Area deprivation in 2010, as measured by the Index of Multiple Deprivation, was by far the strongest predictor of mortality across all models, with higher deprivation linked to higher standardised mortality rates in 2011-12. To put the effects into context, using QOF year 8 models, a change in the Index of Multiple Deprivation from the median (17.25) to the 90th centile (44.88) would correspond to an all-cause standardised mortality rate increase from the median to the 82nd centile. For the condition-specific standardised mortality rate models the effect was weaker, and a change in Index of Multiple Deprivation from the median to the 90th centile would correspond to a condition-specific standardised mortality rate increase from the median to the 73rd centile.
OK the research is about how primary care affects mortality (not very much) but the results demonstrate clearly that the big deal is deprivation - or if you'd prefer, poverty. Reduce levels of poverty and you increase health outcomes across the board. This is nothing to do with the evils of booze, fags and burgers but to do with a whole complex of issues relating to being poor. Things like cold and damp housing, unemployment, mental health issues, inadequate diet and lower levels of educational attainment. Plus greater exposure (and lower resistance) to contagious diseases.
This suggests that, if the purpose of public health campaigns is to reduce mortality rates (and ill health in general) the money currently spent on what we term 'public health' is misplaced and would be better invested in economic development, education and skills training.