The State of US Health, 1990-2016

The State of US Health, 1990-2016 Key PointsQuestionHow have the levels and trends of burden of diseases, injuries, and risk factors in the United States changed from 1990 to 2016 by state? FindingsThis study, involving examination of 333 causes and 84 risk factors, demonstrated that health in the United States improved from 1990 to 2016, although the drivers of mortality and morbidity have changed in some states, with specific risk factors such as drug use disorders, high body mass index (BMI), and alcohol use disorders being associated with adverse outcomes. In 5 states, the probability of death between ages 20 and 55 years has increased more than 10% between 1990 and 2016. MeaningDifferences in health outcomes and drivers of morbidity and mortality at the state level indicate the need for greater investment in preventive and medical care across the life course. The intersection of risk, mortality, and morbidity in particular geographic areas needs to be further explored at the state level. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

The State of US Health, 1990-2016

,; Mokdad, Ali H.; Ballestros, Katherine; Echko, Michelle; Glenn, Scott; Olsen, Helen E.; Mullany, Erin; Lee, Alex; Khan, Abdur Rahman; Ahmadi, Alireza; Ferrari, Alize J.; Kasaeian, Amir; Werdecker, Andrea; Carter, Austin; Zipkin, Ben; Sartorius, Benn; Serdar, Berrin; Sykes, Bryan L.; Troeger, Chris; Fitzmaurice, Christina; Rehm, Colin D.; Santomauro, Damian; Kim, Daniel; Colombara, Danny; Schwebel, David C.; Tsoi, Derrick; Kolte, Dhaval; Nsoesie, Elaine; Nichols, Emma; Oren, Eyal; Charlson, Fiona J.; Patton, George C.; Roth, Gregory A.; Hosgood, H. Dean; Whiteford, Harvey A.; Kyu, Hmwe; Erskine, Holly E.; Huang, Hsiang; Martopullo, Ira; Singh, Jasvinder A.; Nachega, Jean B.; Sanabria, Juan R.; Abbas, Kaja; Ong, Kanyin; Tabb, Karen; Krohn, Kristopher J.; Cornaby, Leslie; Degenhardt, Louisa; Moses, Mark; Farvid, Maryam; Griswold, Max; Criqui, Michael; Bell, Michelle; Nguyen, Minh; Wallin, Mitch; Mirarefin, Mojde; Qorbani, Mostafa; Younis, Mustafa; Fullman, Nancy; Liu, Patrick; Briant, Paul; Gona, Philimon; Havmoller, Rasmus; Leung, Ricky; Kimokoti, Ruth; Bazargan-Hejazi, Shahrzad; Hay, Simon I.; Yadgir, Simon; Biryukov, Stan; Vollset, Stein Emil; Alam, Tahiya; Frank, Tahvi; Farid, Talha; Miller, Ted; Vos, Theo; Bärnighausen, Till; Gebrehiwot, Tsegaye Telwelde; Yano, Yuichiro; Al-Aly, Ziyad; Mehari, Alem; Handal, Alexis; Kandel, Amit; Anderson, Ben; Biroscak, Brian; Mozaffarian, Dariush; Dorsey, E. Ray; Ding, Eric L.; Park, Eun-Kee; Wagner, Gregory; Hu, Guoqing; Chen, Honglei; Sunshine, Jacob E.; Khubchandani, Jagdish; Leasher, Janet; Leung, Janni; Salomon, Joshua; Unutzer, Jurgen; Cahill, Leah; Cooper, Leslie; Horino, Masako; Brauer, Michael; Breitborde, Nicholas; Hotez, Peter; Topor-Madry, Roman; Soneji, Samir; Stranges, Saverio; James, Spencer; Amrock, Stephen; Jayaraman, Sudha; Patel, Tejas; Akinyemiju, Tomi; Skirbekk, Vegard; Kinfu, Yohannes; Bhutta, Zulfiqar; Jonas, Jost B.; Murray, Christopher J. L.
JAMA, Volume 319 (14) – Apr 10, 2018

The State of US Health, 1990-2016

Research JAMA | Original Investigation Burden of Diseases, Injuries, and Risk Factors Among US States The US Burden of Disease Collaborators Editorial page 1438 INTRODUCTION Several studies have measured health outcomes in the United States, but Author Audio Interview none have provided a comprehensive assessment of patterns of health by state. Supplemental content OBJECTIVE To use the results of the Global Burden of Disease Study (GBD) to report trends in CME Quiz at jamanetwork.com/learning the burden of diseases, injuries, and risk factors at the state level from 1990 to 2016. and CME Questions page 1503 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...
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Publisher
American Medical Association
Copyright
Copyright 2018 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.2018.0158
pmid
29634829
Publisher site
See Article on Publisher Site

Abstract

Key PointsQuestionHow have the levels and trends of burden of diseases, injuries, and risk factors in the United States changed from 1990 to 2016 by state? FindingsThis study, involving examination of 333 causes and 84 risk factors, demonstrated that health in the United States improved from 1990 to 2016, although the drivers of mortality and morbidity have changed in some states, with specific risk factors such as drug use disorders, high body mass index (BMI), and alcohol use disorders being associated with adverse outcomes. In 5 states, the probability of death between ages 20 and 55 years has increased more than 10% between 1990 and 2016. MeaningDifferences in health outcomes and drivers of morbidity and mortality at the state level indicate the need for greater investment in preventive and medical care across the life course. The intersection of risk, mortality, and morbidity in particular geographic areas needs to be further explored at the state level.

Journal

JAMAAmerican Medical Association

Published: Apr 10, 2018

References

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