The state of US health, 1990-2016

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

The US Burden of Disease Collaborators, Yohannes Kinfu

Research output: Contribution to journalArticle

142 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). Conclusion 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
Pages (from-to)1444-1472
Number of pages29
JournalJAMA - Journal of the American Medical Association
Volume319
Issue number14
DOIs
Publication statusPublished - 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

Cite this

@article{11cba9e22c1d4b5e866141bfdf987532,
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). Conclusion 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.",
keywords = "Adult, Cost of Illness, Disabled Persons/statistics & numerical data, Female, Health Status Disparities, Humans, Male, Middle Aged, Morbidity/trends, Mortality/trends, Mortality, Premature/trends, Quality-Adjusted Life Years, Risk Factors, United States/epidemiology, Wounds and Injuries/epidemiology",
author = "{The US Burden of Disease Collaborators} 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 {Dean Hosgood}, H. 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 and Max Griswold and Michael Criqui and Michelle Bell and Minh Nguyen and Mitch Wallin and Mojde Mirarefin and Mostafa Qorbani and Mustafa Younis and Nancy Fullman and Patrick Liu and Paul Briant and Philimon Gona and Rasmus Havmoller and Ricky Leung and Ruth Kimokoti and Shahrzad Bazargan-Hejazi and Hay, {Simon I.} and Simon Yadgir and Stan Biryukov and Vollset, {Stein Emil} and Tahiya Alam and Tahvi Frank and Talha Farid and Ted Miller and Theo Vos and Till B{\"a}rnighausen and Gebrehiwot, {Tsegaye Telwelde} and Yuichiro Yano and Ziyad Al-Aly and Alem Mehari and Alexis Handal and Amit Kandel and Ben Anderson and Brian Biroscak and Dariush Mozaffarian and {Ray Dorsey}, E. and Ding, {Eric L.} and Park, {Eun Kee} and Gregory Wagner and Guoqing Hu and Honglei Chen and Sunshine, {Jacob E.} and Jagdish Khubchandani and Janet Leasher and Janni Leung and Joshua Salomon and Jurgen Unutzer and Leah Cahill and Leslie Cooper and Masako Horino and Michael Brauer and Nicholas Breitborde and Peter Hotez and Roman Topor-Madry and Samir Soneji and Saverio Stranges and Spencer James and Stephen Amrock and Sudha Jayaraman and Tejas Patel and Tomi Akinyemiju and Vegard Skirbekk and Yohannes Kinfu and Zulfiqar Bhutta and Jonas, {Jost B.} and Murray, {Christopher J.L.}",
year = "2018",
doi = "10.1001/jama.2018.0158",
language = "English",
volume = "319",
pages = "1444--1472",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "14",

}

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

In: JAMA - Journal of the American Medical Association, Vol. 319, No. 14, 2018, p. 1444-1472.

Research output: Contribution to journalArticle

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 - 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 - Farvid, Maryam

AU - Griswold, Max

AU - Criqui, Michael

AU - Bell, Michelle

AU - Nguyen, Minh

AU - Wallin, Mitch

AU - Mirarefin, Mojde

AU - Qorbani, Mostafa

AU - Younis, Mustafa

AU - Fullman, Nancy

AU - Liu, Patrick

AU - Briant, Paul

AU - Gona, Philimon

AU - Havmoller, Rasmus

AU - Leung, Ricky

AU - Kimokoti, Ruth

AU - Bazargan-Hejazi, Shahrzad

AU - Hay, Simon I.

AU - Yadgir, Simon

AU - Biryukov, Stan

AU - Vollset, Stein Emil

AU - Alam, Tahiya

AU - Frank, Tahvi

AU - Farid, Talha

AU - Miller, Ted

AU - Vos, Theo

AU - Bärnighausen, Till

AU - Gebrehiwot, Tsegaye Telwelde

AU - Yano, Yuichiro

AU - Al-Aly, Ziyad

AU - Mehari, Alem

AU - Handal, Alexis

AU - Kandel, Amit

AU - Anderson, Ben

AU - Biroscak, Brian

AU - Mozaffarian, Dariush

AU - Ray Dorsey, E.

AU - Ding, Eric L.

AU - Park, Eun Kee

AU - Wagner, Gregory

AU - Hu, Guoqing

AU - Chen, Honglei

AU - Sunshine, Jacob E.

AU - Khubchandani, Jagdish

AU - Leasher, Janet

AU - Leung, Janni

AU - Salomon, Joshua

AU - Unutzer, Jurgen

AU - Cahill, Leah

AU - Cooper, Leslie

AU - Horino, Masako

AU - Brauer, Michael

AU - Breitborde, Nicholas

AU - Hotez, Peter

AU - Topor-Madry, Roman

AU - Soneji, Samir

AU - Stranges, Saverio

AU - James, Spencer

AU - Amrock, Stephen

AU - Jayaraman, Sudha

AU - Patel, Tejas

AU - Akinyemiju, Tomi

AU - Skirbekk, Vegard

AU - Kinfu, Yohannes

AU - Bhutta, Zulfiqar

AU - Jonas, Jost B.

AU - Murray, Christopher J.L.

PY - 2018

Y1 - 2018

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). Conclusion 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). Conclusion 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.

KW - Adult

KW - Cost of Illness

KW - Disabled Persons/statistics & numerical data

KW - Female

KW - Health Status Disparities

KW - Humans

KW - Male

KW - Middle Aged

KW - Morbidity/trends

KW - Mortality/trends

KW - Mortality, Premature/trends

KW - Quality-Adjusted Life Years

KW - Risk Factors

KW - United States/epidemiology

KW - Wounds and Injuries/epidemiology

UR - http://www.scopus.com/inward/record.url?scp=85045189452&partnerID=8YFLogxK

U2 - 10.1001/jama.2018.0158

DO - 10.1001/jama.2018.0158

M3 - Article

VL - 319

SP - 1444

EP - 1472

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 14

ER -