At a glance
Chronic diseases account for most illness, disability, and death in the United States and are the leading drivers of health care costs.
![Health and Economic Costs a stethoscope on a pile of hundred dollar bills](/chronic-disease/media/images/Health-and-Economic-Costs-1.png)
The impact of chronic diseases in America
Ninety percent of the nation's $4.5 trillion in annual health care expenditures are for people with chronic and mental health conditions.12 Interventions to prevent and manage these diseases can have significant health and economic benefits.
Diseases
Heart disease and stroke
Nothing kills more Americans than heart disease and stroke. More than 944,800 Americans die of heart disease or stroke every year—that's more than 1 in 3 deaths.3 These diseases take an economic toll, as well, costing our health care system $254 billion per year and causing $168 billion in lost productivity on the job.4 Costs from cardiovascular diseases are projected to hit roughly $2 trillion by 2050.5
See the health and economic benefits of high blood pressure interventions.
Cancer
Each year in the United States, 1.7 million people are diagnosed with cancer, and more than 600,000 die from it, making it the second leading cause of death.6 The cost of cancer care continues to rise and is expected to reach more than $240 billion by 2030.7
See the health and economic benefits of interventions for breast cancer, cervical cancer, colorectal cancer, and skin cancer.
Diabetes
More than 38 million Americans have diabetes, and another 98 million adults in the United States have prediabetes, which puts them at risk for type 2 diabetes.8 Diabetes can cause serious complications, including heart disease, kidney failure, and blindness. In 2022, the total estimated cost of diagnosed diabetes was $413 billion in medical costs and lost productivity.9
See the health and economic benefits of diabetes interventions.
Obesity
Obesity affects 20% of children and 42% of adults, putting them at risk of chronic diseases such as type 2 diabetes, heart disease, and some cancers.10 Just over 1 in 3 young adults aged 17 to 24 are too heavy to join the U.S. military.11 Obesity costs the U.S. health care system nearly $173 billion a year.12
Arthritis
Arthritis affects 53.2 million adults in the United States, which is about 1 in 5 adults.13 It is a leading cause of disability in the United States, and a leading cause of chronic pain.13 Arthritis-attributable medical costs and earning losses were over $300 billion in 2013.14
Alzheimer's disease
Alzheimer's disease, a type of dementia, is an irreversible, progressive brain disease that affects nearly 7 million Americans, including 1 in 9 adults aged 65 and older. Two-thirds of these older adults (4.2 million) are women. Deaths due to Alzheimer's disease more than doubled between 2000 and 2021, increasing 141%. The cost of caring for people with Alzheimer's and other dementias is an estimated $360 billion in 2024, with projected increases to nearly $1 trillion (in today's dollars) by 2050.15
Epilepsy
In the United States, about 3 million adults and about half a million children and teens younger than 18 have active epilepsy—meaning that they have been diagnosed by a doctor, are taking epilepsy medicines, had a recent seizure, or both.16 Adults with epilepsy report worse physical and mental health, and more work limitations c compared to adults without epilepsy.16 In 2019, total health care costs (epilepsy-attributable and other health-related costs) for noninstitutionalized people with epilepsy was $13.4 billion, of which $5.4 billion were directly attributable to epilepsy.17
Tooth decay
Cavities (also called tooth decay) are one of the most common chronic diseases in the United States. One in six children aged 6 to 11 years and 1 in 4 adults have untreated cavities.18 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 almost $46 billion is lost in productivity due to dental disease.1920
See the health and economic benefits of oral disease interventions.
Risk Factors
Cigarette smoking
More than 16 million Americans have at least one disease caused by cigarette smoking.21 This amounts to more than $240 billion in health care spending that could be reduced every year if we could prevent young people from starting to smoke and help every person who smokes to quit.22
See the health and economic benefits of tobacco use interventions.
Physical inactivity
Not getting enough physical activity comes with high health and financial costs. It can lead to heart disease, type 2 diabetes, some cancers, and obesity.23 Physical inactivity also costs the nation $117 billion a year for related health care.24
Excessive alcohol use
Excessive alcohol use is responsible for 178,000 deaths in the United States each year, including 1 in 5 deaths among adults aged 20 to 49 years.2526 Binge drinking is responsible for over one-third these deaths.25 In 2010, excessive alcohol use cost the U.S. economy $249 billion, or $2.05 a drink, and $2 of every $5 of these costs were paid by the public.27 Three-quarters of these costs were due to binge drinking.
- Buttorff C, Ruder T, Bauman M. Multiple Chronic Conditions in the United States. Rand Corp.; 2017.
