The U.S. Burden of Disease Collaborators apply the Global Burden of Disease (GBD) 2010 framework to the United States, quantifying 291 diseases and injuries, 1160 sequelae, and 67 risk factors across 1990–2010 and benchmarking the US against 33 other Organisation for Economic Co-operation and Development (OECD) nations. The central finding is that U.S. population health improved in absolute terms — life expectancy (LE) rose from 75.2 to 78.2 years, health-adjusted life expectancy (HALE) from 65.8 to 68.1 years — but fell sharply behind peers: the US rank for life expectancy dropped from 20th to 27th among OECD countries, and for HALE from 14th to 26th. A second headline finding is that morbidity's share of total health burden grew: years lived with disability (YLDs) rose from 40% to 45% of all disability-adjusted life years (DALYs), with age-specific YLD rates stable while premature mortality fell. Drug use disorder DALYs increased 64% and their years of life lost (YLL) rank jumped from 44th to 15th — a GBD signal of the emerging opioid crisis published two years before Case and Deaton (2015).
"Although life span has increased, rates of age-specific YLDs have remained stable, and morbidity and chronic disability now account for nearly half of the health burden in the United States."
"Improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations."
"In many cases, the best investments for improving population health would likely be public health programs and multisectoral action to address risks such as physical inactivity, diet, ambient particulate pollution, and alcohol and tobacco consumption."
"The absence of [social determinants] in this current assessment should not be taken as implying that they are less important than the more proximal factors studied here."
This paper is the methodological backbone for any serious analysis of U.S. population health trends. Two features are especially important for this wiki. First, the morbidity-expansion finding (YLDs 40%→45% of DALYs) is the strongest available cross-national empirical test of the compression vs. expansion hypotheses — and the result favors expansion. Because the top disabling conditions (musculoskeletal pain, major depressive disorder (MDD), anxiety) are identical in 1990 and 2010 and unchanged in age-specific rate, the absolute burden of these conditions grew as the population lived longer. Second, the drug use disorder YLL surge (44th→15th) is a striking early signal: the GBD 2010 data, published in July 2013, documented the scale of the drug crisis two years before Case-Deaton brought it to mainstream academic and policy attention. The paper's explicit exclusion of social determinants from the risk-factor analysis — for methodological rather than substantive reasons — is worth flagging as a systematic limitation when using GBD figures to interpret socioeconomic status (SES)-driven health patterns.