Chronic Disease Overview

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 Chronic Diseases: The Leading Causes of Death and Disability in the United States
 Health Risk Behaviors that Cause Chronic Diseases
 The Cost of Chronic Diseases and Health Risk Behaviors
 References

Chronic Diseases: The Leading Causes of Death and Disability in the United States

Chronic diseases and conditions—such as heart disease, stroke, cancer, diabetes, obesity, and
arthritis—are among the most common, costly, and preventable of all health problems.

 As of 2012, about half of all adults—117 million people—had one or more chronic health
conditions. One of four adults had two or more chronic health conditions.1
 Seven of the top 10 causes of death in 2010 were chronic diseases. Two of these chronic
diseases—heart disease and cancer—together accounted for nearly 48% of all deaths.2
 Obesity is a serious health concern. During 2009–2010, more than one-third of adults, or
about 78 million people, were obese (defined as body mass index [BMI] ≥30 kg/m2). Nearly
one of five youths aged 2–19 years was obese (BMI ≥95th percentile).3
 Arthritis is the most common cause of disability.4 Of the 53 million adults with a doctor
diagnosis of arthritis, more than 22 million say they have trouble with their usual activities
because of arthritis.5
 Diabetes is the leading cause of kidney failure, lower-limb amputations other than those
caused by injury, and new cases of blindness among adults.6

Health Risk Behaviors that Cause Chronic Diseases

Health risk behaviors are unhealthy behaviors you can change. Four of these health risk
behaviors—lack of exercise or physical activity, poor nutrition, tobacco use, and drinking too
much alcohol—cause much of the illness, suffering, and early death related to chronic
diseases and conditions.

 In 2011, more than half (52%) of adults aged 18 years or older did not meet
recommendations for aerobic exercise or physical activity. In addition, 76% did not meet
recommendations for muscle-strengthening physical activity.7
 About half of US adults (47%) have at least one of the following major risk factors for heart
disease or stroke: uncontrolled high blood pressure, uncontrolled high LDL cholesterol, or
are current smokers.8 Ninety percent of Americans consume too much sodium, increasing
their risk of high blood pressure.9
 In 2011, more than one-third (36%) of adolescents and 38% of adults said they ate fruit less
than once a day, while 38% of adolescents and 23% of adults said they ate vegetables less
than once a day.10
 More than 42 million adults—close to 1 of every 5—said they currently smoked cigarettes in
2012.11 Cigarette smoking accounts for more than 480,000 deaths each year.11 Each day,
more than 3,200 youth younger than 18 years smoke their first cigarette, and another 2,100
youth and young adults who smoke every now and then become daily smokers.11

http://www.cdc.gov/chronicdisease/overview/
  Drinking too much alcohol is responsible for 88,000 deaths each year, more than half of
which are due to binge drinking.12, 13 About 38 million US adults report binge drinking an
average of 4 times a month, and have an average of 8 drinks per binge, yet most binge
drinkers are not alcohol dependent.14

The Cost of Chronic Diseases and Health Risk Behaviors

In the United States, chronic diseases and conditions and the health risk behaviors that cause
them account for most health care costs.

 Eighty-six percent of all health care spending in 2010 was for people with one or more
chronic medical conditions.15
 The total costs of heart disease and stroke in 2010 were estimated to be $315.4 billion. Of
this amount, $193.4 billion was for direct medical costs, not including costs of nursing home
care.16
 Cancer care cost $157 billion in 2010 dollars.17
 The total estimated cost of diagnosed diabetes in 2012 was $245 billion, including $176
billion in direct medical costs and $69 billion in decreased productivity. Decreased
productivity includes costs associated with people being absent from work, being less
productive while at work, or not being able to work at all because of diabetes.18
 The total cost of arthritis and related conditions was about $128 billion in 2003. Of this
amount, nearly $81 billion was for direct medical costs and $47 billion was for indirect costs
associated with lost earnings.19
 Medical costs linked to obesity were estimated to be $147 billion in 2008. Annual medical
costs for people who are obese were $1,429 higher than those for people of normal weight
in 2006.20
 For the years 2009-2012, economic cost due to smoking is estimated to be more than $289
billion a year. This cost includes at least $133 billion in direct medical care for adults and
more than $156 billion for lost productivity from premature death estimated from 2005
through 2009.11
 The economic costs of drinking too much alcohol were estimated to be $223.5 billion, or
$1.90 a drink, in 2006. Most of these costs were due to binge drinking and resulted from
losses in workplace productivity, health care expenses, and crimes related to excessive
drinking.21

References

1. Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012
update. Prev Chronic Dis. 2014;11:130389. DOI: http://dx.doi.org/10.5888/pcd11.130389.
2. Centers for Disease Control and Prevention. Death and Mortality. NCHS FastStats Web site.
http://www.cdc.gov/nchs/fastats/deaths.htm. Accessed December 20, 2013.
3. Centers for Disease Control and Prevention. NCHS Obesity
Data. http://www.cdc.gov/nchs/data/factsheets/factsheet_obesity.htm. Accessed
December 20, 2013.
4. Hootman JM, Brault MW, Helmick CG, Theis KA, Armour BS. Prevalence and most common
causes of disability among adults—United States, 2005. MMWR. 2009;58(16):421-6.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5816a2.htm?s_cid=mm5816a2_e.
Accessed December 23, 2013.
5. Barbour KE, Helmick CG, Theis KA, et al. Prevalence of doctor-diagnosed arthritis and
arthritis-attributable activity limitation—United States, 2010-2012. MMWR.