- National health expenditure data: historical. Center for Medicare & Medicaid Services. Updated December 13, 2023. Accessed February 6, 2024. https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/historical
- Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 2018-2022 on CDC WONDER Online Database website. Reviewed April 26, 2024. Access May 3, 2024. http://wonder.cdc.gov/mcd.html
- Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics—2023 update: a report from the American Heart Association. Circulation. 2023;147(8):e93–e621.
- Kazi D, Elkind M, Deutsch A, Dowd W, et al. Forecasting the economic burden of cardiovascular disease and stroke in the United States through 2050: a presidential advisory from the American Heart Association. Circulation. 2024;149:e00–e00. doi: 10.1161/CIR.0000000000001258
- Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on 2021 submission data (1999–2021): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, and National Cancer Institute. Updated June 2024. Accessed July 2024. www.cdc.gov/cancer/dataviz
- Mariotto AB, Enewold L, Zhao J, Zeruto CA, Yabroff KR. Medical care costs associated with cancer survivorship in the United States. Cancer Epidemiol Biomarkers Prev. 2020;29:1304–1312.
- Centers for Disease Control and Prevention. Diabetes Statistics Report. U.S. Dept of Health and Human Services; 2023. https://www.cdc.gov/diabetes/php/data-research/index.html
- Parker ED, Lin J, Mahoney T, et al. Economic costs of diabetes in the U.S. in 2022. Diabetes Care. 2023. doi: 10.2337/dci23-0085
- Stierman B, Afful J, Carroll M, et al. National Health and Nutrition Examination Survey 2017–March 2020 Prepandemic Data Files Development of Files and Prevalence Estimates for Selected Health Outcomes. National Health Statistics Reports; 2021(158). https://stacks.cdc.gov/view/cdc/106273/cdc_106273_DS1.pdf
- Unfit to Serve: Obesity Is Impacting National Security. Center sfor Disease Control and Prevention; 2022. https://stacks.cdc.gov/view/cdc/106273/cdc_106273_DS1.pdf
- Ward ZJ, Bleich SN, Long MW, Gortmaker SL. Association of body mass index with health care expenditures in the United States by age and sex. PLoS One. 2021;16(3):e0247307
- Fallon EA, Boring MA, Foster AL, et al. Prevalence of diagnosed arthritis — United States, 2019–2021. MMWR Morb Mortal Wkly Rep. 2023;72:1101–1107.
- Murphy LB, Cisternas MG, Pasta DJ, Helmick CG, Yelin EH. Medical expenditures and earnings losses among US adults with arthritis in 2013. Arthritis Care Res (Hoboken). 2018;70(6):869–876.
- Alzheimer's Association. 2024 Alzheimer's disease facts and figures. Alzheimers Dement. 2024; 20(5).
- Karakis I, Boualam N, Moura LMVR; Howard DH. Quality of life and functional limitations in persons with epilepsy. Epilepsy Res. 2023(190):107084.
- Moura LMVR, Karakis I, Zack MM, Tian N, Kobau R, Howard D. Drivers of US health care spending for persons with seizures and/or epilepsies, 2010-2018. Epilepsia. 2022;63(8):2144–2154.
- Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. U.S. Dept of Health and Human Services; 2019. https://www.cdc.gov/oral-health/php/data-research/2019-oral-health-surveillance-report/index.html
- Righolt AJ, Jevdjevic M, Marcenes W Listl S. Global-, regional-, and country-level economic impacts of dental diseases. J Dent Res. 2018;97(5):501–507.
- Naavaal S, Kelekar U. Hours lost due to planned and unplanned dental visits among US adults. Health Behav Policy Rev. 2018;5(2):66–73.
- Centers for Disease Control and Prevention. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. U.S. Depart of Health and Human Services; 2014.
- Xu X, Shrestha SS, Trivers KF, Neff L, Armour BS, King BA. U.S. healthcare spending attributable to cigarette smoking in 2014. Prev Med. 2021;150:106529.
- U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, second edition. Office of Disease Prevention and Health Promotion; 2018.
- Carlson SA, Fulton JE, Pratt M, Yang Z, Adams EK. Inadequate physical activity and health care expenditures in the United States. Prog Cardiovasc Dis. 2015;57:315–323.
- Alcohol-Related Disease Impact (ARDI) web tool. Centers for Disease Control and Prevention. https://nccd.cdc.gov/DPH_ARDI/default/default.aspx
- Esser MB, Leung G, Sherk A, et al. Estimated deaths attributable to excessive alcohol use among US adults aged 20 to 64 years, 2015 to 2019. JAMA Netw Open. 2022;5(11):e2239485. doi: 10.1001/jamanetworkopen.2022.39485
- Sacks JJ, Gonzales KR, Bouchery EE, Tomedi LE, Brewer RD. 2010 national and state costs of excessive alcohol consumption. Am J Prev Med 2015;49(5):e73–e79.