Social ills like poverty or a poor education may be as deadly as smoking cigarettes, according to new research from Columbia University.
In a report published in the American Journal of Public Health, researchers attribute approximately 245,000 deaths in the United States in 2000 to low education, 176,000 to racial segregations, 162,000 to low social support, 133,000 to individual-level poverty, 119,000 to income inequality and 39,000 to area-level poverty. Together that links about 4.5 percent of deaths to social conditions.
Lead author Sandro Galea and his team analyzed data from 47 previous studies to get their numbers. After calculating for the relative risks of mortality from social factors, Galea turned to Census Bureau data to figure out the prevalence of each condition.
Social factors are not the same as diseases or accidents, Galea told the New York Times. But social factors are comparable, he argued, to behaviors like smoking, poor dietary habits and inactivity.
"The question is not 'Why should we think of poverty as a cause of death?'" said Galea, who is the chairman of the department of epidemiology at the Mailman School of Public Health at Columbia University, "but rather 'Why should we not think of poverty as a cause of death?'"
The poor have less access to health screening, less access to quality care and a greater likelihood of engaging in unhealthy behavior, he said.
"If you say that 193,000 deaths are due to heart attack, then heart attack matters," Galea said. "If you say 300,000 deaths are due to obesity, then obesity matters. Well, if 291,000 deaths are due to poverty and income inequality, then those things matter too."
Previous studies confirm poverty as a predictor of premature death. Research out of Lancaster University in 2009 showed no change in the strength of the link between the 1900s and today — despite significant changes in the definition of poverty. The steady association can be explained by the fact that modern diseases "have a possible long-term link to unhealthy living conditions in the distant past," researcher Ian N. Gregory told Reuters.
Researchers at the University of Oxford further argue that social welfare spending is "strongly associated" with risk of death. When social spending was high in Europe, mortality rates fell, according to an article published last summer in the British Medical Journal. When social spending was low, mortality rates rose.
"This report reveals that ordinary people may be paying the ultimate price for budget cuts — potentially costing them their lives," wrote lead author David Stuckler. "Social welfare programmes appear to be a key determinant of future population health that should be taken into account in ongoing economic debates."