I referred to this paper in a previous blog post but decided to give it its own, based on recent interest.
A lot of people are familiar with the often-cited breakthrough analysis, “Actual Causes of Death in the United States,” by McGinnis and Foege in 1993, which was followed by another, impactful analysis in 2002. Both changed ideas about what could be done to promote health and wellness, from looking at “heart disease,” to instead looking at “smoking,” (1993), to instead looking at “behavioral patterns,” (2002).
In the 2002 analysis, “social circumstances,” is listed as being responsible for 15 percent of deaths, with an accompanying editorial that said:
the data are still not crisp enough to quantify the contributions [of social circumstances] in the same fashion as many other factors. (reference)
Well, it’s almost 10 years later, and there is more crisp data, and greater awareness of the “causes of the causes” of poor health. I created a pie chart from that data:
And below are the three studies laid out the same way, 1993, 2002, 2011. We have come a long way in understanding what we can do to improve health. What do we believe the balance is now compared to 2002, and where should we act, and in what proportion, at the level of the individual, family, community, society? Quantified self and/or quantified community? An app for improved social health or one for individual behavior change?