Estimated Deaths Attributable to Social Factors in the United States
Estimated Deaths Attributable to Social Factors in the United States
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DOI：
10.2105/ajph.2010.300086
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发表时间：
2011-08-01
影响因子：
12.7
通讯作者：
Karpati, Adam
中科院分区：
文献类型：
--
作者：
Galea, Sandro;Tracy, Melissa;Karpati, Adam
目标.我们估计了美国社会因素导致的死亡人数。我们对1980年至2007年发表的所有英文文章进行了MEDLINE检索，估计了社会因素与成人全因死亡率之间的关系。我们计算了死亡率的相对风险估计值，并获得并使用每个社会因素的患病率估计值来计算每个因素的人群归因分数。然后，我们计算了2000年美国由各种社会因素导致的死亡人数。2000年美国约有245000例死亡归因于教育程度低，176000例归因于种族隔离，162000例归因于社会支持不足，133000例归因于个人贫困，119000例归因于收入不平等，39000例归因于地区贫困。在美国，归因于社会因素的估计死亡人数与归因于病理生理和行为原因的人数相当。这些研究结果表明，应该对死亡原因进行更广泛的公共卫生概念化，并采取广泛的政策办法，考虑如何解决社会因素，以改善人口健康。(Am J公共卫生。2011;101：1456-1465。doi：10.2105/AJPH.2010.300086）
Objectives. We estimated the number of deaths attributable to social factors in the United States.Methods. We 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. We calculated summary relative risk estimates of mortality, and we obtained and used prevalence estimates for each social factor to calculate the population-attributable fraction for each factor. We then calculated the number of deaths attributable to each social factor in the United States in 2000.Results. Approximately 245000 deaths in the United States in 2000 were attributable to low education, 176000 to racial segregation, 162000 to low social support, 133000 to individual-level poverty, 119000 to income inequality, and 39000 to area-level poverty.Conclusions. The estimated number of deaths attributable to social factors in the United States is comparable to the number attributed to pathophysiological and behavioral causes. 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. (Am J Public Health. 2011;101:1456-1465. doi:10.2105/AJPH.2010.300086)