very little between 1960 and 2000 and actually worsened for infants and for African American men age thirty-five and older. In con…
Title VII Funding and Physician Practice in Rural or Low-Income Areas
CONTEXT: Whether Title VII funding enhances physician supply in underserved areas has not clearly been established. PURPOSE: To determine the relation between Title VII funding in medical school, residency, or both, and the number of family physicians practicing in rural or low-income communities. METHODS: A retrospective cross sectional analysis was carried out using the 2000 American Academy of Family Physicians physician database, Title VII fu…
Woolf and Johnson Respond
We agree with Muennig that income disparities, among other potential factors, might dampen the effectiveness of medical treatments. This point is precisely the subtext of our article.1 However, whether a greater effect of medical advances on mortality might have been realized had circumstances in 1991–2000 been more equitable bears little on how one measures the effect that actually did occur. To borrow Muennig’s example—that medical advances mig…
Woolf and Johnson Respond
Making the Case for a Qualitative Study of Medical Errors in Primary Care
In the interest of publicizing examples of funded qualitative health research, the authors share a proposal to the Agency for Healthcare Research and Quality in Washington, D.C., in which they sought to elicit patient stories of preventable problems in their primary health care that were associated with psychological or physical harms. These stories would allow for the construction of a tentative typology of errors and harms as experienced by pat…
Clinical guidelines
This is the first in a series of four articles on issues in the development and use of clinical guidelines Over the past decade, clinical guidelines have increasingly become a familiar part of clinical practice. Every day, clinical decisions at the bedside, rules of operation at hospitals and clinics, and health spending by governments and insurers are being influenced by guidelines. As defined by the Institute of Medicine, clinical guidelines ar…
Educational Disparities in Adult Mortality Across U.S. States
Adult mortality varies greatly by educational attainment. Explanations have focused on actions and choices made by individuals, neglecting contextual factors such as economic and policy environments. This study takes an important step toward explaining educational disparities in U.S. adult mortality and their growth since the mid-1980s by examining them across U.S. states. We analyzed data on adults aged 45–89 in the 1985–2011 National Health Int…
Giving Everyone the Health of the Educated
Objectives. Social determinants of health, such as inadequate education, contribute greatly to mortality rates. We examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). Methods. Using US vital statistics data for 1996 through 2002, we applied indirect standardization techniques to estimate the maximum n…
Falling Behind
Objectives. To document the evolution of the US life expectancy disadvantage and regional variation across the US states. Methods. I obtained life expectancy estimates in 2022 from the United Nations, the Human Mortality Database, and the US Mortality Database, and calculated changes in growth rates, US global position (rank), and state-level trends. Results. Increases in US life expectancy slowed from 1950 to 1954 (0.21 years/annum) and 1955 to …
Health and Economic Benefits of Reducing the Number of Students per Classroom in US Primary Schools
Objectives. We estimated the costs associated with reducing class sizes in kindergarten through grade 3 as well as the effects of small class sizes on selected outcomes such as quality-adjusted life-years and future earnings. Methods. We used multiple data sets to predict changes in the outcomes assessed according to level of educational attainment. We then used a Markov model to estimate future costs and benefits incurred and quality-adjusted li…
Age-Specific Mortality During the 2020 Covid-19 Pandemic and Life Expectancy Changes in the United States and Peer Countries, 1980–2020
U.S. life expectancy declines in 2020 were larger than in peer countries and involved deaths across a broader age range, particularly among young and middle-aged adults. Both the longstanding U.S. e0 disadvantage and acute losses of life in 2020 signal the need for systemic policy changes in the United States
The Case for Considering Education and Health
Awareness of the impact of education on health remains relatively low among the public, professionals, and policy makers. Virginia Commonwealth University’s Center on Society and Health sought to raise awareness among key decision makers about the impact of education on health outcomes through its Education and Health Initiative (EHI). EHI utilized four key strategies to raise awareness: user-oriented research, strategic communication, local and …
Excess Death Rates by State During the Covid-19 Pandemic
Objectives. To estimate state-level excess death rates during 2020 to 2023 and examine differences by region and partisan orientation. Methods. We modeled death and population counts from the Centers for Disease Control and Prevention to estimate excess death rates for the United States, 9 census divisions, and 50 states. We compared excess death rates for states with different partisan orientations, measured by the party of the seated governor a…
Avertable Deaths Associated With Household Income in Virginia
Objectives. We estimated how many deaths would be averted if the entire population of Virginia experienced the mortality rates of the 5 most affluent counties or cities. Methods. Using census data and vital statistics for the years 1990 through 2006, we applied the mortality rates of the 5 counties/cities with the highest median household income to the populations of all counties and cities in the state. Results. If the mortality rates of the ref…
Woolf and Johnson Respond
