Multiple Chronic Conditions - Women in Hawaii

Hawaii

The Centers for Disease Control and Prevention defines chronic conditions as any condition that lasts more than a year and has one or both of the following characteristics: requires ongoing medical attention and/or limits activities of daily living. Chronic health conditions include physical and mental illnesses, such as diabetes, heart disease and depression. Adults with multiple chronic conditions represent one of the highest-need segments of the population, as each chronic condition likely requires additional medication and monitoring.

People with one or more chronic health conditions are at increased risk of poor health outcomes, such as longer hospital stays and adverse drug events.

The economic burden of multiple chronic conditions is substantial. In the United States, the average health care spending of those with five or more chronic conditions is 14 times higher than those without any chronic conditions. 

Many chronic conditions share similar risk factors, including smoking, excessive alcohol use and physical inactivity. 

According to America’s Health Rankings analysis, the prevalence of having three or more chronic health conditions is higher among:

• Women ages 35-44 compared with women ages 18-34.
• Multiracial and American Indian/Alaska Native women compared with Hispanic and Black women.
• Women who did not graduate college compared with college graduates.
• Women with an annual household income less than $25,000 compared with women with higher levels of income.
• Women living in non-metropolitan areas compared with women in metropolitan areas.
• Women who have difficulty with self-care than women without a disability. 
• LGBQ+ than straight women. 
• Women who have served in the US armed forces than those who have not. 

There are several behavioral changes individuals can take to reduce the risk of developing chronic conditions, including not smoking, eating healthy, exercising regularly, avoiding excessive alcohol consumption, staying up-to-date on health screenings, taking care of their teeth, getting enough sleep and knowing their family health history. These lifestyle modifications can also help individuals manage existing chronic conditions. Chronic disease management programs and self-management education workshops teach individuals how to live with one or more chronic conditions.

Patient-centered care is particularly important for people living with multiple chronic conditions. Patient-centered care addresses the needs of the whole person by creating treatment plans that consider all aspects of a person, as opposed to a specific condition or disease.

The Community Preventive Services Task Force recommends comprehensive telehealth interventions for those who have chronic conditions influenced by dietary behaviors, such as cardiovascular disease or diabetes. These interventions have been shown to effectively improve diet quality and reduce sodium intake.

Healthy People 2030 has several objectives related to specific health conditions, including:

• Reducing the number of diabetes cases diagnosed annually.
• Reducing the proportion of adults with chronic kidney disease. 
• Improving cardiovascular health in adults.
• Increasing the proportion of adults with a serious mental illness who get treatment.

Bierman, Arlene S., Jing Wang, Patrick G. O’Malley, and Dina K. Moss. “Transforming Care for People with Multiple Chronic Conditions: Agency for Healthcare Research and Quality’s Research Agenda.” Health Services Research 56, no. S1 (October 2021): 973–79. https://doi.org/10.1111/1475-6773.13863.

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.

Newman, Daniel, Michelle Tong, Erica Levine, and Sandeep Kishore. “Prevalence of Multiple Chronic Conditions by U.S. State and Territory, 2017.” Edited by Lucy Busija. PLOS ONE 15, no. 5 (May 5, 2020): e0232346. https://doi.org/10.1371/journal.pone.0232346.

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.

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.