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Health and Economic Costs of Chronic Diseases

90% of the nation's $3.3 trillion in annual health care expenditures are for people with chronic and mental health conditions.

Chronic diseases have significant health and economic costs in the United States. Preventing chronic diseases, or managing symptoms when prevention is not possible, can reduce these costs.


Heart Disease and Stroke

nurse using blood pressure cuff on patient

Nothing kills more Americans than heart disease and stroke. More than 810,000 Americans die of heart disease or stroke every year—that’s one-third of all deaths. These diseases take an economic toll, as well, costing our health care system $190 billion per year and causing $126 billion in lost productivity on the job.3


woman sitting with hands on shoulders of female patient

Each year in the United States, more than 1.7 million people are diagnosed with cancer, and almost 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 almost $174 billion by 2020.”4


fruits, veggies, measuring tape, sugar level reading

More than 29 million Americans have diabetes, and another 86 million adults in the United States have a condition called prediabetes, which puts them at risk for type 2 diabetes. Diabetes can cause heart disease, kidney failure, and blindness, and costs the US health care system and employers $245 billion every year.5


scale and measuring tape

Obesity affects almost 1 in 5 children and 1 in 3 adults, putting people at risk for chronic diseases such as diabetes, heart disease, and some cancers. Over a quarter of all Americans 17 to 24 years are too heavy to join the military. Obesity costs the US health care system $147 billion a year.6


portrait of senior couple jogging on the beach

Arthritis affects 54.4 million adults in the United States, which is more than 1 in 4 adults. It is a leading cause of work disability in the United States, one of the most common chronic conditions, and a common cause of chronic pain. The total cost of arthritis and related conditions was about $304 billion in 2013. Of this amount, nearly $140 billion was for direct medical costs and $164 billion was for indirect costs associated with lost earnings.7

Alzheimer's Disease

Shaking elderly hands

Alzheimer’s disease, a type of dementia, is an irreversible, progressive brain disease that affects about 5.7 million Americans. It is the sixth leading cause of death among all adults and the fifth leading cause for those aged 65 or older. In 2010 , the costs of treating Alzheimer’s disease were estimated to fall between $159 billion and $215 billion.8 By 2040, these costs are projected to jump to between $379 billion and $500 billion annually.


Medical expert reviewing images of head

In the United States, about 3 million adults and 470,000 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. The total direct cost of epilepsy in the United States is estimated to be $15.5 billion yearly.9

Tooth Decay

child with toothbrush under water faucet

Cavities (also called tooth decay) are one of the most common chronic conditions in the United States. More than 40% of adults have felt pain in their mouth in the last year. About 20% of children aged 5 to 11 and 13% of adolescents aged 12 to 19 have at least one untreated decayed tooth. Applying dental sealants in schools to the nearly 7 million low-income children who don’t have them could prevent more than 3 million cavities and save up to $300 million in dental treatment costs.10,11

Risk Factors

Cigarette Smoking

chalkboard writing

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 $170 billion in direct medical costs that could be saved every year if we could prevent youth from starting to smoke and help every person who smokes quit.12

Lack of Physical Activity

young woman sitting on couch with remote control in hand

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. In addition, lack of physical activity costs the nation $117 billion annually for related health care.13

Excessive Alcohol Use

alcohol drinks

Excessive alcohol use is responsible for 88,000 deaths in the United States each year, including 1 in 10 deaths among working-age adults. 14,15 In 2010, excessive alcohol use cost the US economy $249 billion, or $2.05 a drink, and $2 of every $5 of these costs were paid by the public. Binge drinking is responsible for over half the deaths and three-quarters of the costs due to excessive alcohol use.16


1. Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States [PDF – 392 KB]. Santa Monica, CA: Rand Corp.; 2017.

2. Center for Medicare & Medicaid Services. National Health Expenditure Data for 2016—Highlights [PDF – 74 KB].

3. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart disease and stroke statistics—2017 update: a report from the American Heart Association. Circulation 2017;135:e1–e458.

4. National Cancer Institute. Cancer Prevalence and Cost of Care Projections. Accessed June 29, 2018.

5. American Diabetes Association. The Cost of Diabetes. Accessed June 29, 2018.

6. 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. PubMed abstract.

7. Centers for Disease Control and Prevention. The Cost of Arthritis in US Adults. Accessed June 29, 2018.

8. Hurd MD, Martorell P, Delavande A, Mullen KJ, Langa KM. Monetary costs of dementia in the United States. N Engl J Med 2013;368(14):1326-34.

9. Institute of Medicine. Epilepsy Across the Spectrum: Promoting Health and Understanding. Washington, DC: The National Academies Press; 2012. NCBI excerpt.

10. Centers for Disease Prevention and Control. Vital signs: dental sealant use and untreated tooth decay among U.S. school-aged children. MMWR 2016;65(41):1141–1145. Accessed February 20, 2018.

11. Centers for Disease Control and Prevention. Dental Sealants Prevent Cavities—Vital Signs website. [PDF – 2 MB]. Accessed January 4, 2018.

12. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General[PDF – 36 MB]. Atlanta, GA: US Dept. of Health and Human Services, Centers for Disease Control and Prevention; 2014. Accessed June 29, 2018.

13. U.S. Department of Health and Human Services. Step It Up! The Surgeon General’s Call to Action to Promote Walking and Walkable Communities. Washington, DC: Office of the Surgeon General; 2015.

14. Centers for Disease Control and Prevention (CDC). Alcohol-Related Disease Impact (ARDI). Atlanta, GA: CDC.

15. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis 2014;11:130293.

16. Kanny D, Naimi TS, Liu Y, Lu H, Brewer RD. Annual Total Binge Drinks Consumed by U.S. Adults, 2015. Am J Prev Med. 2018;54(4):486-496. PubMed abstract.

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