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. Author manuscript; available in PMC: 2025 Jun 8.
Published in final edited form as: Circulation. 2024 Jan 24;149(8):e347–e913. doi: 10.1161/CIR.0000000000001209

Table 2-3.

Leading 20 Risk Factors of YLL and Death in the United States: Rank, Number, and Percentage Change, 1990 and 2019

Risk factors for disability YLL rank (for total number) Total No. of YLLs, in thousands (95% UI) Percent change, 1990–2019 (95% UI) Corresponding total No. of deaths, in thousands (95% UI) Corresponding percent change, 1990–2019 (95% UI)
1990 2019 1990 2019 Total No. of YLLs Age-standardized YLL rate 1990 2019 Total No. of deaths Age-standardized death rate
Smoking 1 1 11 005.06 (10 692.42 to 11 351.22) 10 371.03 (10 017.19 to 10 728.28) −5.76% (−8.46% to −2.93%) −46.43% (−47.91% to −44.85%) 515.41 (496.77 to 537.03) 527.74 (505.55 to 550.83) 2.39% (−1.3% to 6.28%) −42.21% (−44.18% to −40.15%)
High SBP 2 2 8466.11 (7465.95 to 9424.27) 7815.63 (6814.38 to 8821.87) −7.68% (−13.09% to −2.58%) −45.76% (−48.82% to −42.81%) 503.63 (425.60 to 573.56) 495.20 (407.47 to 574.65) −1.67% (−9.73% to 6.05%) −45.94% (−49.57% to −42.07%)
High BMI 4 3 4994.23 (3131.76 to 6877.86) 7778.57 (5416.09 to 9912.24) 55.75% (41.31% to 80.47%) −9.18% (−17.75% to 5.86%) 232.16 (138.00 to 334.08) 393.86 (257.61 to 528.44) 69.65% (52.54% to 98.96%) −5.82% (−15.3% to 10%)
High FPG 5 4 4664.81 (3563.73 to 6006.04) 7121.62 (5548.50 to 9006.14) 52.67% (37.87% to 68%) −12.25% (−20.59% to −3.79%) 263.41 (193.27 to 355.67) 439.38 (320.11 to 582.66) 66.81% (48.24% to 85.48%) −8.01% (−17.9% to 2.09%)
Drug use 18 5 999.47 (899.54 to 1135.28) 4265.41 (4080.78 to 4494.41) 326.77% (277.64% to 372.57%) 242.34% (202.34% to 280.43%) 24.76 (22.26 to 27.73) 104.74 (100.39 to 109.98) 323.09% (280.5% to 364.71%) 214.02% (181.7% to 245.57%)
Alcohol use 6 6 2708.90 (2327.61 to 3129.89) 3936.71 (3457.94 to 4524.58) 45.33% (30.7% to 60.18%) −5.97% (−14.74% to 2.75%) 76.48 (61.08 to 93.37) 136.66 (115.68 to 162.66) 78.69% (54.74% to 108.25%) 6.66% (−6.18% to 22.33%)
High LDL-C 3 7 6291.91 (5210.65 to 7354.85) 3863.72 (3077.21 to 4730.88) −38.59% (−43.38% to −34.18%) −63.6% (−66.17% to −61.13%) 353.09 (267.44 to 443.65) 226.34 (158.85 to 304.37) −35.9% (−43.1% to −29.38%) −64.86% (−68.02% to −61.77%)
Kidney dysfunction 7 8 2138.32 (1781.84 to 2527.38) 3159.52 (2795.42 to 3536.01) 47.76% (37.73% to 60.92%) −13.36% (−19.3% to −5.75%) 138.81 (111.85 to 167.70) 214.74 (182.32 to 248.84) 54.71% (43.24% to 69.01%) −15% (−20.89% to −6.95%)
Diet low in whole grains 9 9 1897.21 (868.61 to 2445.35) 1778.79 (855.23 to 2258.78) −6.24% (−10% to 0.74%) −44.83% (−47.05% to −40.69%) 103.24 (46.57 to 133.79) 102.25 (48.18 to 131.55) −0.96% (−5.31% to 6.17%) −45.32% (−47.42% to −41.37%)
Low temperature 13 10 1320.06 (1079.50 to 1579.76) 1734.12 (1488.09 to 1989.52) 31.37% (21.84% to 42.8%) −28.03% (−33.6% to −21.47%) 92.53 (76.50 to 108.86) 123.09 (104.13 to 141.28) 33.02% (24.01% to 42.4%) −28.1% (33.15% to 22.91%)
