Fast Facts: Health and Economic Costs of Chronic Conditions

At a glance

Chronic diseases account for most illness, disability, and deaths in the United States and are the leading drivers of health care costs.

a stethoscope on a pile of hundred dollar bills

The impact of chronic diseases in America

Ninety percent of the nation's $4.5 trillion in annual health care expenditures are for people with chronic and mental health conditions.12 Interventions to prevent and manage these diseases have significant health and economic benefits.


Heart disease and stroke

Nothing kills more Americans than heart disease and stroke. More than 934,500 Americans die of heart disease or stroke every year—that's more than 1 in 4 deaths.3 These diseases take an economic toll, as well, costing our health care system $251 billion per year and causing $156 billion in lost productivity on the job. Costs from cardiovascular diseases are projected to top $1 trillion by 2035.3

See the health and economic benefits of high blood pressure interventions.


Each year in the United States, 1.7 million people are diagnosed with cancer, and more than 600,000 die from it, making it the second leading cause of death. The cost of cancer care continues to rise and is expected to reach more than $240 billion by 2030.4

See the health and economic benefits of interventions for breast cancer, cervical cancer, colorectal cancer, and skin cancer.


More than 38 million Americans have diabetes, and another 98 million adults in the United States have prediabetes, which puts them at risk for type 2 diabetes. Diabetes can cause serious complications, including heart disease, kidney failure, and blindness. In 2022, the total estimated cost of diagnosed diabetes was $413 billion in medical costs and lost productivity.5

See the health and economic benefits of diabetes interventions.


Obesity affects 20% of children and 42% of adults, putting them at risk of chronic diseases such as type 2 diabetes, heart disease, and some cancers. Over 25% of young people aged 17 to 24 are too heavy to join the U.S. military. Obesity costs the U.S. health care system nearly $173 billion a year.6


Arthritis affects 53.2 million adults in the United States, which is about 1 in 5 adults.7 It is a leading cause of work disability in the United States, one of the most common chronic conditions, and a leading cause of chronic pain. Arthritis costs appear to be increasing and were estimated at over $600 billion in 2019.89

Alzheimer's disease

Alzheimer's disease, a type of dementia, is an irreversible, progressive brain disease that affects nearly 7 million Americans, including 1 in 9 adults aged 65 and older. Two-thirds of these older adults (4.1 million) are women. Deaths due to Alzheimer's disease more than doubled between 2000 and 2019, increasing 145%. The cost of caring for people with Alzheimer's and other dementias was an estimated $345 billion in 2023, with projected increases to nearly $1 trillion (in today's dollars) by 2050.10


In the United States, about 3 million adults and about half a million children and teens younger than 18 have active epilepsy—meaning that they have been diagnosed by a doctor, had a recent seizure, or both. Adults with epilepsy report worse mental health, more cognitive impairment, and barriers in social participation compared to adults without epilepsy. In 2019, total health care costs (epilepsy-attributable and other health-related costs) for noninstitutionalized people with epilepsy was $13.4 billion, of which $5.4 billion were directly attributable to epilepsy.11

Tooth decay

Cavities (also called tooth decay) are one of the most common chronic diseases in the United States. One in six children aged 6 to 11 years and 1 in 4 adults have untreated cavities. Untreated cavities can cause pain and infections that may lead to problems eating, speaking, and learning. On average, 34 million school hours are lost each year because of unplanned (emergency) dental care, and almost $46 billion is lost in productivity due to dental disease.1213

See the health and economic benefits of oral disease interventions.

Risk Factors

Cigarette smoking

Cigarette smoking is the leading cause of preventable death and disease in the United States. More than 16 million Americans have at least one disease caused by smoking. This amounts to more than $240 billion in health care spending that could be reduced every year if we could prevent young people from starting to smoke and help every person who smokes quit.14

See the health and economic benefits of tobacco use interventions.

