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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
Show Affiliations
Authors Affiliations
  1. 1. University of Louisville, Louisville, KY, United States
  2. 2. Kermanshah University of Medical Sciences, Kermanshah, Iran
  3. 3. Karolinska Institutet, Stockholm, Sweden
  4. 4. School of Public Health, University of Queensland, Brisbane, Australia
  5. 5. Queensland Centre for Mental Health Research, Brisbane, Australia
  6. 6. Hematology-Oncology and Stem Cell Transplantation Research Center, Hematologic Malignancies Research Center, Tehran University of Medical Sciences, Tehran, Iran
  7. 7. Competence Center Mortality-Follow-Up of the German National Cohort, Federal Institute for Population Research, Wiesbaden, Hessen, Germany
  8. 8. Public Health Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
  9. 9. UKZN Gastrointestinal Cancer Research Centre, South African Medical Research Council, Durban, South Africa
  10. 10. University of Colorado, Aurora, United States
  11. 11. Departments of Criminology, Law and Society, Sociology, and Public Health, University of California, Irvine, United States
  12. 12. Division of Hematology, Department of Medicine, University of Washington, Seattle, Fred Hutchinson Cancer Research Center, Seattle, United States
  13. 13. Montefiore Medical Center, Bronx, NY, United States
  14. 14. Department of Health Sciences, Northeastern University, Boston, MA, United States
  15. 15. University of Alabama at Birmingham, United States
  16. 16. Division of Cardiology, Brown University, Providence, RI, United States
  17. 17. Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University, San Diego, CA, United States
  18. 18. Murdoch Childrens Research Institute, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
  19. 19. Albert Einstein College of Medicine, Bronx, NY, United States
  20. 20. Cambridge Health Alliance, Cambridge, MA, United States
  21. 21. Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States
  22. 22. Stellenbosch University, Cape Town, Western Cape, South Africa
  23. 23. Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
  24. 24. Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, United States
  25. 25. Case Western Reserve University, Cleveland, OH, United States
  26. 26. Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
  27. 27. School of Social Work, University of Illinois at Urbana-Champaign, United States
  28. 28. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
  29. 29. Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
  30. 30. Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute for Health Policy, Massachusetts General Hospital, Boston, United States
  31. 31. University of California, San Diego, San Diego, CA, United States
  32. 32. Yale University, New Haven, CT, United States
  33. 33. VA Medical Center, Washington, DC, United States
  34. 34. Neurology Department, Georgetown University, Washington, DC, United States
  35. 35. Hunger Action Los Angeles, Los Angeles, CA, United States
  36. 36. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Alborz, Iran
  37. 37. Jackson State University, Jackson, MS, United States
  38. 38. University of Massachusetts, Boston, United States
  39. 39. State University of New York, Albany, Rensselaer, NY, United States
  40. 40. Simmons College, Boston, MA, United States
  41. 41. College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
  42. 42. David Geffen School of Medicine, University of California at Los Angeles, United States
  43. 43. Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
  44. 44. Center for Disease Burden, Norwegian Institute of Public Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
  45. 45. Pacific Institute for Research and Evaluation, Calverton, MD, United States
  46. 46. School of Public Health, Curtin University, Perth, Australia
  47. 47. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
  48. 48. Africa Health Research Institute, Mtubatuba, South Africa
  49. 49. Institute of Public Health, Heidelberg University, Heidelberg, Germany
  50. 50. Jimma University, Jimma, Oromia, Ethiopia
  51. 51. Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
  52. 52. Washington University in St Louis, St Louis, MO, United States
  53. 53. College of Medicine, Howard University, Washington, DC, United States
  54. 54. University of New Mexico, Albuquerque, United States
  55. 55. University at Buffalo, Buffalo, NY, United States
  56. 56. University of Washington, Seattle, United States
  57. 57. University of South Florida, Tampa, United States
  58. 58. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
  59. 59. University of Rochester, Medical Center, Rochester, NY, United States
  60. 60. Department of Medical Humanities and Social Medicine, College of Medicine, Kosin University, Busan, South Korea
  61. 61. Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
  62. 62. Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha, Hunan, China
  63. 63. Michigan State University, East Lansing, United States
  64. 64. Department of Nutrition and Health Science, Ball State University, Muncie, India
  65. 65. College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, United States
  66. 66. School of Public Health, University of Queensland, Brisbane, Australia
  67. 67. Dalhousie University, Halifax, Canada
  68. 68. Mayo Clinic, Jacksonville, FL, United States
  69. 69. Bureau of Child, Family and Community Wellness, Nevada Division of Public and Behavioral Health, Carson City, United States
  70. 70. University of British Columbia, Vancouver, Canada
  71. 71. Ohio State University, Columbus, United States
  72. 72. College of Medicine, Baylor University, Houston, TX, United States
  73. 73. Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Krakow, Poland
  74. 74. Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
  75. 75. Dartmouth College, Hanover, NH, United States
  76. 76. Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Canada
  77. 77. Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
  78. 78. Oregon Health and Science University, Portland, United States
  79. 79. Department of Surgery, Virginia Commonwealth University, Richmond, United States
  80. 80. White Plains Hospital, White Plains, NY, United States
  81. 81. Norwegian Institute of Public Health, Oslo, Norway
  82. 82. Columbia University, New York, NY, United States
  83. 83. Centre for Research and Action in Public Health, University of Canberra, Canberra, Australia
  84. 84. Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
  85. 85. Centre for Global Child Health, Hospital for Sick Children, Toronto, Canada
  86. 86. Department of Ophthalmology, Medical Faculty Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany

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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