Multiple Chronic Conditions in United States

United States

Chronic conditions are health conditions lasting more than a year that require ongoing medical attention and/or limit daily functions such as eating, bathing and mobility. The more chronic conditions an individual has, the higher their risk of the following outcomes: 

• Physical, social and cognitive limitations.
• Longer hospital stays.
• Adverse drug events.
• Mortality.

The economic burden of multiple chronic conditions is substantial. Approximately 90% of the $4.5 trillion spent on health care yearly is for chronic conditions. Adults who have five or more chronic conditions spend 14 times more on health services compared with adults who have no chronic conditions.

According to America’s Health Rankings analysis, populations of adults that have a higher prevalence of three or more multiple chronic conditions include:

• Women compared with men.
• Adults ages 65 and older compared with younger adults.
• American Indian/Alaska Native and multiracial adults compared with Hawaiian/Pacific Islander, Hispanic and Asian adults. The prevalence is higher among white adults than Black, Hawaiian/Pacific Islander and Hispanic and Asian adults.
• Adults with less than a high school education compared with adults with higher levels of education. 
• Adults with an annual household income less than $25,000 compared with adults with higher household incomes. The prevalence decreases with each increase in income level. 

There are many actions that an individual can take to reduce their risk of developing chronic diseases, including eating healthy, not smoking, getting enough regular physical activity and avoiding excessive drinking. These lifestyle modifications can also help manage existing chronic conditions. It is recommended that individuals take an active role in their care by understanding and learning about their chronic conditions and medications, communicating with their health care providers and taking medications as prescribed.

County Health Rankings & Roadmaps has a page on evidence-based programs that involve practitioners, support networks and patients in managing chronic diseases. Additionally, the Community Preventive Services Task Force provides multiple interventions for health care facilities to help support individuals with chronic conditions such as comprehensive telehealth interventions to improve diet and text messaging interventions for medication adherence.

Buttorff, Christine, Teague Ruder, and Melissa Bauman. “Multiple Chronic Conditions in the United States.” Tools. Santa Monica, CA: RAND Corporation, 2017. https://doi.org/10.7249/TL221.

Skinner, Halcyon G., Rosanna Coffey, Jenna Jones, Kevin C. Heslin, and Ernest Moy. “The Effects of Multiple Chronic Conditions on Hospitalization Costs and Utilization for Ambulatory Care Sensitive Conditions in the United States: A Nationally Representative Cross-Sectional Study.” BMC Health Services Research 16, no. 1 (December 2016): 77. https://doi.org/10.1186/s12913-016-1304-y.

U.S. Department of Health and Human Services. “Multiple Chronic Conditions—A Strategic Framework: Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions.” Washington, D.C.: U.S. Department of Health and Human Services, 2010. https://www.hhs.gov/sites/default/files/ash/initiatives/mcc/mcc_framework.pdf.

Vogeli, Christine, Alexandra E. Shields, Todd A. Lee, Teresa B. Gibson, William D. Marder, Kevin B. Weiss, and David Blumenthal. “Multiple Chronic Conditions: Prevalence, Health Consequences, and Implications for Quality, Care Management, and Costs.” Journal of General Internal Medicine 22, no. S3 (December 2007): 391–95. https://doi.org/10.1007/s11606-007-0322-1.