Columbia University MailmanHere’s an interesting piece of news that seems to redefine the meaning of a health problem. According to researchers from the Columbia University’s Mailman School of Public Health, the average low-income person appears to lose about 8.2 years of perfect health while an average high school dropout loses 5.1 years. Interestingly the obese lose about 4.2 years and the average smoker loses 6.6 years of perfect health to their habit. These figures seem to indicate that high school dropout and poverty rates are not really seen as health problems.

The analysis suggests that in the United States, poverty and dropout rates appear to be at least as important a health problem as smoking. Low-income has been defined by the researchers as household earnings that are below 200% of the Federal Poverty Line. Apparently on average poverty seems to have had the largest impact on health. It was followed by smoking while being a high school dropout was next in the list. These were followed by being non-Hispanic Black, obese, a binge drinker, and uninsured.

Data from various national datasets designed to ascertain both health and life expectancy attribute to these findings. Researchers point out that healthy life lost is a combination of both health and life expectancy as a single number. It is supposedly also called quality-adjusted life years sometimes.

“While public health policy needs to continue its focus on risky health behaviors and obesity, it should redouble its efforts on non-medical factors, such as high school graduation and poverty reduction programs,” commented Peter Muennig, MD, assistant professor of health policy and management at the Mailman School of Public Health and principal investigator of the findings.

According to Dr. Muennig, specific policies that claim to have been successful earlier are reduced class size in grades K-3 and earned income tax credit programs. To evaluate the medical and non-medical policies that could have an effect on population health, the researchers closely analyzed such policy goals. These included smoking prevention, increased access to medical care, poverty reduction, and early childhood education. This aimed at offering policymakers with a sense of how different policy priorities could influence population health.

On the basis of earlier research, the scientists seem to have investigated health disparities that could have resulted from an individual’s membership in a socially identifiable and disadvantaged group. This was then compared to membership in a non-disadvantaged counterpart. The experts suggest that public health policy appears to always have been directed at individual social and behavioral risks. Until now however, there appears to have been very little systematic investigation of their relative contribution to U.S. population health.

“The smaller impact of schooling in our analyses probably had a lot to do with the fact that we are only measuring the health of people in the general population. We miss those in prisons and chronic care facilities, most of whom lack a high school diploma. If we captured these individuals, the numbers would be higher.

“As with other burden of disease studies, the policies we identify will not eliminate the risk factor in the population; our estimates can only serve as guideposts for policymakers,” says Dr. Muennig.

Furthermore, the researchers were also unable to capture all population health risks. They did not for example examine analysis of transportation policy that could affect health. These included lowered accidents, reduced pollution, and increased exercise.

This new research has been published in the December 2009 issue of the American Journal of Public Health.