We agree with Muennig that income disparities, among other potential factors, might dampen the effectiveness of medical treatments. This point is precisely the subtext of our article.1 However, whether a greater effect of medical advances on mortality might have been realized had circumstances in 1991–2000 been more equitable bears little on how one measures the effect that actually did occur. To borrow Muennig’s example—that medical advances mig…
Making the Case for a Qualitative Study of Medical Errors in Primary Care
In the interest of publicizing examples of funded qualitative health research, the authors share a proposal to the Agency for Healthcare Research and Quality in Washington, D.C., in which they sought to elicit patient stories of preventable problems in their primary health care that were associated with psychological or physical harms. These stories would allow for the construction of a tentative typology of errors and harms as experienced by pat…
Clinical guidelines
This is the first in a series of four articles on issues in the development and use of clinical guidelines Over the past decade, clinical guidelines have increasingly become a familiar part of clinical practice. Every day, clinical decisions at the bedside, rules of operation at hospitals and clinics, and health spending by governments and insurers are being influenced by guidelines. As defined by the Institute of Medicine, clinical guidelines ar…
Making the Case for a Qualitative Study of Medical Errors in Primary Care
In the interest of publicizing examples of funded qualitative health research, the authors share a proposal to the Agency for Healthcare Research and Quality in Washington, D.C., in which they sought to elicit patient stories of preventable problems in their primary health care that were associated with psychological or physical harms. These stories would allow for the construction of a tentative typology of errors and harms as experienced by pat…
What If We Were Equal? A Comparison Of The Black-White Mortality Gap In 1960 And 2000
The United States has made progress in decreasing the black-white gap in civil rights, housing, education, and income since 1960, but health inequalities persist. We examined trends in black-white standardized mortality ratios (SMRs) for each age-sex group from 1960 to 2000. The black-white gap measured by SMR changed very little between 1960 and 2000 and actually worsened for infants and for African American men age thirty-five and older. In con…
Title VII Funding and Physician Practice in Rural or Low-Income Areas
CONTEXT: Whether Title VII funding enhances physician supply in underserved areas has not clearly been established. PURPOSE: To determine the relation between Title VII funding in medical school, residency, or both, and the number of family physicians practicing in rural or low-income communities. METHODS: A retrospective cross sectional analysis was carried out using the 2000 American Academy of Family Physicians physician database, Title VII fu…
Woolf and Johnson Respond
We agree with Muennig that income disparities, among other potential factors, might dampen the effectiveness of medical treatments. This point is precisely the subtext of our article.1 However, whether a greater effect of medical advances on mortality might have been realized had circumstances in 1991–2000 been more equitable bears little on how one measures the effect that actually did occur. To borrow Muennig’s example—that medical advances mig…
Woolf and Johnson Respond
Giving Everyone the Health of the Educated
Objectives. Social determinants of health, such as inadequate education, contribute greatly to mortality rates. We examined whether correcting the social conditions that account for excess deaths among individuals with inadequate education might save more lives than medical advances (e.g., new drugs and devices). Methods. Using US vital statistics data for 1996 through 2002, we applied indirect standardization techniques to estimate the maximum n…
Health and Economic Benefits of Reducing the Number of Students per Classroom in US Primary Schools
Objectives. We estimated the costs associated with reducing class sizes in kindergarten through grade 3 as well as the effects of small class sizes on selected outcomes such as quality-adjusted life-years and future earnings. Methods. We used multiple data sets to predict changes in the outcomes assessed according to level of educational attainment. We then used a Markov model to estimate future costs and benefits incurred and quality-adjusted li…
Inattention to the Fidelity of Health Care Delivery Is Costing Lives
Leroy et al.1 examined what we call the fidelity of health care delivery, the extent to which the system provides patients with the interventions they need, delivered properly and precisely when they need them.2 According to their analysis of interventions for children in 42 low-income countries, improving fidelity rather than the technology of care (e.g., new drugs) would save almost 3 times as many lives. They reported that research on child mo…
The Meaning of Translational Research and Why It Matters
Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archiv…
The Health Impact of Resolving Racial Disparities
The US health system spends far more on the “technology” of care (e.g., drugs, devices) than on achieving equity in its delivery. For 1991 to 2000, we contrasted the number of lives saved by medical advances with the number of deaths attributable to excess mortality among African Americans. Medical advances averted 176 633 deaths, but equalizing the mortality rates of Whites and African Americans would have averted 886202 deaths. Achieving equity…
The Priority Is Screening, Not Colonoscopy
Like Neugut and Lebwohl,1 we welcome the recent successes in promoting colorectal cancer screening. We also agree that offering too many testing options can dampen enthusiasm for screening, but we disagree with their solution: to promote a “preferred” test. Setting aside the question of whether colonoscopy is the “best” test—Neugut and Lebwohl themselves acknowledge that only fecal occult blood testing (FOBT) has been proven to lower mortality ra…
