Chronic Disease

Chronic diseases affect six out of ten American adults and are the leading cause of death and disability in the United States, yet many of these conditions can be prevented or effectively managed through healthy lifestyle choices and proper medical care.

Table of contents

• What is Chronic Disease?
• Common Chronic Diseases
• Risk Factors
• Who Is at Higher Risk
• Impact on Daily Life
• Prevention
• Living With Chronic Disease
• Economic and Health Burden

What is Chronic Disease?

Chronic diseases are health conditions that last one year or more and require ongoing medical attention, limit activities of daily living, or both^[1]. These conditions typically develop slowly over time and may persist for the rest of a person’s life^[7]. Unlike acute illnesses—short-term conditions like the flu or a cold that resolve within weeks—chronic diseases often cannot be cured completely, but they can be managed^[7].

The term “chronic disease” includes a wide range of conditions affecting different parts of the body. While the specific definition can vary across different organizations and fields, most agree that chronic conditions are characterized by complex causes, multiple risk factors, long periods between the onset of illness and feeling its effects, and functional impairment or disability^[8].

In medicine, chronic conditions are distinguished from acute ones by their duration and how they affect the body. An acute condition typically affects one portion of the body and responds to treatment, while a chronic condition usually affects multiple areas of the body, is not fully responsive to treatment, and persists for an extended period of time^[3].

Common Chronic Diseases

Several chronic diseases are particularly common and have significant impacts on health. The most prevalent chronic diseases in the United States include heart disease, stroke, cancer, type 2 diabetes, chronic obstructive pulmonary disease (COPD)—which includes emphysema and chronic bronchitis—asthma, Alzheimer’s disease, high blood pressure, and chronic kidney disease^[7].

According to the Centers for Disease Control and Prevention, chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States^[1]. Heart disease and cancer account for over half of all deaths in New York State alone^[2].

Other common chronic conditions include arthritis, obesity, depression, high cholesterol, HIV/AIDS, epilepsy, multiple sclerosis, and various autoimmune diseases^[3]. The list also encompasses conditions like Alzheimer’s disease, Crohn’s disease, cystic fibrosis, endometriosis, fibromyalgia, migraines, mood disorders, narcolepsy, Parkinson’s disease, sickle cell disease, and ulcerative colitis^[17].

Risk Factors

Many preventable chronic diseases are caused by a short list of risk behaviors: smoking, poor nutrition, physical inactivity, and excessive alcohol use^[1]. Understanding these risk factors is essential because they can often be modified to prevent or delay the development of chronic conditions.

Smoking

Cigarette smoking causes more than 480,000 deaths each year in the United States, and over 16 million Americans are living with a disease caused by smoking^[1]. Smoking is the leading cause of preventable death in the United States, causing nearly one in five deaths^[2]. It can lead to cancer, heart disease, stroke, lung diseases, diabetes, and COPD^[1].

Poor Nutrition and Physical Inactivity

Poor nutrition and physical inactivity are significant risk factors for obesity and other chronic diseases, such as type 2 diabetes, heart disease, stroke, certain cancers, and depression^[1]. Approximately two out of every three adult New Yorkers have either obese or overweight body mass index status^[2].

Excessive Alcohol Use

Over time, excessive alcohol use can lead to serious problems, including alcohol use disorder and problems with learning, memory, and mental health^[1]. Chronic health conditions linked to excessive alcohol use include high blood pressure, heart disease, stroke, liver disease, and some kinds of cancer^[1]. More than 8,000 New Yorkers die each year due to excessive alcohol use, shortening the lives of those who die by an average of 24 years^[2].

Who Is at Higher Risk

Three in four American adults have at least one chronic condition, and over half have two or more chronic conditions^[1]. Having more than one chronic condition is referred to as multimorbidity^[3]. The prevalence of chronic disease increases with age: among adults ages 65 and older, more than 90% have at least one chronic condition; among midlife adults ages 35 to 64, more than 75% have at least one condition; and among younger adults ages 18 to 34, 60% have at least one condition^[1].

Some groups are at higher risk of chronic diseases because of conditions where they are born, live, work, and age. These nonmedical factors, called social determinants of health, can be positive or negative^[1]. When they are negative, they limit the opportunities to make healthy choices and get good medical care. For example, some communities lack safe spaces like parks for people to be active, or grocery stores that sell fresh fruits and vegetables^[1]. In some rural areas, it’s hard to get medical care because of doctor shortages, hospital closures, or long distances to care^[1].

Social determinants of health, such as lack of access to safe and secure housing, quality education, affordable and nutritious food, and transportation, contribute to disparities in the burden of chronic diseases^[2].

Impact on Daily Life

Chronic illnesses commonly interfere with activities of daily living—things that seem ordinary like using the toilet, dressing, or feeding yourself^[12]. Not being able to do these tasks on your own can have a serious impact on your quality of life.

