School of Public Health

Health Disparities

We investigate mortality, disease burden, and risk factor exposures in population subgroups, based on individual and community characteristics.

We have documented disparities in child mortality and in exposure to environmental and nutritional risk factors for child mortality, by socioeconomic status in different countries and regions and across municipios in Mexico . We have shown that environmental and nutritional interventions related to the Millennium Development Goals (MDGs) can deliver significantly larger health benefits if they reach the poor than better off households who nonetheless are in need of intervention.

We documented one the longest periods of decline and stagnation in life expectancy in United States counties, leading to disparities in life expectancy that are enormous by international standards. We also identified the Eight Americas, subgroups of the US population based on race and location and socioeconomic characteristics of county residence, as parsimonious groups that capture most of the differentials in life expectancy. We demonstrated that a significant part of these disparities, especially those related to cardiovascular diseases, are related to disparities to exposure to risk factors with known intervention.

Work on subnational patterns of mortality, disease incidence, and risk factor exposure in the UK has recently begun in collaboration with the Small Area Health Statistics Unit (SAHSU).

 

Publications (complete list on publications page)

Powles J, Zatonski W, Vander Hoorn S, Ezzati M. The contribution of leading diseases and risk factors to excess losses of healthy life in eastern Europe: burden of disease study. BMC Public Health 2005; 5:116

Pongou R, Ezzati M, Salomon J. Household and community socioeconomic and environmental determinants of child nutritional status in Cameroon. BMC Public Health 2006; 6(1):98

Pongou R, Salomon J, Ezzati M. Health impacts of macroeconomic crises and policies: determinants of variation in childhood malnutrition trends in Cameroon. International Journal of Epidemiology 2006; 35(3):648-656

Murray CJL, Kulkarni SC, Michaud C, Tomijima N, Bulzacchelli MT, Iandiorio TJ, Ezzati M. Eight Americas: investigating mortality disparities across races, counties and race-counties in the United States. PLoS Medicine 2006; 3(9):e260

Gakidou E, Oza S, Vidal Fuertes C, Li AY, Lee DK, Sousa A, Hogan MC, Vander Hoorn S, Ezzati M. Improving child survival through environmental and nutritional interventions: the importance of targeting interventions toward the poor. JAMA 2007; 298(16): 1876-1887

Kim D, Kawachi I, Vander Hoorn S, Ezzati M. Is inequality at the heart of it? cross-country associations of income inequality with cardiovascular diseases and risk factors. Social Science and Medicine 2008; 66(8): 1719-1732

Ezzati M, Friedman AB, Kulkarni SC, Murray CJL. The reversal of fortunes: trends in county mortality and cross-county mortality disparities in the United States. PLoS Medicine 2008; 5(4):e66

Stevens G, Dias RH, Ezzati M. The effects of three environmental risks on mortality disparities across Mexican communities. Proceedings of the National Academy of Sciences USA 2008; 105(44): 16860-16865

Danaei G, Rimm EB, Oza S, Kulkarni SC, Murray CJL, Ezzati M. The promise of prevention: the effects of four preventable risk factors on national life expectancy and life expectancy disparities by race and county in the United States. PLoS Medicine 2010; 7(3): e1000248

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