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Home > The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states

The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states [1]

Abstract

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 disease, injuries, and risk factors at the state level from 1990 to 2016. 

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 person. 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 disorder 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.

Citation: 

US Burden of Disease Collaborators. The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States. JAMA. 10 April 2018; 319(14):1-33. doi:10.1001/jama.2018.0158

Related Documents: 
Warning signs: new US health study reveals ‘dangerous disparities’ among states [2]
A conversation with Dr. Christopher Murray on the new US burden of disease study [3]
The State of US Health: Findings from the Global Burden of Disease Study (GBD) [4]
Tackling America’s burden [5]
Opioid deaths in the US [6]
Overweight and obesity in the US [7]
Mental health in the US [8]
Diabetes in the US [9]
Cardiovascular disease in the US [10]
Cancer in the US [11]
US deaths from opioid use disorders, 1990–2016 [12]
US firearm homicides, 1990–2016 [13]
People: 
Ali Mokdad [14]
Christopher J.L. Murray [15]
Scott Glenn [16]
Erin Mullany [17]
Alize Ferrari [18]
Austin Carter [19]
Chris Troeger [20]
Christina Fitzmaurice [21]
Damian Santomauro [22]
Emma Nichols [23]
Fiona Charlson [24]
Gregory Roth [25]
Harvey Whiteford [26]
Hmwe Hmwe Kyu [27]
Holly Erskine [28]
Ira Martopullo [29]
Liane Ong [30]
Kris Krohn [31]
Louisa Degenhardt [32]
Mark Moses [33]
Nancy Fullman [34]
Patrick Liu [35]
Simon Iain Hay [36]
Stein Emil Vollset [37]
Tahiya Alam [38]
Tahvi Frank [39]
Theo Vos [40]
Michael Brauer [41]
Topics: 
US Health

Links
[1] http://www.healthdata.org/research-article/state-us-health-1990-2016-burden-diseases-injuries-and-risk-factors-among-us-states
[2] http://www.healthdata.org/news-release/new-us-health-study-reveals-%E2%80%98dangerous-disparities%E2%80%99-among-states
[3] http://www.healthdata.org/video/conversation-dr-christopher-murray-new-us-burden-disease-study
[4] http://www.healthdata.org/infographic/state-us-health-findings-global-burden-disease-study-gbd
[5] http://www.healthdata.org/acting-data/tackling-america%E2%80%99s-burden
[6] http://www.healthdata.org/infographic/opioid-deaths-us
[7] http://www.healthdata.org/infographic/overweight-and-obesity-us
[8] http://www.healthdata.org/infographic/mental-health-us
[9] http://www.healthdata.org/infographic/diabetes-us
[10] http://www.healthdata.org/infographic/cardiovascular-disease-us
[11] http://www.healthdata.org/infographic/cancer-us
[12] http://www.healthdata.org/video/us-deaths-opioid-use-disorders-1990%E2%80%932016
[13] http://www.healthdata.org/video/us-firearm-homicides-1990%E2%80%932016
[14] http://www.healthdata.org/about/ali-mokdad
[15] http://www.healthdata.org/about/christopher-jl-murray
[16] http://www.healthdata.org/about/scott-glenn
[17] http://www.healthdata.org/about/erin-mullany
[18] http://www.healthdata.org/about/alize-ferrari
[19] http://www.healthdata.org/about/austin-carter
[20] http://www.healthdata.org/about/chris-troeger
[21] http://www.healthdata.org/about/christina-fitzmaurice
[22] http://www.healthdata.org/about/damian-santomauro
[23] http://www.healthdata.org/about/emma-nichols
[24] http://www.healthdata.org/about/fiona-charlson
[25] http://www.healthdata.org/about/gregory-roth
[26] http://www.healthdata.org/about/harvey-whiteford
[27] http://www.healthdata.org/about/hmwe-hmwe-kyu
[28] http://www.healthdata.org/about/holly-erskine
[29] http://www.healthdata.org/about/ira-martopullo
[30] http://www.healthdata.org/about/liane-ong
[31] http://www.healthdata.org/about/kristopher-krohn
[32] http://www.healthdata.org/about/louisa-degenhardt
[33] http://www.healthdata.org/about/mark-moses
[34] http://www.healthdata.org/about/nancy-fullman
[35] http://www.healthdata.org/about/patrick-liu
[36] http://www.healthdata.org/about/simon-iain-hay
[37] http://www.healthdata.org/about/stein-emil-vollset
[38] http://www.healthdata.org/about/tahiya-alam
[39] http://www.healthdata.org/about/tahvi-frank
[40] http://www.healthdata.org/about/theo-vos
[41] http://www.healthdata.org/about/michael-brauer