About Chronic Diseases

Key points

  • Chronic diseases are the leading cause of illness, disability, and death in America.
  • Most chronic diseases are caused by a short list of risk factors: smoking, poor nutrition, physical inactivity, and excessive alcohol use.
  • Some groups are more affected than others because of factors that limit their ability to make healthy choices.
Person getting his blood pressure measured

Chronic diseases in America


Chronic diseases are defined broadly as conditions that last 1 year or more and require ongoing medical attention or limit activities of daily living or both.

Chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States. They are also leading drivers of the nation's $4.5 trillion in annual health care costs.123

Many preventable chronic diseases are caused by a short list of risk behaviors: smoking, poor nutrition, physical inactivity, and excessive alcohol use.

Risk factors


Cigarette smoking causes more than 480,000 deaths each year in the United States, and over 16 million Americans are living with a disease caused by smoking. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.

Poor nutrition and physical inactivity

Poor nutrition and physical inactivity are significant risk factors for obesity and other chronic diseases, such as type 2 diabetes, heart disease, stroke, certain cancers, and depression.

Excessive alcohol use

Over time, excessive alcohol use can lead to serious problems, including alcohol use disorder and problems with learning, memory, and mental health. Chronic health conditions linked to excessive alcohol use include high blood pressure, heart disease, stroke, liver disease, and some kinds of cancer.

Who is at risk

Some groups are at higher risk of chronic diseases because of conditions where they are born, live, work, and age. These nonmedical factors, called social determinants of health, can be positive or negative. When they are negative, they limit the opportunities to make healthy choices and get good medical care.

For example, some communities lack safe spaces like parks for people to be active, or grocery stores that sell fresh fruits and vegetables. In some rural areas, it's hard to get medical care because of doctor shortages, hospital closures, or long distances to care. This makes it challenging to get preventive screenings or specialist follow-up care.

What CDC is doing

CDC's National Center for Chronic Disease Prevention and Health Promotion supports state, local, tribal, and territorial public health organizations to reduce chronic disease risk factors. Funded programs like REACH and Getting Further Faster focus on addressing the social determinants of health, so that everyone can have the same opportunity to live their healthiest life.

  1. National health expenditure data: historical. Center for Medicare & Medicaid Services. Updated December 13, 2023. Accessed February 6, 2024. https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
  2. Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Rand Corp.; 2017.
  3. Leading causes of death. Centers for Disease Control and Prevention. Updated January 23, 2023. Accessed November 7, 2023. https://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm
  • Chronic disease definition: US Department of Health and Human Services. Multiple Chronic Conditions: A Strategic Framework; 2010.