Chronic Disease Overview

The profile of diseases contributing most heavily to death, illness, and disability among Americans changed dramatically during the last century. Today, chronic diseases—such as cardiovascular disease (primarily heart disease and stroke), cancer, and diabetes—are among the most prevalent, costly, and preventable of all health problems. Seven of every 10 Americans who die each year, or more than 1.7 million people, die of a chronic disease. The prolonged course of illness and disability from such chronic diseases as diabetes and arthritis results in extended pain and suffering and decreased quality of life for millions of Americans. Chronic, disabling conditions cause major limitations in activity for more than one of every 10 Americans, or 25 million people.

Costs of Chronic Disease

The United States cannot effectively address escalating health care costs without addressing the problem of chronic diseases: 

• More than 90 million Americans live with chronic illnesses. 
• Chronic diseases account for 70% of all deaths in the United States. 
• The medical care costs of people with chronic diseases account for more than 75% of the nation’s $1.4 trillion medical care costs. 
• Chronic diseases account for one-third of the years of potential life lost before age 65. 
• Hospitalizations for pregnancy-related complications occurring before delivery account for more than $1 billion annually.
• The direct and indirect costs of diabetes are nearly $132 billion a year. 
• Each year, arthritis results in estimated medical care costs of more than $22 billion, and estimated total costs (medical care and lost productivity) of almost $82 billion. 
• The estimated direct and indirect costs associated with smoking exceed $75 billion annually. 
• In 2001, approximately $300 billion was spent on all cardiovascular diseases. Over $129 in lost productivity was due to cardiovascular disease. 
• The direct medical costs associated with physical inactivity was nearly $76.6 billion in 2000. 
• Nearly $68 billion is spent on dental services each year.

Cost-Effectiveness of Prevention

• For every $1 spent on water fluoridation, $38 is saved in dental restorative treatment costs. 
• For a cost ranging from $1,108 to $4,542 for smoking cessation programs, 1 quality-adjusted year of life is saved. Smoking cessation interventions have been called the gold standard of cost-effective interventions. 
• The direct medical costs associated with physical inactivity was $29 billion in 1987 and nearly $76.6 billion in 2000. Engaging in regular physical activity is associated with taking less medication and having fewer hospitalizations and physician visits. 
• For each $1 spent on the Safer Choice Program (a school-based HIV, other STD, and pregnancy prevention program), about $2.65 is saved on medical and social costs. 
• For every $1 spent on preconception care programs for women with diabetes, $1.86 can be saved by preventing birth defects among their offspring. 
• According to one Northern California study, for every $1 spent on the Arthritis Self-Help Program, $3.42 was saved in physician visits and hospital costs. 
• A mammogram every 2 years for women aged 50–69 costs only about $9,000 per year of life saved. This cost compares favorably with other widely used clinical preventive services. 
• For the cost of 100 Papanicolaou tests for low-income elderly women, about $5,907 and 3.7 years of life are saved. 
• After controlling for physical limitation and major socioeconomic factors, more than 12% of annual medical costs of the inactive persons with arthritis is associated with physical inactivity. Physical activity interventions may be a cost-effective strategy for reducing the burden of arthritis.

Burden of Chronic Disease on Minority Racial Populations and Women

Breast and Cervical Cancer 

• African American women are more likely to die of breast cancer than are women of any other racial or ethnic group. The incidence of cervical cancer—a 100% preventable cancer—is more than five times greater among Vietnamese women in the United States than among white women. 

Cardiovascular Disease 

• More than half of persons who die each year of heart disease are women. 
• Heart disease is the leading cause of death for all racial and ethnic groups in the United States. In 1998, rates of death from cardiovascular disease were about 30% higher among African American adults than among white adults.

Diabetes 

• Diabetes affects more women than men. 
• The prevalence of diabetes is 70% higher among African Americans and nearly 100% higher among Hispanics than among whites. The prevalence of diabetes among American Indians and Alaska Natives is more than twice that of the total population, and the Pimas of Arizona have the highest known prevalence of diabetes in the world. 

Infant and Maternal Mortality 

• African American, American Indian, and Puerto Rican infants have higher death rates than white infants. In 1998, the death rate among African American infants was 2.3 times greater than that among white infants. 
• African American women are four times more likely to die of pregnancy-related complications than are white women, and American Indian and Alaska Native women are nearly twice as likely to die.

Disability

• Life expectancy is higher for women than for men, but women older than 70 years are more likely to be disabled.

Related Information

• Birth Defects and Developmental Disabilities
• Genomics and Disease Prevention
• The Burden of Chronic Disease and the Future of Public Health

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This page last reviewed October 15, 2004

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion