Multiple Chronic Conditions in United States

United States

Chronic conditions are conditions lasting more than a year that require ongoing medical attention and/or limit daily functions such as eating, bathing and mobility. Adults with multiple chronic conditions represent one of the highest-need segments of the population, as each chronic condition may require additional medication and monitoring. As the number of chronic conditions an individual has increases, the risks of the following outcomes also increase: 

• Physical, social and cognitive limitations.
• Unnecessary hospitalizations.
• Adverse drug events.
• Mortality.

The economic burden of multiple chronic conditions is substantial. Adults who have five or more chronic conditions spend 14 times more on health services compared with adults who have no chronic conditions. It is estimated that 71 cents of every dollar of health care spending goes toward treating people with multiple chronic conditions.

According to America’s Health Rankings data, 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; the prevalence is lower with each decrease in age range.
• American Indian/Alaska Native adults compared with all other race and ethnicity groups. 
• Multiracial adults compared with Hawaiian/Pacific Islander, Hispanic and Asian adults. The prevalence is higher among white adults than Black, 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 things that an individual can do 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 and support networks as well as patients in the management of chronic diseases. Additionally, the Community Preventive Services Task Force provides multiple interventions for health care facilities to help support individuals with multiple 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.

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.

Wolff, Jennifer L., Barbara Starfield, and Gerard Anderson. “Prevalence, Expenditures, and Complications of Multiple Chronic Conditions in the Elderly.” Archives of Internal Medicine 162, no. 20 (November 11, 2002): 2269–76. https://doi.org/10.1001/archinte.162.20.2269.