Avertable Deaths Associated With Household Income in Virginia
Objectives. We estimated how many deaths would be averted if the entire population of Virginia experienced the mortality rates of the 5 most affluent counties or cities. Methods. Using census data and vital statistics for the years 1990 through 2006, we applied the mortality rates of the 5 counties/cities with the highest median household income to the populations of all counties and cities in the state. Results. If the mortality rates of the ref…
Where Health Disparities Begin
Health disparities by racial or ethnic group or by income or education are only partly explained by disparities in medical care. Inadequate education and living conditions-ranging from low income to the unhealthy characteristics of neighborhoods and communities-can harm health through complex pathways. Meaningful progress in narrowing health disparities is unlikely without addressing these root causes. Policies on education, child care, jobs, com…
The Case for Considering Education and Health
Awareness of the impact of education on health remains relatively low among the public, professionals, and policy makers. Virginia Commonwealth University’s Center on Society and Health sought to raise awareness among key decision makers about the impact of education on health outcomes through its Education and Health Initiative (EHI). EHI utilized four key strategies to raise awareness: user-oriented research, strategic communication, local and …
Life Expectancy and Mortality Rates in the United States, 1959-2017
Importance: US life expectancy has not kept pace with that of other wealthy countries and is now decreasing. Objective: To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends. Evidence: Life expectancy data for 1959-2016 and cause-specific mortality rates for 19…
Educational Disparities in Adult Mortality Across U.S. States
Adult mortality varies greatly by educational attainment. Explanations have focused on actions and choices made by individuals, neglecting contextual factors such as economic and policy environments. This study takes an important step toward explaining educational disparities in U.S. adult mortality and their growth since the mid-1980s by examining them across U.S. states. We analyzed data on adults aged 45–89 in the 1985–2011 National Health Int…
US State Policies, Politics, and Life Expectancy
Policy Points Changes in US state policies since the 1970s, particularly after 2010, have played an important role in the stagnation and recent decline in US life expectancy. Some US state policies appear to be key levers for improving life expectancy, such as policies on tobacco, labor, immigration, civil rights, and the environment. US life expectancy is estimated to be 2.8 years longer among women and 2.1 years longer among men if all US state…
Age-Specific Mortality During the 2020 Covid-19 Pandemic and Life Expectancy Changes in the United States and Peer Countries, 1980–2020
U.S. life expectancy declines in 2020 were larger than in peer countries and involved deaths across a broader age range, particularly among young and middle-aged adults. Both the longstanding U.S. e0 disadvantage and acute losses of life in 2020 signal the need for systemic policy changes in the United States
Neighborhood Predictors of Poor Prenatal Care and Well-Child Visit Attendance
Neighborhood-level factors performed well in predicting inadequate PCV and WCV attendance. The disproportionate impact impact of inadequate PCV and WCV in neighborhoods where higher proportions of Black people lived highlights the potential influence of systemic racism and segregation on healthcare utilization
Policies Have Consequences
Hurricane Maria, a category 5 hurricane, swept through Puerto Rico.Official reports claimed that 67 people had died, but experts worried that the storm might have claimed far more lives.Researchers turned to an established epidemiologic tool, the measurement of excess deaths, to address these concerns.The term excess deaths refers to the difference between observed deaths from all causes and the number that would be expected under normal circumst…
Falling Behind
Objectives. To document the evolution of the US life expectancy disadvantage and regional variation across the US states. Methods. I obtained life expectancy estimates in 2022 from the United Nations, the Human Mortality Database, and the US Mortality Database, and calculated changes in growth rates, US global position (rank), and state-level trends. Results. Increases in US life expectancy slowed from 1950 to 1954 (0.21 years/annum) and 1955 to …
Malignant Neglect
Malignant Neglect: Accounting for Public Disinterest in Deteriorating Health Outcomes in the United States Steven H. Woolf MD, MPH Affiliation Steven H. Woolf is with the Center on Society and Health and Department of Family Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA. CopyRightCorrespondence should be sent to Steven H. Woolf, MD, MPH, Center on Society and Health, Virginia Commonwealth University School of Medicin…
Excess Death Rates by State During the Covid-19 Pandemic
Objectives. To estimate state-level excess death rates during 2020 to 2023 and examine differences by region and partisan orientation. Methods. We modeled death and population counts from the Centers for Disease Control and Prevention to estimate excess death rates for the United States, 9 census divisions, and 50 states. We compared excess death rates for states with different partisan orientations, measured by the party of the seated governor a…
The Plight of Marginalized Populations in 2025
Medicine (24 obras) · Environmental health (13 obras) · Political science (12 obras) · Demography (10 obras) · Economics (10 obras) · Health disparities and outcomes (10 obras) · Healthcare Policy and Management (10 obras) · Population (10 obras) · Family medicine (9 obras) · Gerontology (9 obras)