The state of US health, 1990-2016

Burden of diseases, injuries, and risk factors among US states

The US Burden of Disease Collaborators

Research output: Contribution to journalArticle

122 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1444-1472
Number of pages29
JournalJAMA - Journal of the American Medical Association
Volume319
Issue number14
DOIs
StatePublished - Apr 10 2018

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Quality-Adjusted Life Years
Life Expectancy
Uncertainty
Health
Wounds and Injuries
Body Mass Index
Alcohols
Tobacco Use
Fasting
Parturition
Diet
Mississippi
Glucose
Health Priorities
Geography
Heart Neoplasms
Premature Mortality
Mortality
Information Storage and Retrieval
Low Back Pain

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The state of US health, 1990-2016 : Burden of diseases, injuries, and risk factors among US states. / The US Burden of Disease Collaborators.

In: JAMA - Journal of the American Medical Association, Vol. 319, No. 14, 10.04.2018, p. 1444-1472.

Research output: Contribution to journalArticle

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title = "The state of US health, 1990-2016: Burden of diseases, injuries, and risk factors among US states",
abstract = "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.",
author = "{The US Burden of Disease Collaborators} and Murray, {Christopher J.L.} and Mokdad, {Ali H.} and Katherine Ballestros and Michelle Echko and Scott Glenn and Olsen, {Helen E.} and Erin Mullany and Alex Lee and Khan, {Abdur Rahman} and Alireza Ahmadi and Ferrari, {Alize J.} and Amir Kasaeian and Andrea Werdecker and Austin Carter and Ben Zipkin and Benn Sartorius and Berrin Serdar and Sykes, {Bryan L.} and Chris Troeger and Christina Fitzmaurice and Rehm, {Colin D.} and Damian Santomauro and Daniel Kim and Danny Colombara and Schwebel, {David C.} and Derrick Tsoi and Dhaval Kolte and Elaine Nsoesie and Emma Nichols and Eyal Oren and Charlson, {Fiona J.} and Patton, {George C.} and Roth, {Gregory A.} and Hosgood, {Howard D.} and Whiteford, {Harvey A.} and Hmwe Kyu and Erskine, {Holly E.} and Hsiang Huang and Ira Martopullo and Singh, {Jasvinder A.} and Nachega, {Jean B.} and Sanabria, {Juan R.} and Kaja Abbas and Kanyin Ong and Karen Tabb and Krohn, {Kristopher J.} and Leslie Cornaby and Louisa Degenhardt and Mark Moses and Maryam Farvid",
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TY - JOUR

T1 - The state of US health, 1990-2016

T2 - Burden of diseases, injuries, and risk factors among US states

AU - The US Burden of Disease Collaborators

AU - Murray, Christopher J.L.

AU - Mokdad, Ali H.

AU - Ballestros, Katherine

AU - Echko, Michelle

AU - Glenn, Scott

AU - Olsen, Helen E.

AU - Mullany, Erin

AU - Lee, Alex

AU - Khan, Abdur Rahman

AU - Ahmadi, Alireza

AU - Ferrari, Alize J.

AU - Kasaeian, Amir

AU - Werdecker, Andrea

AU - Carter, Austin

AU - Zipkin, Ben

AU - Sartorius, Benn

AU - Serdar, Berrin

AU - Sykes, Bryan L.

AU - Troeger, Chris

AU - Fitzmaurice, Christina

AU - Rehm, Colin D.

AU - Santomauro, Damian

AU - Kim, Daniel

AU - Colombara, Danny

AU - Schwebel, David C.

AU - Tsoi, Derrick

AU - Kolte, Dhaval

AU - Nsoesie, Elaine

AU - Nichols, Emma

AU - Oren, Eyal

AU - Charlson, Fiona J.

AU - Patton, George C.

AU - Roth, Gregory A.

AU - Hosgood, Howard D.

AU - Whiteford, Harvey A.

AU - Kyu, Hmwe

AU - Erskine, Holly E.

AU - Huang, Hsiang

AU - Martopullo, Ira

AU - Singh, Jasvinder A.

AU - Nachega, Jean B.

AU - Sanabria, Juan R.

AU - Abbas, Kaja

AU - Ong, Kanyin

AU - Tabb, Karen

AU - Krohn, Kristopher J.

AU - Cornaby, Leslie

AU - Degenhardt, Louisa

AU - Moses, Mark

AU - Farvid, Maryam

PY - 2018/4/10

Y1 - 2018/4/10

N2 - 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.

AB - 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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