Prevalence of Multiple Chronic Conditions Among US Adults, 2018

Peter Boersma, MPH; Lindsey I. Black, MPH; Brian W. Ward, PhD

Prev Chronic Dis. 2020;17(9):e106

Objective

In 2012, 25.5% of US adults had multiple (≥2) diagnosed chronic conditions among 10 different conditions: arthritis, cancer, chronic obstructive pulmonary disease (COPD), coronary heart disease, current asthma, diabetes, hepatitis, hypertension, stroke, and weak or failing kidneys.^[1,2] Compared with adults without chronic conditions, adults with multiple chronic conditions have worse health-related quality of life, higher health care costs, and increased risk of death.^[3–5] Using 2018 National Health Interview Survey (NHIS) data, we provide estimates of the prevalence of single and multiple chronic conditions among US adults.

1 2 3 4 5

Next Section

Table. Percentage and Number of US Adults Aged 18 Years or Older With Chronic Conditions, ^a by Select Characteristics, United States, 2018
Characteristic	0 Chronic Conditions		1 Chronic Condition		≥2 Chronic Conditions
Characteristic	% Population^b (95% CI)	N	% Population^b (95% CI)	N	% Population^b (95% CI)	N
Total^c	48.2 (47.3–49.1)	120,230	24.6 (23.9–25.3)	61,371	27.2 (26.5–27.9)	67,854
Sex^d
Male	49.8 (48.5–51.0)	59,921	24.4 (23.4–25.4)	29,346	25.9 (24.9–26.9)	31,175
Female	46.7 (45.6–47.9)	60,309	24.8 (23.9–25.7)	32,025	28.4 (27.5–29.4)	36,679
Race/ethnicity^e
Non-Hispanic White	43.8 (42.7–44.8)	68,839	25.6 (24.8–26.4)	40,248	30.6 (29.7–31.6)	48,202
Non-Hispanic Black	47.6 (45.0–50.2)	13,845	25.4 (23.3–27.6)	7,390	27.0 (25.0–29.1)	7,855
Non-Hispanic Asian	62.0 (58.6–65.2)	9,400	21.6 (19.0–24.4)	3,280	16.4 (14.0–19.0)	2,486
Hispanic	61.5 (59.3–63.5)	25,042	20.8 (19.1–22.5)	8,478	17.7 (16.2–19.3)	7,230
Age, y^d
18–44	72.6 (71.4–73.7)	83,444	20.7 (19.7–21.8)	23,841	6.7 (6.1–7.3)	7,723
45–64	36.6 (35.3–37.9)	30,404	30.4 (29.2–31.6)	25,250	33.0 (31.7–34.3)	27,383
≥65	12.4 (11.5–13.3)	6,382	23.9 (22.7–25.1)	12,280	63.7 (62.3–65.1)	32,748
Health insurance coverage^f
Age 18–64 y^d
Private	58.6 (57.5–59.8)	80,085	25.7 (24.7–26.7)	35,065	15.7 (14.9–16.5)	21,418
Public	48.9 (46.3–51.6)	12,192	23.4 (21.4–25.5)	5,830	27.6 (25.5–29.9)	6,886
Uninsured	66.8 (64.3–69.3)	17,059	21.6 (19.4–23.9)	5,511	11.6 (10.1–13.2)	2,995
Age ≥65 y^g
Private	12.4 (11.1–13.8)	2,633	24.4 (22.6–26.3)	5,190	63.2 (61.2–65.3)	13,451
Dual eligible	6.8 (4.6–9.6)	239	16.4 (13.0–20.1)	577	76.9 (72.5–80.8)	2,713
Medicare Advantage	11.9 (10.2–13.6)	1,556	25.2 (22.9–27.6)	3,300	63.0 (60.3–65.6)	8,257
Medicare only excluding Medicare Advantage	16.1 (13.6–18.8)	1,280	25.4 (22.2–28.9)	2,020	58.5 (54.8–62.1)	4,645
Location of residence^d
Urban	49.5 (48.5–50.5)	107,383	24.5 (23.7–25.2)	53,125	26.1 (25.3–26.9)	56,577
Rural	39.7 (37.3–42.1)	12,847	25.5 (23.8–27.2)	8,246	34.8 (32.8–37.0)	11,277

^aChronic conditions measured were arthritis, cancer, chronic obstructive pulmonary disease, coronary heart disease, current asthma, diabetes, hepatitis, hypertension, stroke, and weak/failing kidneys.
^bPopulation in 1,000s.
^cTotal 2018 US adult population: 249 million people. Numbers may not sum to group totals because of rounding.
^dDifference in estimates of multiple chronic conditions (≥2 conditions) between all subcategories was significant at P < .001.
^eWith the exception of Hispanic vs non–Hispanic Asian adults (P = .37), all other differences in estimates of multiple chronic conditions among racial/ethnic groups were significant (all P < .001 except for between non-Hispanic White and non-Hispanic Black adults [P = .002]).
^fHealth insurance coverage was based on a hierarchy of mutually exclusive categories (6).
^gWith the exception of private vs Medicare Advantage (P = .88), all other differences in estimates of multiple chronic conditions among adults aged ≥65 by insurance status were significant (all P < .001 except for between private and Medicare [P = .02] and between Medicare Advantage and Medicare [P = .04]).