Multiple Chronic Conditions

One in four Americans has multiple chronic conditions, those that last a year or more and require ongoing medical attention or that limit activities of daily living.¹ That number rises to three in four Americans aged 65 and older.²

This high prevalence has several underlying causes: the rapidly growing population of older adults, the increasing life expectancy associated with advances in public health and clinical medicine, and the high prevalence of some risk factors, such as tobacco use and physical inactivity.

As a person’s number of chronic conditions increases, his or her risk for dying prematurely, being hospitalized, and even receiving conflicting advice from health care providers increases. People with multiple chronic conditions also are at greater risk of poor day-to-day functioning.

Having multiple chronic conditions is also associated with substantial health care costs. Approximately 71% of the total health care spending in the United States is associated with care for the Americans with more than one chronic condition.² Among Medicare fee-for-service beneficiaries, people with multiple chronic conditions account for 93% of total Medicare spending.³ People with multiple chronic conditions face substantial out-of-pocket costs of their care, including higher costs for prescription drugs.

References

1. Multiple Chronic Conditions—A Strategic Framework: Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions. [PDF – 234.43 KB] Washington, DC: US Dept. of Health and Human Services; 2010. Accessed November 18, 2014.

2. Gerteis J, Izrael D, Deitz D, LeRoy L, Ricciardi R, Miller T, Basu J. Multiple Chronic Conditions Chartbook. [PDF – 10.62 MB] AHRQ Publications No, Q14-0038. Rockville, MD: Agency for Healthcare Research and Quality; 2014. Accessed November 18, 2014.

3. Chronic Conditions Among Medicare Beneficiaries, Chart Book 2012. [PDF – 4.85 MB] Baltimore, MD: Centers for Medicare & Medicaid Services; 2012. Accessed November 18, 2014.

Resources from CDC Authors

Preventing Chronic Disease bundled set of MCC reports

• Bundled set [PDF – 16.82 MB]
• Podcast

Ashman J, Beresovsky V. Multiple chronic conditions among U.S. adults who visited the doctor: data from the National Ambulatory Medical Care Survey, 2009. Prev Chronic Dis 2013;10:120308.

Barile JP, Thompson WW, Zack MM, Krahn GL, Horner-Johnson W, Bowen SE. Multiple chronic medical conditions and health-related quality of life in older adults, 2004–2006. Prev Chronic Dis 2013;10:120282.

Crews JE, Jones GC, Kim JH. Double jeopardy: the effects of comorbid conditions among older people with vision loss. J Vis Impair Blind 2006;100 (special supplement):824-48.

CDC. Comorbidity in adults with epilepsy—United States, 2010. MMWR 2013;62(43):850-3.

Ford ES, Croft JB, Posner SF, Goodman RA, Giles WH. Co-occurrence of leading lifestyle-related co-occurring chronic conditions among adults in the United States, 2002-2009. Prev Chronic Dis 2013;10:120316.

Fox MH, Reichard A. Disability, health, and multiple chronic conditions among people eligible for both Medicare and Medicaid, 2005–2010. Prev Chronic Dis 2013;10:130064.

Freid VM, Bernstein AB, Bush MA. Multiple chronic conditions among adults age 45 and over: trends over the past 10 years. NCHS data brief, No. 100. Hyattsville, MD: National Center for Health Statistics. 2012. PubMed abstract.

Goodman RA, Posner SF, Huang ES, Parekh AK, Koh HK. Defining and measuring chronic conditions: imperatives for research, policy, programs, and practice. Prev Chronic Dis 2013;10:120239.

Parekh AK, Goodman RA, Gordon C, Koh HK. Managing multiple chronic conditions: a strategic framework for improving health outcomes and quality of life. Public Health Rep 2011;126(4):460-71.

Ward BW, Schiller JS. Prevalence of multiple chronic conditions among US Adults: estimates from the National Health Interview Survey, 2010. Prev Chronic Dis 2013;10:120203.

Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among U.S. adults: a 2012 update. Prev Chronic Dis 2014;11:130389.