social causes of death

There is a new piece in the American Journal of Public Health that does a meta analysis of the “social causes” of death: poverty (individual and area), segregation, low levels of education, and inequality. The results shouldn’t surprise. In 2000 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. As reported elsewhere, “For example, the number of deaths the researchers calculated as attributable to low education (245,000) is comparable to the number caused by heart attacks (192,898), which was the leading cause of U.S. deaths in 2000. The number of deaths attributable to racial segregation (176,000) is comparable to the number from cerebrovascular disease (167,661), the third leading cause of death in 2000, and the number attributable to low social support (162,000) compares to deaths from lung cancer (155,521).” I have some questions about the study. And I wonder about whether “social” and “physiological/behavioral” causes can be treated as analytically distinct (the conclusion claims, “The estimated number of deaths attributable to social factors in the United States is comparable to the number attributed to pathophysiological and behavioral cause”). Still, the study is worth checking out.

The article is: Sandro Galea, Melissa Tracy, Katherine J. Hoggatt, Charles DiMaggio, Adam Karpati. Estimated Deaths Attributable to Social Factors in the United StatesAmerican Journal of Public Health, 2011. Linked above.

4 thoughts on “social causes of death”

  1. How are they distinguishing between “individual-level poverty” and “area-level poverty”? Is it as simple as “If you’re broke but don’t live in a ghetto (technical definition), you’re an individual-level death?”

    It seems the 3:1 ratio casts doubt on whatever (MSA?) data they’re using.


  2. In this kind of analysis I think “attributable” just means as delineated by a simple decomposition. If men die more than women, the difference is the number of deaths attributable to gender, with whatever adjustments they do (at least age).


  3. I got around to looking at the article. It is a meta-analysis. They are just trying to estimate the size of the “social” factor. It isn’t like a single study that is controlling for other factors. I interpret the statements about the size of the “social factors” relative to other kinds of factors not as saying that the social factors are this strong after behavior or physical factors are controlled, but just saying that the magnitude of the “social” factors is as large as these other kinds of factors. E.g. they say that the poverty effect is comparable to the rate of dying from cardiac arrest. Dying from cardiac arrest is a possible cause of death that is increased by poverty, but they are not saying that poverty increases the death rate controlling for having had a cardiac arrest, nor anything else about how mediating factors work.


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