Cause-specific years of life lost attributable to non-optimal body mass index by county, sex, race, and ethnicity in the USA, 2000–2019: a systematic analysis of health disparities

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Non-optimal BMI / Obesity. Intervention: Non-optimal BMI. Primary outcome: Obesity prevalence and years of life lost (YLLs) attributable to non-optimal BMI (increase of 12.3 percentage points, 95% CI 11.9-12.8).

GBD US Health Disparities Collaborators; Farah Mouhanna; Ethan Kahn; Chris A. Schmidt; Theresa A. McHugh; Mathew M Baumann; Yekaterina O. Kelly; Wichada La Motte-Kerr; Rebecca M Cogen; Xiaochen Dai; Emmanuela Gakidou; César Montalvo-Clavijo; Zhuochen Li; Michael Celone; Nicole K. DeCleene; Kosuke Tamura; K Choi; Juliana Teruel Camargo; Amanda S. Hinerman; Christian S. Alvarez; GA Mensah; Elíseo J. Pérez-Stable; Christopher J. L. Murray; Ali H. Mokdad; Laura Dwyer-Lindgren

doi:10.1186/s12916-026-04795-y

Key result

Non-optimal BMI drives racial and ethnic disparities in years of life lost beyond obesity prevalence.

increase of 12.3 percentage points
95% CI 11.9-12.8

Why the study?

Disparities in mortality attributable to non-optimal BMI by race, ethnicity, and county in the USA are poorly understood.

Key Points

To quantify county-level and racial or ethnic disparities in obesity prevalence and cause-specific years of life lost attributable to non-optimal body mass index across the United States from 2000 to 2019.
Estimated annual obesity prevalence across 3,110 US counties stratified by age, sex, and five racial and ethnic groups using data from BRFSS, Gallup Daily, and NHANES.
Calculated population attributable fractions and cause-specific years of life lost (YLLs) attributable to non-optimal BMI for 27 causes of death, emphasizing ischemic heart disease, colorectal cancer, and diabetes.
National age-standardized obesity prevalence increased by 12.3 percentage points (95% UI 11.9–12.8) to 40.2% (40.0–40.6) between 2000 and 2019, peaking among Black and American Indian and Alaska Native (AIAN) populations.
In 2019, Black populations experienced the highest attributable YLL rates for ischemic heart disease and colorectal cancer, whereas AIAN populations had the highest attributable YLL rate for diabetes.
Despite significant reductions in attributable IHD and diabetes YLL rates across all groups over time, relative county-level disparities were two to four times larger for attributable YLL rates than for obesity prevalence.

Study Design

Type

Observational

Multicenter

Yes

Structured PICO

P

Population

Population-level analysis of 3110 US counties from 2000 to 2019 assessing obesity prevalence and years of life lost attributable to non-optimal BMI.

E

Exposure

Non-optimal BMI (exposure)

O

Outcome

Obesity prevalence (BMI ≥ 30) and years of life lost (YLLs) attributable to non-optimal BMI for 27 causes of death (focusing on ischemic heart disease, colorectal cancer, and diabetes)hard clinical

Main Result

Effect estimate: increase of 12.3 percentage points (95% CI 11.9-12.8)

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Implication

Racial and ethnic disparities in years of life lost attributable to non-optimal BMI are larger than disparities in obesity prevalence alone, highlighting compounded health inequities.

Abstract

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Discussion

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Cite This Study

Collaborators et al. (2026) conducted an observational in Non-optimal BMI / Obesity. Non-optimal BMI was evaluated on Obesity prevalence and years of life lost (YLLs) attributable to non-optimal BMI (increase of 12.3 percentage points, 95% CI 11.9-12.8). Age-standardized obesity prevalence in the USA increased by 12.3 percentage points (95% UI 11.9-12.8) to 40.2% from 2000 to 2019, driving substantial disparities in attributable years of life lost.

synapsesocial.com/papers/69be38a46e48c4981c67933f https://doi.org/10.1186/s12916-026-04795-y

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Cause-specific years of life lost attributable to non-optimal body mass index by county, sex, race, and ethnicity in the USA, 2000–2019: a systematic analysis of health disparities

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Cause-specific years of life lost attributable to non-optimal body mass index by county, sex, race, and ethnicity in the USA, 2000–2019: a systematic analysis of health disparities

Key Points

Study Design

Structured PICO

Main Result

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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