@article{ref1,
title="The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states",
journal="JAMA journal of the American Medical Association",
year="2018",
author="Mokdad, Ali H. and Ballestros, Katherine and Echko, Michelle and Glenn, Scott and Olsen, Helen E. and Mullany, Erin and Lee, Alex and Khan, Abdur Rahman and Ahmadi, Alireza and Ferrari, Alize J. and Kasaeian, Amir and Werdecker, Andrea and Carter, Austin and Zipkin, Ben and Sartorius, Benn and Serdar, Berrin and Sykes, Bryan L. and Troeger, Chris and Fitzmaurice, Christina and Rehm, Colin D. and Santomauro, Damian and Kim, Daniel and Colombara, Danny and Schwebel, David C. and Tsoi, Derrick and Kolte, Dhaval and Nsoesie, Elaine and Nichols, Emma and Oren, Eyal and Charlson, Fiona J. and Patton, George C. and Roth, Gregory A. and Hosgood, H. Dean and Whiteford, Harvey A. and Kyu, Hmwe and Erskine, Holly E. and Huang, Hsiang and Martopullo, Ira and Singh, Jasvinder A. and Nachega, Jean B. and Sanabria, Juan R. and Abbas, Kaja and Ong, Kanyin and Tabb, Karen and Krohn, Kristopher J. and Cornaby, Leslie and Degenhardt, Louisa and Moses, Mark and Farvid, Maryam and Griswold, Max and Criqui, Michael and Bell, Michelle and Nguyen, Minh and Wallin, Mitch and Mirarefin, Mojde and Qorbani, Mostafa and Younis, Mustafa and Fullman, Nancy and Liu, Patrick and Briant, Paul and Gona, Philimon and Havmoller, Rasmus and Leung, Ricky and Kimokoti, Ruth and Bazargan-Hejazi, Shahrzad and Hay, Simon I. and Yadgir, Simon and Biryukov, Stan and Vollset, Stein Emil and Alam, Tahiya and Frank, Tahvi and Farid, Talha and Miller, Ted R. and Vos, Theo and Bärnighausen, Till and Gebrehiwot, Tsegaye Telwelde and Yano, Yuichiro and Al-Aly, Ziyad and Mehari, Alem and Handal, Alexis and Kandel, Amit and Anderson, Ben and Biroscak, Brian and Mozaffarian, Dariush and Dorsey, E. Ray and Ding, Eric L. and Park, Eun-Kee and Wagner, Gregory and Hu, Guoqing and Chen, Honglei and Sunshine, Jacob E. and Khubchandani, Jagdish and Leasher, Janet and Leung, Janni and Salomon, Joshua and Unützer, Jurgen and Cahill, Leah and Cooper, Leslie and Horino, Masako and Brauer, Michael and Breitborde, Nicholas J. K. and Hotez, Peter and Topór-Madry, Roman and Soneji, Samir and Stranges, Saverio and James, Spencer and Amrock, Stephen and Jayaraman, Sudha and Patel, Tejas and Akinyemiju, Tomi and Skirbekk, Vegard and Kinfu, Yohannes and Bhutta, Zulfiqar and Jonas, Jost B. and Murray, Christopher J. L.",
volume="319",
number="14",
pages="1444-1472",
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. <br><br>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. <br><br>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. <br><br>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). <br><br>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.<p /> <p>Language: en</p>",
language="en",
issn="0098-7484",
doi="10.1001/jama.2018.0158",
url="http://dx.doi.org/10.1001/jama.2018.0158"
}