J-Shaped Curves and Public Health | Cardiology | JAMA | JAMA Network
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October 6, 2015

J-Shaped Curves and Public Health

Author Affiliations
  • 1New York City Health and Hospitals Corporation, New York, New York
  • 2New York University Langone Medical Center, New York, New York
  • 3City of Detroit Department of Health and Wellness Promotion, Detroit, Michigan
JAMA. 2015;314(13):1339-1340. doi:10.1001/jama.2015.9566

Interventions that alter population-level risk exposure have yielded a number of improvements in public health. Tobacco taxes are an example of such population-based approaches to disease prevention. In the case of tobacco, the harms of shifting total population exposure through taxation are minimal, because there is no safe level of consumption. However, other risk factors do not exhibit the same linear relationship between exposure and mortality—and therefore may introduce new complexities in communicating with individuals and the public. In particular, many risk factors, such as alcohol consumption, exhibit a J-shaped association when plotting health effects like mortality on the vertical axis against the magnitude of the risk factor on the horizontal axis (Figure).