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Millions are treated daily with drugs designed reduce cholesterol levels in the bloodstream. Americans pay billions of dollars for these drugs because they have been repeatedly told that these medications will reduce their risks of developing coronary heart disease. Despite these claims, health professionals often do not have sound understanding of the methodological and substantive issues originally involved in correlating these risk factors (such as high blood pressure, cholesterol, smoking, diet, and obesity) to coronary heart disease. The risk factor concept may have revolutionized medicine, but it has produced widely uneven results.
In ''[https://www.amazon.com/gp/product/1580462863/ref=as_li_tl?ie=UTF8&camp=1789&creative=9325&creativeASIN=1580462863&linkCode=as2&tag=dailyh0c-20&linkId=9942b2c2143d07402d78085684d6006c Public Health and the Risk Factor: The History of an Uneven Medical Revolution]'', sociologist William Rothstein attempts to explain why the outcome of this revolution has been mixed. By examining the history of the risk factor concept and its application to coronary heart disease, Rothstein slowly builds towards the conclusion that the American medical establishment has misinterpreted the evidence of various studies examining coronary heart disease. These erroneous conclusions have distracted the medical community from the most likely causes of heart disease, obesity and insufficient exercise. Instead, physicians and drug companies have developed expensive treatments, drugs, and surgical procedures which address the symptoms, but not the causes of heart disease.
Life insurance companies (especially the Metropolitan Life Insurance Company), not the medical profession, originally developed the concept of risk factors. Not surprisingly, life insurance companies were especially keen to develop accurate mortality tables. It was critical for life insurance companies to identify criteria to quickly evaluate the general health of their potential customers. It was even more important for companies writing industrial life insurance policies because these policies were small and carried slender profits. Industrial insurance companies only made money by selling the policies in large quantities to poor, urban clients. In the United States, tens of millions of these policies were sold and they became a fixture among urban working classes. In order for industrial insurance to be profitable, it was critical to identify criteria that could accurately predict mortality.
