Health and Economic Costs of Chronic Diseases
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.
Nothing kills more Americans than heart disease and stroke. More than 868,000 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 $214 billion per year and causing $138 billion in lost productivity on the job.3
More than 34.2 million Americans have diabetes, and another 88 million adults in the United States have a condition called prediabetes, which puts them at risk for type 2 diabetes. Diabetes can cause serious complications, including heart disease, kidney failure, and blindness. In 2017, the total estimated cost of diagnosed diabetes was $327 billion in medical costs and lost productivity.5
Arthritis affects 54.4 million adults in the United States, which is about 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 attributable to arthritis and related conditions was about $304 billion in 2013. Of this amount, nearly $140 billion was for medical costs and $164 billion was for indirect costs associated with lost earnings.7
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.
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. In 2016, health care spending for epilepsy was $8.6 billion in direct costs.9
Cavities (also called tooth decay) are one of the most common chronic diseases in the United States. One in five children aged 6 to 11 years and one in four 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 over $45 billion is lost in productivity due to dental disease.10,11
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 $225 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
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 icon[PDF – 392 KB]external icon. Santa Monica, CA: Rand Corp.; 2017.
2. Martin AB, Hartman M, Lassman D, Catlin A. National Health Care Spending In 2019: Steady Growth For The Fourth Consecutive Yearexternal icon. Health Aff. 2020;40(1):1-11.
4. National Cancer Institute. Cancer Prevalence and Cost of Care Projectionsexternal icon. Accessed June 29, 2018.
5. American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2017. Diabetes Care 2018;41(5):917-928. PubMed abstractexternal icon.
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 abstractexternal icon.
7. Centers for Disease Control and Prevention. The Cost of Arthritis in US Adults. Accessed June 29, 2018.
9. Dieleman JL, Cao J, Chapin A, Chen C, Li Z, Liu A, et al. US health care spending by payer and health condition, 1996-2016. JAMA 2020;323(9):863-884. PubMed abstractexternal icon.
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11. Naavaal S, Kelekar U. Hours lost due to planned and unplanned dental visits among US adultsexternal icon. Health Behav Policy Rev 2018; 5(2):66-73.
12. Xu X, Shrestha SS, Trivers KF, Neff L, Armour BS, King BA. U.S. healthcare spending attributable to cigarette smoking in 2014external icon. Prev. Med. 2021.
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 abstractexternal icon.