1. The Costs of Chronic Disease
Jack Zwanziger
School of Public Health
UIC

2. Overview of Chronic Disease in the United States
Cancer
Cardiovascular Disease
Diabetes
Tobacco
Overweight and Obese
Deaths/yr
570,280
927,000
200,000
440,000
112,000
Current # affected
1.4 million
71.3 million
18.2 million
45.8 million smokers
60 million adults, 9 million kids
Direct medical costs
$69 billion
$273 billion
$92 billion
$75 billion
$61 billion
Indirect medical costs
$120 billion
$130 billion
$40 billion
$80 billion
$56 billion
Total costs
$189 billion
$403 billion
$132 billion
$150 billion
$117 billion
Sources: Centers for Disease Control, American Cancer Society, American Heart Association

3. Summary
Chronic diseases account for 70% of all deaths in the United States. 
The medical care costs of people with chronic diseases account for more than 75% of the nation’s $1.4 trillion medical care costs. 
Chronic diseases account for one-third of the years of potential life lost before age 65. 
Chronic diseases increase with age  

4. Diabetes by Age
Estimated total prevalence of diabetes in people aged 20 years or older, by age group— United States, 2005
Source: CDC, 1999–2002 National Health and Nutrition Examination Survey estimates of total prevalence (both diagnosed and undiagnosed) were projected to year 2005.

5. Diabetes Prevalence
Prevalence of Diagnosed Diabetes by Age, United States, 1980–2004
Source: CDC, National Center for Chronic Disease Prevention and Health Promotion

6. Prevalence of Cardiovascular Diseases in Americans Age 20 and Older by Age and Sex
Source: NHANES: CDC/NCHS and NHLBI. Includes coronary heart disease, heart failure, stroke and hypertension.

7. Estimated Per Capita Health Expenditures, by Age and Sex, 1995
Source: CDC National Center for Chronic Disease Prevention and Health Promotion, citing: From Baby Boom to Elder Boom: Providing Health Care for an Aging Population. Copyright 1996, Watson Wyatt Worldwide.

8. U.S. Population Projections 2000- 2030 (in thousands)
Age
Group
2000
2010
2020
2030
Numerical
change
Percent
Change
Total
275,306
299,862
324,927
351,070
75,764
27.5%
0-9
38,646
39,537
43,354
46,028
7,382
19.1%
10-19
39,805
41,576
42,370
46,615
6,810
17.1%
20-29
36,379
41,000
42,404
43,738
7,359
20.2%
30-39
41,856
38,041
42,438
44,343
2,487
5.9%
40-49
42,519
42,631
38,807
43,405
886
2.1%
50-59
30,589
41,111
41,216
37,770
7,181
23.5%
60-69
20,113
28,411
38,294
38,697
18,584
92.4%
70-79
16,175
16,170
23,348
31,907
15,732
97.3%
80-84
4,913
5,600
6,024
9,638
4,725
96.2%
85+
4,313
5,786
6,764
8,930
4,617
107.0%
Source: Population Projections Program, Population Division, U.S. Census Bureau, Internet Release Date January 13, 2000

9. Illinois Population Projections 2000-2030
Age
Group
2000
2010
2020
2030
Numeric
Change
Percent
Total
12,419,293
12,916,894
13,236,720
13,432,892
1,013,599
8.2%
0-9
1,806,407
1,821,434
1,858,071
1,841,184
34,777
1.9%
10-19
1,799,099
1,736,411
1,738,728
1,765,730
-33,369
-1.8%
20-29
1,742,602
1,845,778
1,763,871
1,768,679
26,077
1.5%
30-39
1,916,801
1,747,374
1,811,423
1,739,216
-177,585
-9.3%
40-49
1,860,796
1,829,635
1,662,800
1,718,361
-142,435
-7.6%
50-59
1,330,677
1,693,746
1,649,565
1,504,144
173,467
13.0%
60-69
860,329
1,108,377
1,387,092
1,346,350
486,021
56.5%
70-79
691,752
643,938
843,230
1,061,076
369,324
53.4%
80-84
218,799
230,824
233,527
336,211
117,412
53.7%
85+
192,301
259,377
288,413
351,941
159,640
83.0%
Source: U.S Census Bureau, Population Division, Interim State Population Projections, Internet Release Date: April 21, 2005

10. Projecting costs Basic assumptions
8% underlying growth in healthcare costs (based on 25 years experience)
Relative expenditures by age groups remain the same
National and Illinois census projections
Nationally, average costs would increase by ~7.7 X (2005 vs 2030); even without aging it would increase by 6.5X
Illinois average costs would increase by ~7.6X
During the same period the overall economy would be expected to increase by %

11. Implications The rates of increases are unsustainable
Aging will accelerate health care cost increases
Illinois with relatively low population growth and rapidly aging population will face an even greater challenge over the long term
Cost savings must be generated from reductions in chronic disease costs (the Willie Sutton principle)