 Chronic Disease and Health Costs: A Snapshot for State Legislatures
Published 2005 Introduction
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Chronic diseases—including heart disease, stroke, diabetes and cancer—are among the leading causes of disability and death in the United States. Chronic diseases account for 70 percent of deaths and about 78 percent of health spending. Costs of treating chronic diseases fall disproportionately on state-run Medicaid programs and on the federal Medicare program. This means that taxpayers and policymakers have a large stake in preventing and controlling chronic diseases. In 2000, about 60 million Americans had multiple chronic conditions. - 23 percent of Americans had one chronic condition, accounting for an estimated 20 percent of health care costs;
- 11 percent had two chronic conditions, accounting for 18 percent of health care costs; and
- 10 percent had from three to five chronic conditions, accounting for about 40 percent of health care costs.
Many chronic diseases and their debilitating and costly effects can be prevented, delayed or lessened if people adopt healthy behaviors such as eating a healthy diet, exercising regularly, and refraining from tobacco use and excessive alcohol use. State policymakers promote health by supporting health education initiatives; improving access to recommended health screenings, patient counseling and health care services; and improving opportunities for physical activity. The Healthy People 2010 initiative, a nationwide health promotion and disease prevention agenda sponsored by the U.S. Department of Health and Human Services, has two overarching goals: - To increase quality and years of healthy life, and
- To eliminate health disparities.
The initiative lists 28 focus areas, including heart disease and stroke, cancer, diabetes, nutrition and overweight, physical activity and fitness, and tobacco use. States play a number of roles in preventing and treating chronic disease, such as: - Promoting health education and prevention activities.
- Sponsoring screening and treatment programs.
- Ensuring that state employees, Medicaid patients and others in state-funded programs receive appropriate education, screening and treatment.
- Supporting or requiring physical education in schools.
- Encouraging or requiring nutrition education and healthy foods in schools.
- Promoting physical activity through community design and recreational activities.
- Enacting insurance incentives or coverage requirements.
- Addressing access issues related to healthy foods, such as neighborhood grocery stores and farmers’ markets.
- Encouraging efforts to promote health and prevent or manage chronic conditions.
- Working with employers to promote wellness among employees and their families.
The intent of this booklet is to help legislators and legislative staff gain a better understanding of chronic diseases, their associated costs, key risk factors for developing many chronic diseases, and to offer suggestions about what states can do to help prevent or reduce their incidence. posted 3/10/2006 
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