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 - Dean Hosgood, H.
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 - Breitborde, Nicholas
N1 - Publisher Copyright:
© 2018 American Medical Association. All rights reserved.
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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U2 - 10.1001/jama.2018.0158
DO - 10.1001/jama.2018.0158
M3 - Article
C2 - 29634829
AN - SCOPUS:85045189452
SN - 0098-7484
VL - 319
SP - 1444
EP - 1472
JO - JAMA - Journal of the American Medical Association
JF - JAMA - Journal of the American Medical Association
IS - 14
ER -