The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States.
Journal: JAMA
Volume: 319
Issue: 14
Year of Publication: 2018
Affiliated Institutions:
Institute for Health Metrics and Evaluation, University of Washington, Seattle.
University of Louisville, Louisville, Kentucky.
Kermanshah University of Medical Sciences, Kermanshah, Iran.
Hematology-Oncology and Stem Cell Transplantation Research Center, and Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Competence Center Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Hessen, Germany.
Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
University of Colorado, Aurora.
Departments of Criminology, Law & Society, Sociology, and Public Health, University of California, Irvine.
Montefiore Medical Center, Bronx, New York.
Department of Health Sciences, Northeastern University, Boston, Massachusetts.
University of Alabama at Birmingham.
Division of Cardiology, Brown University, Providence, Rhode Island.
Division of Epidemiology & Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, California.
Murdoch Childrens Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
Albert Einstein College of Medicine, Bronx, New York.
Cambridge Health Alliance, Cambridge, Massachusetts.
Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia.
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, England.
School of Social Work, University of Illinois at Urbana-Champaign.
Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
University of California, San Diego, La Jolla, California.
Yale University, New Haven, Connecticut.
VA Medical Center, Washington, DC.
Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Alborz, Iran.
Jackson State University, Jackson, Mississippi.
University of Massachusetts, Boston.
Karolinska Institutet, Stockholm, Sweden.
State University of New York, Albany, Rensselaer, New York.
Simmons College, Boston, Massachusetts.
College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California.
Pacific Institute for Research & Evaluation, Calverton, Maryland.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Jimma University, Jimma, Oromia, Ethiopia.
Department of Preventive Medicine, Northwestern University, Chicago, Illinois.
Washington University in St Louis, St Louis, Missouri.
College of Medicine, Howard University, Washington, DC.
University of New Mexico, Albuquerque.
University at Buffalo, Buffalo, New York.
University of Washington, Seattle.
Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
University of Rochester Medical Center, Rochester, New York.
Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea.
Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts.
Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China.
Michigan State University, East Lansing.
Department of Nutrition and Health Science, Ball State University, Muncie, Indiana.
College of Optometry, Nova Southeastern University, Fort Lauderdale, Florida.
Mayo Clinic, Jacksonville, Florida.
Bureau of Child, Family & Community Wellness, Nevada Division of Public and Behavioral Health, Carson City.
The Ohio State University, Columbus.
College of Medicine, Baylor University, Houston, Texas.
Institute of Public Health, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland.
Dartmouth College, Hanover, New Hampshire.
Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Canada.
Oregon Health & Science University, Portland.
Department of Surgery, Virginia Commonwealth University, Richmond.
White Plains Hospital, White Plains, New York.
Norwegian Institute of Public Health, Oslo, Norway.
Centre for Research and Action in Public Health, University of Canberra, Canberra, Australia.
Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan.
Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.
Abstract summary
Several studies have measured health outcomes in the United States, but none have provided a comprehensive assessment of patterns of health by state.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.A systematic analysis of published studies and available data sources estimates the burden of disease by age, sex, geography, and year.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.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).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.
Authors & Co-authors:
Mokdad Ali H AH
Ballestros Katherine K
Echko Michelle M
Glenn Scott S
Olsen Helen E HE
Mullany Erin E
Lee Alex A
Khan Abdur Rahman AR
Ahmadi Alireza A
Ferrari Alize J AJ
Kasaeian Amir A
Werdecker Andrea A
Carter Austin A
Zipkin Ben B
Sartorius Benn B
Serdar Berrin B
Sykes Bryan L BL
Troeger Chris C
Fitzmaurice Christina C
Rehm Colin D CD
Santomauro Damian D
Kim Daniel D
Colombara Danny D
Schwebel David C DC
Tsoi Derrick D
Kolte Dhaval D
Nsoesie Elaine E
Nichols Emma E
Oren Eyal E
Charlson Fiona J FJ
Patton George C GC
Roth Gregory A GA
Hosgood H Dean HD
Whiteford Harvey A HA
Kyu Hmwe H
Erskine Holly E HE
Huang Hsiang H
Martopullo Ira I
Singh Jasvinder A JA
Nachega Jean B JB
Sanabria Juan R JR
Abbas Kaja K
Ong Kanyin K
Tabb Karen K
Krohn Kristopher J KJ
Cornaby Leslie L
Degenhardt Louisa L
Moses Mark M
Farvid Maryam M
Griswold Max M
Criqui Michael M
Bell Michelle M
Nguyen Minh M
Wallin Mitch M
Mirarefin Mojde M
Qorbani Mostafa M
Younis Mustafa M
Fullman Nancy N
Liu Patrick P
Briant Paul P
Gona Philimon P
Havmoller Rasmus R
Leung Ricky R
Kimokoti Ruth R
Bazargan-Hejazi Shahrzad S
Hay Simon I SI
Yadgir Simon S
Biryukov Stan S
Vollset Stein Emil SE
Alam Tahiya T
Frank Tahvi T
Farid Talha T
Miller Ted T
Vos Theo T
Bärnighausen Till T
Gebrehiwot Tsegaye Telwelde TT
Yano Yuichiro Y
Al-Aly Ziyad Z
Mehari Alem A
Handal Alexis A
Kandel Amit A
Anderson Ben B
Biroscak Brian B
Mozaffarian Dariush D
Dorsey E Ray ER
Ding Eric L EL
Park Eun-Kee EK
Wagner Gregory G
Hu Guoqing G
Chen Honglei H
Sunshine Jacob E JE
Khubchandani Jagdish J
Leasher Janet J
Leung Janni J
Salomon Joshua J
Unutzer Jurgen J
Cahill Leah L
Cooper Leslie L
Horino Masako M
Brauer Michael M
Breitborde Nicholas N
Hotez Peter P
Topor-Madry Roman R
Soneji Samir S
Stranges Saverio S
James Spencer S
Amrock Stephen S
Jayaraman Sudha S
Patel Tejas T
Akinyemiju Tomi T
Skirbekk Vegard V
Kinfu Yohannes Y
Bhutta Zulfiqar Z
Jonas Jost B JB
Murray Christopher J L CJL
Study Outcome
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