 Health equity and the fallacy of treating causes of population health as if they sum to 100%N. Krieger American Journal of Public Health, 2017, vol. 107, issue 4, 541-549 Abstract: Numerous examples exist in population health of work that erroneously forces the causes of health to sum to 100%.This is surprising. Clear refutations of this error extend back 80 years. Because public health analysis, action, and allocation of resources are ill served by faulty methods, I consider why this error persists. I first review several highprofile examples, including Doll and Peto's 1981 opus on the causes of cancer and its current interpretations; a 2015 highpublicity article in Science claiming that two thirds of cancer is attributable to chance; and the influential Web site "County Health Rankings &Roadmaps: Building a Culture of Health, CountybyCounty,"whose model sums causes of health to equal 100%: physical environment (10%), social and economic factors(40%),clinicalcare(20%), and health behaviors (30%). Critical analysis of these works and earlier historical debates reveals that underlying the error of forcing causes of health to sum to 100% is the still dominantbutdeeply flawed view that causation can be parsed as nature versus nurture. Better approaches exist for tallying risk and monitoring efforts to reach health equity. Date: 2017 Downloads: (external link) Related works: Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2017.303655_0 Access Statistics for this article American Journal of Public Health is currently edited by Alfredo Morabia More articles in American Journal of Public Health from American Public Health Association |
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