Chronic illness can be very disruptive to your life, often in ways other people don’t see. Time demands are significant: chronic illnesses can take up a lot of your time, including appointments to get a diagnosis, follow-up visits, or needing care unexpectedly^[12]. Financial strain is also common, as chronic conditions can be expensive and can make it harder to work, earn money, or keep insurance^[12].

Chronic illnesses can have a wide range of symptoms depending on which condition you have. Some common symptoms and effects include pain, physical limitations like trouble with muscle strength, balance, or coordination, fatigue, body changes, and risks of developing other conditions^[12]. People with chronic conditions also have a higher risk of mood disorders like depression or anxiety^[12].

Strained relationships can develop, as chronic illnesses can be very isolating. You might be afraid to make plans with people because you’re afraid your illness might interfere or force you to cancel^[12]. Depending on the condition or its effects, you might not be able to do certain things or might have to stop doing the activities you once enjoyed^[12].

Prevention

Many chronic diseases can be prevented or significantly delayed through healthy behaviors^[7]. Not all chronic diseases are preventable, but some conditions and their complications can be delayed or avoided by addressing common risk factors: tobacco use, poor nutrition, physical inactivity, and excessive alcohol use^[7].

Stopping smoking—or never starting—lowers the risk of serious health problems such as heart disease, cancer, type 2 diabetes, and lung disease, as well as premature death, even for longtime smokers^[11]. Eating healthy helps prevent, delay, and manage heart disease, type 2 diabetes, and other chronic diseases. A balanced, healthy dietary pattern includes a variety of fruits, vegetables, whole grains, lean protein, and low-fat dairy products and limits added sugars, saturated fats, and sodium^[11].

Regular physical activity can help you prevent, delay, or manage chronic diseases. Adults should aim for moderate intensity physical activity, like brisk walking or gardening, for at least 150 minutes a week, with muscle-strengthening activities two days a week^[11]. By not drinking too much alcohol, you can reduce health risks associated with excessive use^[11].

Getting regular screenings is also important. To prevent chronic diseases or catch them early, visit your doctor and dentist regularly for preventive services^[11]. Early detection and treatment help to improve outcomes^[7].

Living With Chronic Disease

If you have a chronic condition, it’s important to eat well, stay active, and follow your treatment plan. These steps can help you feel well and avoid complications^[10].

Following Your Treatment Plan

Once you’ve decided on a treatment plan with your doctor, make sure you understand their instructions about when and how to take medicines, what equipment you’ll need, and other important details^[10]. Taking your medicines as prescribed—the right dose at the right time and in the right way—is essential for managing your chronic conditions^[10].

Some treatment plans include checking your blood sugar, blood pressure, or other health numbers on a regular basis. Be sure to stay on schedule and reach out to your doctor if anything looks wrong^[10]. Schedule regular checkups with your doctor, as chronic diseases can affect your body in many different ways^[10].

Self-Management and Education

If you have a chronic disease, learning how to solve problems and make informed decisions about your health can empower you to live a healthier life^[10]. Self-management education programs can help you learn skills to manage symptoms of your condition, improve your eating and sleeping habits, reduce stress, and maintain a healthy lifestyle^[10].

Staying Active and Eating Well

Physical activity is one of the best things you can do to improve your health. If you have a chronic disease, regular activity can help you manage your condition and prevent complications^[10]. Staying active can immediately help you feel, function, and sleep better; help you stay independent and fit so you can complete daily tasks; help you control your weight; improve your mental health; and decrease pain and improve function if you have arthritis^[10].

Reaching Out for Support

Living with chronic illness can make you feel very alone^[17]. Sharing with and learning from people who have the same condition and feelings as you can help you cope with your own illness. Many organizations and hospitals run support groups, and there are also online blogs and discussion groups about many topics^[17].

You may find it hard to tell others that you have a chronic illness, but telling people about your illness can help keep you safe and ensure they understand what is going on with you^[17]. Let your loved ones and friends know how they can help you. Sometimes all you need is someone to talk to^[17].

Adapting to a New Normal

The most important lesson many people learn is that with debilitating, persistent conditions, there is no going back to exactly how things were before^[26]. Instead, you create a new normal that works in the context of your illnesses. Everyone, sick or healthy, has needs. Acknowledging and respecting them can be frustrating in the short term, but allows you to live better in the long term^[26].

Economic and Health Burden

Chronic diseases are the leading cause of illness, disability, and death in America^[1]. They are also leading drivers of the nation’s $4.9 trillion in annual health care costs^[1]. Sixty-three percent of all deaths worldwide are from chronic conditions^[3], and the World Health Organization attributes 38 million deaths a year to non-communicable diseases^[3].

More than 40% of New York adults suffer from a chronic disease, and six out of every 10 deaths in New York State are caused by chronic diseases^[2]. Although common and costly, many chronic diseases are also preventable through healthy lifestyle choices^[2].