http://www.cdc.gov/chronicdisease/overview/
 2013;62(14):869-73. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6244a1.htm.
Accessed March 13, 2014.
6. Centers for Disease Control and Prevention. National Diabetes Fact Sheet, 2011. Atlanta, GA:
Centers for Disease Control and Prevention, US Dept. of Health and Human Services; 2011.
http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2011.pdf[PDF - 2.66 MB] Accessed December
20, 2013.
7. Centers for Disease Control and Prevention. Exercise or Physical Activity. NCHS FastStats
Web site. http://www.cdc.gov/nchs/fastats/exercise.htm. Accessed December 20, 2013.
8. Fryar CD, Chen T, Li X. Prevalence of uncontrolled risk factors for cardiovascular disease:
United States, 1999–2010. NCHS Data Brief, No. 103. Hyattsville, MD: National Center for
Health Statistics, Centers for Disease Control and Prevention, US Dept. of Health and Human
Services; 2012.
9. Cogswell ME, Zhang Z, Carriquiry AL, et al. Sodium and potassium intakes among US adults:
NHANES 2003–2008. Am J Clin Nutr. 2012;96:647-57.
10. Centers for Disease Control and Prevention. State Indicator Report on Fruits and Vegetables,
2013. Atlanta, GA: Centers for Disease Control and Prevention, US Dept. of Health and
Human Services; 2013. http://www.cdc.gov/nutrition/downloads/State-Indicator-Report-
Fruits-Vegetables-2013.pdf.[PDF - 4.51 MB] Accessed December 23, 2013.
11. US Department of Health and Human Services. The Health Consequences of Smoking—50
Years of Progress: A Report of the Surgeon General. Atlanta, GA: US Dept. of Health and
Human Services, Centers for Disease Control and Prevention; 2014.
http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf.[PDF -
28.58 MB] Accessed February 7, 2014.
12. Centers for Disease Control and Prevention. Alcohol and Public Health: Alcohol Related
Disease Impact (ARDI). http://apps.nccd.cdc.gov/DACH_ARDI/Default/Default.aspx.
Accessed March 11, 2014.
13. Centers for Disease Control and Prevention. Alcohol-attributable deaths and years of
potential life lost, United States, 2001. MMWR. 2004;53:866-70.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5337a2.htm. Accessed April 9, 2014.
14. Kanny D, Liu Y, Brewer RD, Garvin WS, Balluz L. Vital signs: Binge drinking prevalence,
frequency, and intensity among adults—United States, 2010. MMWR. 2012;61:14-19.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6101a4.htm?s_cid=mm6101a4_e%0d
%0a. Accessed April 9, 2014.
15. Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, Basu J. Multiple Chronic Conditions
Chartbook. AHRQ Publications No, Q14-0038. Rockville, MD: Agency for Healthcare Research
and Quality; 2014. http://www.ahrq.gov/professionals/prevention-chronic-
care/decision/mcc/mccchartbook.pdf.[PDF - 10.62 MB] Accessed November 18, 2014.
16. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al; American Heart
Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and
stroke statistics--2014 update: a report from the American Heart Association.Circulation.
2014;129(3):e28-292.
http://circ.ahajournals.org/content/early/2013/12/18/01.cir.0000441139.02102.80.full.pdf.[
PDF - 15.97 MB] Accessed January 6, 2014.
17. National Cancer Institute. Cancer Prevalence and Cost of Care Projections.
http://costprojections.cancer.gov/. Accessed December 23, 2013.
18. American Diabetes Association. The Cost of Diabetes.
http://www.diabetes.org/advocate/resources/cost-of-diabetes.html. Accessed December
23, 2013.
19. Centers for Disease Control and Prevention. Arthritis Cost Statistics.
http://www.cdc.gov/arthritis/data_statistics/cost.htm. Accessed December 23, 2013.

http://www.cdc.gov/chronicdisease/overview/
 20. Finkelstein EA, Trogdon JG, Cohen JW, Dietz W. Annual medical spending attributable to
obesity: payer- and service-specific estimates. Health Aff. 2009;28(5):w822-31.
http://content.healthaffairs.org/content/28/5/w822.full.html. Accessed December 23, 2013.
21. Bouchery EE, Harwood HJ, Sacks JJ, Simon CJ, Brewer RD. Economic costs of excessive
alcohol consumption in the US, 2006. Am J Prev Med. 2011;41(5):516-24.
http://www.sciencedirect.com/science/article/pii/S0749379711005381#. Accessed
December 23, 2013.

http://www.cdc.gov/chronicdisease/overview/