Health in the US improved from 1990 to 2016; however, the drivers of mortality and morbidity have changed in some states, with specific risk factors such as drug use disorders and high body mass index (BMI) associated with adverse outcomes. Researchers used results of the Global Burden of Disease Study to report trends in the burden of diseases, injuries, and risk factors at the state level from 1990 top 2016. Prevalence, incidence, 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. Among the findings:

• During the study period, overall death rates in the US declined from 745.2 per 100,000 persons to 578.0 per 100,000 persons.
• The probability of death among adults aged 20 to 55 years declined in 31 states and Washington, DC, but increased by >10% in 5 states.
• Hawaii had the highest life expectancy at birth (81.3 years) and Mississippi had the lowest (74.7 years).
• Specific risk factors for mortality and morbidity associated with adverse outcomes included drug use disorders, high BMI, and alcohol use disorders.
• The leading causes of DALYs in the US for the study period were ischemic heart disease and lung cancer.