Prevalence of Multiple Chronic Conditions Among US Adults, 2018

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

Disclosures

Prev Chronic Dis. 2020;17(9):e106 

In This Article

Discussion

In 2018, just over a quarter (27.2%) of US adults had multiple chronic conditions. This finding is consistent with previous research that found the prevalence to be 25.5% in 2012, 26.0% in 2010, and 21.8% in 2001.[1,10] In 2018, prevalence of multiple chronic conditions was higher among women, non-Hispanic white adults, older adults, adults aged 18–64 on Medicaid, dual-eligible adults (Medicare and Medicaid), and adults in rural areas. These disparities were similar to those identified in previous research, which found a higher prevalence among women, older adults, and adults on public insurance but did not examine prevalence by location of residence or separate insurance status by age.[1,10]

This study has several limitations. First, although NHIS data are nationally representative of the civilian, noninstitutionalized population, the exclusion of institutionalized adults, particularly those in long-term care settings, may lead to underreporting of the prevalence of chronic conditions. Second, NHIS captures only 10 of the 20 chronic conditions outlined by the US Department of Health and Human Services.[2] However, it is important to note that this is the first report on overall prevalence to use the expanded definition of COPD, which now includes a question that asks explicitly about diagnosed COPD in addition to questions that ask about diagnosed emphysema and chronic bronchitis.[7] Third, data are based on self-report of diagnosed conditions, which may result in recall bias. Lastly, NHIS collects data only on diagnosed conditions, so undiagnosed conditions are not recorded.

We found that nearly 30% of the US adult population has multiple chronic conditions. This work builds on previous research and provides current estimates of the prevalence using a nationally representative sample. These findings may allow for an expanded understanding of the epidemiology of multiple chronic conditions by providing estimates of overall burden and identifying high-risk subgroups.

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