Abstract
Having multiple (two or more) chronic conditions (MCC) is associated with an increased risk of mortality and functional decline, health resource utilization, and healthcare expenditures. As a result, understanding the prevalence of MCC is increasingly being recognized as a public health imperative. This research describes the prevalence and distribution of adults with MCC across the United States using 2017 data from the Behavioral Risk Factors Surveillance System (BRFSS). Prevalence of MCC was calculated for each U.S. state and territory overall, by sex and by age. Additionally, the most common condition dyads (two condition combinations) and triads (three condition combinations) were assessed for each state. Prevalence of MCC ranged from 37.9% in the District of Columbia to 64.4% in West Virginia. Females had a higher prevalence than males in 47 of 53 states and territories, and MCC prevalence increased with age in every state and territory. Overall prevalence estimates were higher than estimates using data from the National Health Interview Survey (NHIS), especially in the younger population (aged 18–44), due partly to the inclusion of high cholesterol, obesity, and depression as chronic conditions. Analysis of the most prevalent dyads and triads revealed the greatest state-by-state variability in the 18-44-year-old population. Multiple states’ most prevalent dyads and triads for this population included obesity and depression. These findings build an accurate picture of the prevalence of multiple chronic conditions across the United States and will aid public health officials in creating programs targeted to their region.
Highlights
Individuals living with multiple chronic conditions (MCC) face significant and unique challenges
We defined a person as having MCC if they reported ever having been diagnosed with 2 or more of the 12 chronic conditions collected by Behavioral Risk Factors Surveillance System (BRFSS): arthritis, asthma, cancer, chronic obstructive pulmonary disease (COPD), depression, diabetes, heart disease, high blood pressure, high cholesterol, kidney disease, obesity, stroke
We coded an individual as having MCC if they reported ever having been diagnosed with 2 or more of the 12 chronic conditions collected by BRFSS
Summary
Individuals living with multiple (two or more) chronic conditions (MCC) face significant and unique challenges. MCC are associated with an increased risk of mortality and functional decline,[1,2] and negative impacts on quality of life.[3] MCC are associated with increased health resource utilization,[4] disproportionately high use of specialist services,[5] more complex physician visits,[6] and increased overall health expenditures.[4,7,8]. As a result, characterizing the prevalence MCC is becoming increasingly recognized as a public health imperative. In 2011, the U.S Department of Health and Human Services (HHS).
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