Health care and premature deaths

From Different Perspectives for Assigning Weights to Determinants of Health, by Bridget C. Booske, Jessica K. Athens, David A. Kindig, Hyojun Park, and Patrick L. Remington:

An oft cited McGinnis et al (2002) paper states: “…using the best available estimates, the impacts of various domains on early deaths in the U.S. distribute roughly as follows: genetic predispositions, about 30%; social circumstances, 15%; environmental exposures, 5%; behavioral patterns, 40%; and shortfalls in medical care, 10%”. […]

However, some caveats should be noted:

1) The “long standing estimate” of 10% for medical care is actually based on “expert” estimates of the contribution of health care system deficiencies to total mortality; (DHHS, 1980);

I’d like to read that old DHHS document, but I cannot find it. However, it is true that McGinnis et al (2002) cite it in support of the 10% figure. (All references are in the paper linked to at the top of this post. It’s ungated.)

I’m not claiming 10% is the wrong figure. But I sure don’t see how we can be certain it is right. If it is, it is not clear that citing McGinnis et al or the DHHS document is the way to support that figure.


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