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The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States.

Publication ,  Journal Article
US Burden of Disease Collaborators; Mokdad, AH; Ballestros, K; Echko, M; Glenn, S; Olsen, HE; Mullany, E; Lee, A; Khan, AR; Ahmadi, A; Rehm, CD ...
Published in: JAMA
April 10, 2018

INTRODUCTION: Several studies have measured health outcomes in the United States, but none have provided a comprehensive assessment of patterns of health by state. OBJECTIVE: To use the results of the Global Burden of Disease Study (GBD) to report trends in the burden of diseases, injuries, and risk factors at the state level from 1990 to 2016. DESIGN AND SETTING: A systematic analysis of published studies and available data sources estimates the burden of disease by age, sex, geography, and year. MAIN OUTCOMES AND MEASURES: Prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost (YLLs) due to premature mortality, years lived with disability (YLDs), and disability-adjusted life-years (DALYs) for 333 causes and 84 risk factors with 95% uncertainty intervals (UIs) were computed. RESULTS: Between 1990 and 2016, overall death rates in the United States declined from 745.2 (95% UI, 740.6 to 749.8) per 100 000 persons to 578.0 (95% UI, 569.4 to 587.1) per 100 000 persons. The probability of death among adults aged 20 to 55 years declined in 31 states and Washington, DC from 1990 to 2016. In 2016, Hawaii had the highest life expectancy at birth (81.3 years) and Mississippi had the lowest (74.7 years), a 6.6-year difference. Minnesota had the highest HALE at birth (70.3 years), and West Virginia had the lowest (63.8 years), a 6.5-year difference. The leading causes of DALYs in the United States for 1990 and 2016 were ischemic heart disease and lung cancer, while the third leading cause in 1990 was low back pain, and the third leading cause in 2016 was chronic obstructive pulmonary disease. Opioid use disorders moved from the 11th leading cause of DALYs in 1990 to the 7th leading cause in 2016, representing a 74.5% (95% UI, 42.8% to 93.9%) change. In 2016, each of the following 6 risks individually accounted for more than 5% of risk-attributable DALYs: tobacco consumption, high body mass index (BMI), poor diet, alcohol and drug use, high fasting plasma glucose, and high blood pressure. Across all US states, the top risk factors in terms of attributable DALYs were due to 1 of the 3 following causes: tobacco consumption (32 states), high BMI (10 states), or alcohol and drug use (8 states). CONCLUSIONS AND RELEVANCE: There are wide differences in the burden of disease at the state level. Specific diseases and risk factors, such as drug use disorders, high BMI, poor diet, high fasting plasma glucose level, and alcohol use disorders are increasing and warrant increased attention. These data can be used to inform national health priorities for research, clinical care, and policy.

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Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

April 10, 2018

Volume

319

Issue

14

Start / End Page

1444 / 1472

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • United States
  • Risk Factors
  • Quality-Adjusted Life Years
  • Mortality, Premature
  • Mortality
  • Morbidity
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
Chicago
ICMJE
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US Burden of Disease Collaborators, Mokdad, A. H., Ballestros, K., Echko, M., Glenn, S., Olsen, H. E., … Murray, C. J. L. (2018). The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. JAMA, 319(14), 1444–1472. https://doi.org/10.1001/jama.2018.0158
US Burden of Disease Collaborators, Ali H. Mokdad, Katherine Ballestros, Michelle Echko, Scott Glenn, Helen E. Olsen, Erin Mullany, et al. “The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States.JAMA 319, no. 14 (April 10, 2018): 1444–72. https://doi.org/10.1001/jama.2018.0158.
US Burden of Disease Collaborators, Mokdad AH, Ballestros K, Echko M, Glenn S, Olsen HE, et al. The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. JAMA. 2018 Apr 10;319(14):1444–72.
US Burden of Disease Collaborators, et al. “The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States.JAMA, vol. 319, no. 14, Apr. 2018, pp. 1444–72. Pubmed, doi:10.1001/jama.2018.0158.
US Burden of Disease Collaborators, Mokdad AH, Ballestros K, Echko M, Glenn S, Olsen HE, Mullany E, Lee A, Khan AR, Ahmadi A, Ferrari AJ, Kasaeian A, Werdecker A, Carter A, Zipkin B, Sartorius B, Serdar B, Sykes BL, Troeger C, Fitzmaurice C, Rehm CD, Santomauro D, Kim D, Colombara D, Schwebel DC, Tsoi D, Kolte D, Nsoesie E, Nichols E, Oren E, Charlson FJ, Patton GC, Roth GA, Hosgood HD, Whiteford HA, Kyu H, Erskine HE, Huang H, Martopullo I, Singh JA, Nachega JB, Sanabria JR, Abbas K, Ong K, Tabb K, Krohn KJ, Cornaby L, Degenhardt L, Moses M, Farvid M, Griswold M, Criqui M, Bell M, Nguyen M, Wallin M, Mirarefin M, Qorbani M, Younis M, Fullman N, Liu P, Briant P, Gona P, Havmoller R, Leung R, Kimokoti R, Bazargan-Hejazi S, Hay SI, Yadgir S, Biryukov S, Vollset SE, Alam T, Frank T, Farid T, Miller T, Vos T, Bärnighausen T, Gebrehiwot TT, Yano Y, Al-Aly Z, Mehari A, Handal A, Kandel A, Anderson B, Biroscak B, Mozaffarian D, Dorsey ER, Ding EL, Park E-K, Wagner G, Hu G, Chen H, Sunshine JE, Khubchandani J, Leasher J, Leung J, Salomon J, Unutzer J, Cahill L, Cooper L, Horino M, Brauer M, Breitborde N, Hotez P, Topor-Madry R, Soneji S, Stranges S, James S, Amrock S, Jayaraman S, Patel T, Akinyemiju T, Skirbekk V, Kinfu Y, Bhutta Z, Jonas JB, Murray CJL. The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. JAMA. 2018 Apr 10;319(14):1444–1472.
Journal cover image

Published In

JAMA

DOI

EISSN

1538-3598

Publication Date

April 10, 2018

Volume

319

Issue

14

Start / End Page

1444 / 1472

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • United States
  • Risk Factors
  • Quality-Adjusted Life Years
  • Mortality, Premature
  • Mortality
  • Morbidity
  • Middle Aged
  • Male
  • Humans