Literature DB >> 29634829

The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States.

Ali H Mokdad1, Katherine Ballestros1, Michelle Echko1, Scott Glenn1, Helen E Olsen1, Erin Mullany1, Alex Lee1, Abdur Rahman Khan2, Alireza Ahmadi3,4, Alize J Ferrari1,5,6, Amir Kasaeian7, Andrea Werdecker8, Austin Carter1, Ben Zipkin1, Benn Sartorius9,10, Berrin Serdar11, Bryan L Sykes12, Chris Troeger1, Christina Fitzmaurice1,13, Colin D Rehm14, Damian Santomauro1,5,6, Daniel Kim15, Danny Colombara1, David C Schwebel16, Derrick Tsoi1, Dhaval Kolte17, Elaine Nsoesie1, Emma Nichols1, Eyal Oren18, Fiona J Charlson1,5,6, George C Patton19, Gregory A Roth1, H Dean Hosgood20, Harvey A Whiteford1,5,6, Hmwe Kyu1, Holly E Erskine1,5,6, Hsiang Huang21, Ira Martopullo1, Jasvinder A Singh16, Jean B Nachega22,23,24, Juan R Sanabria25,26, Kaja Abbas27, Kanyin Ong1, Karen Tabb28, Kristopher J Krohn1, Leslie Cornaby1, Louisa Degenhardt1,29, Mark Moses1, Maryam Farvid30,31, Max Griswold1, Michael Criqui32, Michelle Bell33, Minh Nguyen1, Mitch Wallin34,35, Mojde Mirarefin1,36, Mostafa Qorbani37, Mustafa Younis38, Nancy Fullman1, Patrick Liu1, Paul Briant1, Philimon Gona39, Rasmus Havmoller4, Ricky Leung40, Ruth Kimokoti41, Shahrzad Bazargan-Hejazi42,43, Simon I Hay1,44, Simon Yadgir1, Stan Biryukov1, Stein Emil Vollset1,45, Tahiya Alam1, Tahvi Frank1, Talha Farid2, Ted Miller46,47, Theo Vos1, Till Bärnighausen48,49,50, Tsegaye Telwelde Gebrehiwot51, Yuichiro Yano52, Ziyad Al-Aly53, Alem Mehari54, Alexis Handal55, Amit Kandel56, Ben Anderson57, Brian Biroscak33,58, Dariush Mozaffarian59, E Ray Dorsey60, Eric L Ding30, Eun-Kee Park61, Gregory Wagner62, Guoqing Hu63, Honglei Chen64, Jacob E Sunshine57, Jagdish Khubchandani65, Janet Leasher66, Janni Leung57,5, Joshua Salomon48, Jurgen Unutzer57, Leah Cahill30,67, Leslie Cooper68, Masako Horino69, Michael Brauer1,70, Nicholas Breitborde71, Peter Hotez72, Roman Topor-Madry73,74, Samir Soneji75, Saverio Stranges76,77, Spencer James1, Stephen Amrock78, Sudha Jayaraman79, Tejas Patel80, Tomi Akinyemiju16, Vegard Skirbekk81,82, Yohannes Kinfu83, Zulfiqar Bhutta84,85, Jost B Jonas86, Christopher J L Murray1.   

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.

Entities:  

Mesh:

Year:  2018        PMID: 29634829      PMCID: PMC5933332          DOI: 10.1001/jama.2018.0158

Source DB:  PubMed          Journal:  JAMA        ISSN: 0098-7484            Impact factor:   56.272


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