Percentage Of Middle Age And Older Adults With Multiple Chronic Conditions Rose Significantly Over Ten Years

from Spencer’s Benefits Reports: Between 1999-2000 and 2009-2010, the percentage of adults aged 45-64 and 65 and over with two or more of nine selected chronic conditions increased for both men and women, all racial and ethnic groups examined, and most income groups, the National Center for Health Statistics of the Centers for Disease Control and Prevention found. In 2009–2010, 21 percent of adults aged 45-64 and 45 percent of adults aged 65 and over had been diagnosed with two or more chronic conditions, compared with 16.1 percent and 37.2 percent, respectively in 1999-2000, the NCHS Data Brief, Multiple Chronic Conditions Among Adults Aged 45 and Over: Trends Over the Past 10 Years, found. The Data Brief is based on data from the National Health Interview Survey, 1999–2000 and 2009–2010.

The prevalence of two or more chronic conditions for both age groups of adults decreased with rising family income, but among those aged 65 and over the prevalence varied less by family income than among those aged 45-64, where it was more than twice as high among those living in poverty as among those at 400 percent or more of the poverty level.

During the ten-year period, the percentage of adults aged 65 and over with both hypertension and diabetes rose from 9 percent to 15 percent; prevalence of hypertension and heart disease increased from 18 percent to 21 percent; and prevalence of hypertension and cancer increased from 8 percent to 11 percent. For adults age 45 through 64 during the same ten-year period, prevalence of hypertension increased from 35 percent to 41 percent, diabetes from 10 percent to 15 percent, and cancer from 9 percent to 11 percent. However, the NCHS acknowledges that because this report includes only respondent-reported information of a physician diagnosis, estimates may be understated due to missing undiagnosed chronic conditions.

Needed Medical Care

In 2009-2010, the percentage of adults aged 45-64 with two or more of nine selected chronic conditions who did not receive or delayed needed medical care due to cost increased from 17 percent to 23 percent, and the percentage who did not receive needed prescription drugs due to cost increased from 14 percent to 22 percent. For adults aged 65 and over with two or more chronic conditions, there was no change in the percentage who did not receive or delayed needed medical care due to cost, while the percentage who did not receive needed prescription drugs in the past year increased over the ten-year period.

Studies suggest that the presence of multiple chronic conditions adds a layer of complexity to disease management, the NCHS noted. Recently the U.S. Department of Health and Human Services established a strategic framework for improving the health of this population. The conditions examined were the following: hypertension, heart disease, diabetes, cancer, stroke, chronic bronchitis, emphysema, current asthma, and kidney disease. Examining trends in the prevalence of multiple chronic conditions informs policy on chronic disease management and prevention, and helps to predict future health care needs and use for Medicare and other payers, the NCHS noted.

The prevalence of obesity—a risk factor for certain types of heart disease and cancer, hypertension, stroke, and diabetes—increased in the United States over the past 30 years, but has leveled off in recent years, the NCHS observed. “Advances in medical treatments and drugs are contributing to increased survival for persons with some chronic conditions. During this ten-year period, death rates for heart disease, cancer, and stroke declined. In recent years, the percentage of Americans who were aware of their hypertension, and the use of hypertension medications, has increased.

“The rising prevalence of multiple chronic conditions has implications for the financing and delivery of health care. Persons with multiple chronic conditions are more likely to be hospitalized, fill more prescriptions have higher annual prescription drug costs, more physician visits, and higher out-of-pocket spending is higher for persons with multiple chronic conditions.

“Chronic disease, and combinations of chronic diseases, affects individuals to varying degrees and may impact an individual’s life in different ways. The increasing prevalence of multiple chronic conditions presents a complex challenge to the U.S. health care system, both in terms of quality of life and expenditures for an aging population,” the NCHS Data Brief concluded.

For more information, visit http://www.cdc.gov/nchs/data/databriefs/db100.htm.

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