mortality

US Mortality Rates Have Declined, but Vary Widely by State

Overall mortality rates in the United States decreased between 1990 and 2016, but varied widely by state, according to updated data on the US burden of disease, injuries, risk factors, and life expectancy.

The new data emerged from a systematic analysis of recent health data performed by the US Burden of Disease Collaborators. In their analysis, they examined 333 causes and 84 risk factors as drivers of morbidity and mortality.
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Specifically, the effects of these factors on prevalence, incidence, mortality, life expectancy, healthy life expectancy (HALE), years of life lost due to premature mortality, years lived with disability, and disability-adjusted life-years (DALYs) were examined.

Ultimately, overall US death rates were found to decline from 745.2 per 100,000 persons in 1990 to 578.0 per 100,000 persons in 2016, and the likelihood of death among adults aged 20 to 55 years decreased in 31 states and Washington DC.

However, life expectancy was found to vary by state and was affected by numerous causes.

“There are wide differences in the burden of disease at the state level,” the researchers wrote. “Specific diseases and risk factors, such as drug use disorders, high [body mass index (BMI)], poor diet, high fasting plasma glucose level, and alcohol use disorders are increasing and warrant increased attention.”

Specifically, the researchers found the following:

  • In 2016, Hawaii and Mississippi had the highest and lowest life expectancies at birth, respectively (81.3 years vs 74.7 years).
  • In 2016, Minnesota had the highest HALE at birth, while West Virginia had the lowest (70.3 years vs 63.8 years).
  • Between 1990 and 2016, the leading causes of DALYs were ischemic heart disease and lung cancer, with the third leading causes being low back pain in 1990 and chronic obstructive pulmonary disease in 2016.
  • From 1990 to 2016, opioid use disorders jumped from the 11th to the 7th leading cause of DALYs.
  • In 2016, tobacco consumption, high BMI, poor diet, alcohol and drug use, high fasting plasma glucose, and high blood pressure individually. comprised more than 5% of risk-attributable DALYs.
  • The leading risk factors in terms of attributable DALYs were due to tobacco consumption in 32 states, high BMI in 10 states, and alcohol and drug use in 8 states.

The researchers emphasized that these data, which were published in the Journal of the American Medical Association, could “inform national health priorities for research, clinical care, and policy” in the future.

—Christina Vogt

Reference:

The US Burden of Disease Collaborators. The state of US health, 1990-2016: burden of diseases, injuries, and risk factors among US states. JAMA. 2018; 319(14):1444-1472. doi:10.1001/jama.2018.0158

 

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