Chronic Disease

Disease states or conditions are either acute or chronic. This discussion is about chronic diseases. To be classified as a chronic disease, the condition must have some of the following characteristics: It is nonreversible, leaving the individual with a residual disability, and generally requires specialized treatment for a long period of time. Patient education is important to help the patient cope with the chronic condition. These conditions/diseases do not resolve spontaneously and are rarely cured completely.

The focus on treating chronic diseases, when possible, should be to work on prevention rather than treatment. Treatment is directed at keeping the condition under control rather than at a cure.

Understanding chronic disease and possible treatments is vital to developing a national policy to address the significant financial impact these conditions have on the amount of total health care dollars spent. In 1994, the medical costs of people with chronic diseases accounted for more than 60% ($400 billion annually) of all medical costs. These same conditions accounted for 70% of all deaths in the United States. The dramatic widespread impact of chronic diseases on society is felt because almost 75% of adults older than 65 have more than one chronic illness.

The Centers for Disease Control and Prevention (CDC) has pointed out that chronic diseases affect more than just health care dollars. These illnesses have financial, personal, and occupational costs that go beyond only health care expenditures. Unfortunately, the societal impact of these long-term conditions is rarely considered.

Examples of chronic diseases are Alzheimer's disease, arthritis, cancer, cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes, epilepsy, and osteoporosis. Because of their impact both socially and financially, these conditions have been the major beneficiaries of government financing, in the hope of finding cures for these “incurable” diseases.

Statistics are important in understanding the impact these conditions have on society. Researchers estimate that more than 1.5 million osteoporotic fractures occur each year. The direct health care expenditure for treating these fractures is $14 billion. About 2.3 million Americans require treatment for epilepsy. Diabetes affects 16 million Americans, and the condition also leads to blindness, renal failure, amputations, and heart disease. Diabetes costs society more than $98 billion yearly. Smoking leads to COPD, which causes more than 100,000 deaths yearly. Cardiovascular disease affects 58 million Americans. In 1999, the cost for treating these diseases was $287 billion. The American Cancer Society estimates that 8.4 million Americans have a history of cancer, with 1.2 million cases being diagnosed in 2000. Cancer is the second leading cause of death in the United States, with approximately 550,000 deaths per year. Arthritis affects 43 million Americans, with a cost of $65 billion annually in medical care and lost productivity. Alzheimer's disease affects more than 4 million people, with a cost of $152 billion.

The societal impact of chronic disease on society is monumental.