The Relative Health Burden of Selected Social and Behavioral Risk Factors in the United States

Implications for Policy

Bibliographic Data

ID11017608
AuthorsPeter Muennig (0000-0002-4234-0498, Peter Muennig is with the Department of Health Policy and Management at the Mailman School of Public Health, Columbia University, New York, NY. Kevin Fiscella is with the Departments of Family Medicine and Community and Preventive Medicine at the University of Rochester School of Medicine and Dentistry, Rochester, NY. Daniel Tancredi is with the Center for Healthcare Policy and Research and the Department of Pediatrics at the University of California at Davis. Peter Franks is with the Center for...), Kevin Fiscella (0000-0003-3613-8012, Peter Muennig is with the Department of Health Policy and Management at the Mailman School of Public Health, Columbia University, New York, NY. Kevin Fiscella is with the Departments of Family Medicine and Community and Preventive Medicine at the University of Rochester School of Medicine and Dentistry, Rochester, NY. Daniel Tancredi is with the Center for Healthcare Policy and Research and the Department of Pediatrics at the University of California at Davis. Peter Franks is with the Center for...), Daniel J Tancredi (0000-0002-3884-7907, University of Rochester), Daniel Tancredi (Peter Muennig is with the Department of Health Policy and Management at the Mailman School of Public Health, Columbia University, New York, NY. Kevin Fiscella is with the Departments of Family Medicine and Community and Preventive Medicine at the University of Rochester School of Medicine and Dentistry, Rochester, NY. Daniel Tancredi is with the Center for Healthcare Policy and Research and the Department of Pediatrics at the University of California at Davis. Peter Franks is with the Center for...), Peter Franks (0000-0002-9782-0181, Peter Muennig is with the Department of Health Policy and Management at the Mailman School of Public Health, Columbia University, New York, NY. Kevin Fiscella is with the Departments of Family Medicine and Community and Preventive Medicine at the University of Rochester School of Medicine and Dentistry, Rochester, NY. Daniel Tancredi is with the Center for Healthcare Policy and Research and the Department of Pediatrics at the University of California at Davis. Peter Franks is with the Center for...)
Year2010
Volume100
Issue9
Pages1758-1764
Publication date2010-09-01
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2009.165019
PMID20019300
PMCIDPMC2920959
OpenAlexW1979953427
LanguageEN
Citations received20
References cited42

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

Behavioral Risk Factor Surveillance System · Binge drinking · Body mass index · Confidence interval · Environmental health · National Health Interview Survey · Overweight · Poison control · Population · Poverty · Public health · Relative risk · Suicide prevention · Demography · Health disparities and outcomes · Health Systems, Economic Evaluations, Quality of Life · Medicine · Public Health Policies and Education · Gerontology

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