Diet low in legumes 12 11 1471.67 (348.59 to 2464.41) 1299.03 (337.88 to 2145.69) −11.73% (−15.97% to 2.02%) −48.26% (−50.62% to −39.91%) 80.91 (20.30 to 134.49) 76.84 (19.83 to 126.33) −5.03% (−10.1% to 8.8%) −48.05% (−50.45% to −41.09%)
Diet high in red meat 16 12 1258.35 (677.77 to 1830.45) 1268.70 (754.94 to 1787.30) 0.82% (−7.68% to 16.14%) −40.06% (−45.03% to −30.7%) 59.84 (31.13 to 88.85) 65.65 (37.01 to 94.39) 9.71% (−0.52% to 29.65%) −38.55% (−44.31% to −27.11%)
Diet high in trans fatty acids 14 13 1311.91 (77.03 to 1776.96) 1097.24 (55.44 to 1490.02) −16.36% (−24.34% to −12.35%) −50.97% (−55.84% to −48.6%) 71.37 (4.33 to 97.34) 64.39 (3.44 to 88.07) −9.78% (−18.55% to −4.86%) −50.56% (−55.32% to −48.06%)
Diet high in processed meat 19 14 850.40 (283.64 to 1366.73) 969.35 (405.97 to 1459.61) 13.99% (−0.22% to 53.8%) −32.69% (−41.36% to −9.36%) 42.16 (13.90 to 69.60) 50.90 (20.97 to 78.62) 20.71% (5.93% to 59.18%) −32.15% (−40.76% to −9.05%)
Ambient particulate matter pollution 8 15 2001.60 (842.72 to 3490.50) 931.95 (526.95 to 1361.42) −53.44% (−76.57% to 3.52%) −71.21% (−84.9% to −39.42%) 95.26 (37.62 to 171.26) 47.79 (26.06 to 71.53) −49.84% (−75.93% to 18.1%) −71.29% (−85.9% to −33.4%)
Diet high in sodium 24 16 574.46 (36.43 to 1999.45) 914.24 (61.08 to 2622.57) 59.15% (25.57% to 270.02%) −4.75% (−25.72% to 132.21%) 31.62 (2.16 to 113.50) 48.50 (3.26 to 151.35) 53.38% (23.18% to 208.55%) −13.04% (−30.53% to 82.94%)
LBW 10 17 1512.98 (1436.65 to 1601.27) 853.24 (778.57 to 935.91) −43.61% (−49.31% to −37.44%) −38.47% (−44.69% to −31.75%) 17.04 (16.18 to 18.03) 9.61 (8.77 to 10.54) −43.62% (−49.32% to −37.46%) −38.49% (−44.71% to −31.77%)
Short gestation 11 18 1492.43 (1415.76 to 1577.76) 830.26 (756.11 to 909.70) −44.37% (−49.91% to −38.33%) −39.3% (−45.36% to −32.72%) 16.81 (15.94 to 17.77) 9.35 (8.51 to 10.24) −44.38% (−49.92% to −38.35%) −39.32% (−45.37% to −32.74%)
Secondhand smoke 17 19 1072.52 (858.49 to 1288.00) 765.32 (597.81 to 943.60) −28.64% (−35.48% to −21.24%) −58.57% (−62.38% to −54.53%) 44.43 (35.48 to 53.61) 35.58 (27.27 to 44.12) −19.92% (−28.44% to −10.64%) −55.34% (−59.81% to −50.32%)
Diet low in fruits 21 20 845.55 (505.63 to 1141.76) 745.10 (463.85 to 1006.64) −11.88% (−21.92% to 0.05%) −47.98% (−53.6% to −41.37%) 42.79 (25.00 to 57.89) 40.17 (24.61 to 54.38) 6.13% (−18.07% to 9.22%) −47.6% (−53.99% to −39.31%)

During each annual GBD Study cycle, population health estimates are produced for the full time series. Improvements in statistical and geospatial modeling methods and the addition of new data sources may lead to changes in past results across GBD Study cycles.

BMI indicates body mass index; FPG, fasting plasma glucose; GBD, Global Burden of Disease; LBW, low birth weight; LDL-C, low-density lipoprotein cholesterol; SBP, systolic blood pressure; UI, uncertainty interval; and YLL, year of life lost to premature mortality.

Source: Data derived from GBD Study 2019. Institute for Health Metrics and Evaluation. Used with permission. All rights reserved.105