Zip Codes and Premature Death

George Davey Smith, James D. Neaton, Deborah Wentworth, Rose Stamler, and Jeremiah Stamler, Am J Public Health, 1996;86:486-496

This study isn't junk science. So what's it doing on the Junk Science Home Page? Several visitors have suggested that I should include examples of what I think are good studies. So, here goes.

This study of more than 300,000 white males associated socioeconomic status (SES) with health. I'm not in advertising, but if I was, my slogan would be

Wealth = Health!

These researchers supported this proposition by comparing median income, as determined by ZIP codes, with disease rates. They report, for example, that every $10,000 decrement in median income was associated with

An 18% increase in rate of premature death;
A 15% increase in cancer rate;
A 17% increase in cardiovascular disease rate;
A 27% increase in lung cancer rate;
A 57% increase in heart failure rate;
A 47% increase in pulmonary disease rate; and
A 62% increase in diabetes rate.

All these reported associations had 95% confidence intervals above 1.0. Many other positive associations, both significant and not, were reported as well.

Sure, sure. I know, I know. These are all weak associations--the same weak associations that tend to be junk science. But it does have some measure of plausibility. The wealthier one is, the better the lifestyle one can live. Better food. Better medical care. Better education. Better job. Better neighborhood. More exercise. I find this result tough to dispute.

Now, I'm waiting for the government to take action on this. This is my suggestion for all real estate contracts:

SURGEON GENERAL'S WARNING: YOUR ZIP CODE CAN BE DANGEROUS TO YOUR HEALTH.

Don't hold your breath, though.

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