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The State of Us Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among Us States Publisher Pubmed



Khan AR1 ; Ahmadi A2, 3 ; Ferrari AJ4, 5, 66 ; Kasaeian A6 ; Werdecker A7 ; Sartorius B4, 8, 9, 66 ; Serdar B10 ; Sykes BL11 ; Fitzmaurice C12 ; Rehm CD13 ; Santomauro D4, 5, 66 ; Kim D14 ; Schwebel DC15 ; Kolte D16 Show All Authors
Authors
  1. Khan AR1
  2. Ahmadi A2, 3
  3. Ferrari AJ4, 5, 66
  4. Kasaeian A6
  5. Werdecker A7
  6. Sartorius B4, 8, 9, 66
  7. Serdar B10
  8. Sykes BL11
  9. Fitzmaurice C12
  10. Rehm CD13
  11. Santomauro D4, 5, 66
  12. Kim D14
  13. Schwebel DC15
  14. Kolte D16
  15. Oren E17
  16. Charlson FJ4, 5, 66
  17. Patton GC18
  18. Dean Hosgood H19
  19. Whiteford HA4, 5, 66
  20. Erskine HE4, 5, 66
  21. Huang H20
  22. Singh JA15
  23. Nachega JB21, 22, 23
  24. Sanabria JR24, 25
  25. Abbas K26
  26. Tabb K27
  27. Degenhardt L28
  28. Farvid M4, 29, 30, 66
  29. Criqui M31
  30. Bell M32
  31. Wallin M33, 34
  32. Mirarefin M35
  33. Qorbani M36
  34. Younis M37
  35. Gona P38
  36. Havmoller R3
  37. Leung R39
  38. Kimokoti R40
  39. Bazarganhejazi S41, 42
  40. Hay SI43
  41. Vollset SE44
  42. Farid T1
  43. Miller T45, 46
  44. Barnighausen T47, 48, 49
  45. Gebrehiwot TT50
  46. Yano Y51
  47. Alaly Z52
  48. Mehari A53
  49. Handal A54
  50. Kandel A55
  51. Anderson B56
  52. Biroscak B32, 57
  53. Mozaffarian D58
  54. Ray Dorsey E59
  55. Ding EL29
  56. Park EK60
  57. Wagner G61
  58. Hu G62
  59. Chen H63
  60. Sunshine JE56
  61. Khubchandani J64
  62. Leasher J65
  63. Leung J4, 56, 66
  64. Salomon J47
  65. Unutzer J56
  66. Cahill L29, 67
  67. Cooper L68
  68. Horino M69
  69. Brauer M70
  70. Breitborde N71
  71. Hotez P72
  72. Topormadry R73, 74
  73. Soneji S75
  74. Stranges S76, 77
  75. Amrock S78
  76. Jayaraman S79
  77. Patel T80
  78. Akinyemiju T15
  79. Skirbekk V81, 82
  80. Kinfu Y83
  81. Bhutta Z84, 85
  82. Jonas JB86

Source: JAMA - Journal of the American Medical Association Published:2018


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. © 2018 American Medical Association. All rights reserved.
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