Physical inactivity

Not getting enough physical activity comes with high health and financial costs. It can lead to heart disease, type 2 diabetes, some cancers, and obesity.15 Physical inactivity also costs the nation $117 billion a year for related health care.16

Excessive alcohol use

Excessive alcohol use is responsible for 140,000 deaths in the United States each year, including 1 in 5 deaths among adults aged 20 to 49 years.1718 Binge drinking is responsible for over 40% these deaths.17 In 2010, excessive alcohol use cost the U.S. economy $249 billion, or $2.05 a drink, and $2 of every $5 of these costs were paid by the public.19 Three-quarters of these costs were due to binge drinking.

  1. Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Rand Corp.; 2017.
  2. National health expenditure data: historical. Center for Medicare & Medicaid Services. Updated December 13, 2023. Accessed February 6, 2024.
  3. Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999–2019 on CDC WONDER Online Database website. Accessed February 1, 2023.
  4. Mariotto AB, Enewold L, Zhao J, Zeruto CA, Yabroff KR. Medical care costs associated with cancer survivorship in the United States. Cancer Epidemiol Biomarkers Prev. 2020;29:1304–1312.
  5. Parker ED, Lin J, Mahoney T, et al. Economic costs of diabetes in the U.S. in 2022. Diabetes Care. 2023. doi: 10.2337/dci23-0085
  6. Ward ZJ, Bleich SN, Long MW, Gortmaker SL. Association of body mass index with health care expenditures in the United States by age and sex. PLoS One. 2021;16(3):e0247307.
  7. Fallon EA, Boring MA, Foster AL, et al. Prevalence of diagnosed arthritis—United States, 2019–2021. MMWR Morb Mortal Wkly Rep. 2023;72:1101–1107.
  8. Murphy LB, Cisternas MG, Pasta DJ, Helmick CG, Yelin EH. Medical expenditures and earnings losses among US adults with arthritis in 2013. Arthritis Care Res (Hoboken). 2018;70(6):869–876.
  9. Lo J, Chan L, Flynn S. A systematic review of the incidence, prevalence, costs, and activity and work limitations of amputation, osteoarthritis, rheumatoid arthritis, back pain, multiple sclerosis, spinal cord injury, stroke, and traumatic brain injury in the United States: a 2019 Update. Arch Phys Med Rehabil. 2021;102(1):115–131.
  10. Alzheimer's Association. 2023 Alzheimer's disease facts and figures. Alzheimers Dement. 2023;19(4).
  11. Moura LMVR, Karakis I, Zack MM, Tian N, Kobau R, Howard D. Drivers of US health care spending for persons with seizures and/or epilepsies, 2010-2018. Epilepsia. 2022;63(8):2144–2154.
  12. Righolt AJ, Jevdjevic M, Marcenes W Listl S. Global-, regional-, and country-level economic impacts of dental diseases. J Dent Res. 2018;97(5):501–507.
  13. Naavaal S, Kelekar U. Hours lost due to planned and unplanned dental visits among US adults. Health Behav Policy Rev. 2018;5(2):66–73.
  14. Xu X, Shrestha SS, Trivers KF, Neff L, Armour BS, King BA. U.S. healthcare spending attributable to cigarette smoking in 2014. Prev Med. 2021;150:106529.
  15. U.S. Department of Health and Human Services. Step It Up! The Surgeon General's Call to Action to Promote Walking and Walkable Communities. Office of the Surgeon General; 2015.
  16. Carlson SA, Fulton JE, Pratt M, Yang Z, Adams EK. Inadequate physical activity and health care expenditures in the United States. Prog Cardiovasc Dis. 2015;57:315–323.
  17. Centers for Disease Control and Prevention (CDC). Alcohol-Related Disease Impact (ARDI).
  18. Esser MB, Leung G, Sherk A, et al. Estimated deaths attributable to excessive alcohol use among US adults aged 20 to 64 years, 2015 to 2019. JAMA Netw Open. 2022;5(11):e2239485. doi: 10.1001/jamanetworkopen.2022.39485
  19. Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 national and state costs of excessive alcohol consumption. Am J Prev Med 2015;49(5):e73–e79.