Chronic condition


A chronic condition, also known as chronic disease or chronic illness, is a health condition or disease that is persistent or otherwise long-lasting in its effects or a disease that comes with time. The term chronic is often applied when the course of the disease lasts for more than three months. Common chronic diseases include diabetes, functional gastrointestinal disorder, eczema, arthritis, asthma, chronic obstructive pulmonary disease, autoimmune diseases, genetic disorders and some viral diseases such as hepatitis C and acquired immunodeficiency syndrome. An illness which is lifelong because it ends in death is a terminal illness. It is possible and not unexpected for an illness to change in definition from terminal to chronic as medicine progresses. Diabetes and HIV for example were once terminal yet are now considered chronic, due to the availability of insulin for diabetics and daily drug treatment for individuals with HIV, which allow these individuals to live while managing symptoms.
In medicine, chronic conditions are distinguished from those that are acute. An acute condition typically affects one portion of the body and responds to treatment. On the other hand, a chronic condition usually affects multiple areas of the body, is not fully responsive to treatment, and persists for an extended period of time. Chronic conditions may have periods of remission or relapse where the disease temporarily goes away, or subsequently reappear. Periods of remission and relapse are commonly discussed when referring to substance abuse disorders which some consider to fall under the category of chronic condition.
Chronic conditions are often associated with non-communicable diseases, which are distinguished by their non-infectious causes. Some chronic conditions are caused by transmissible infections such as HIV/AIDS. 63% of all deaths worldwide are from chronic conditions. Chronic diseases constitute a major cause of mortality, and the World Health Organization attributes 38 million deaths a year to non-communicable diseases. In the United States approximately 40% of adults have at least two chronic conditions. Having more than one chronic condition is referred to as multimorbidity.

Types

Chronic conditions have often been used to describe the various health related states of the human body such as syndromes, physical impairments, disabilities as well as diseases. Epidemiologists have found interest in chronic conditions due to the fact they contribute to disease, disability, and diminished physical and/or mental capacity. For example, high blood pressure or hypertension is considered to be not only a chronic condition itself but also correlated with diseases such as heart attack or stroke. Researchers, particularly those studying the United States, utilize the Chronic Condition Indicator which maps ICD codes as "chronic" or "non-chronic". The list below includes these chronic conditions and diseases. In 2015, the World Health Organization produced a report on non-communicable diseases, citing the four major types as:
Other examples of chronic diseases and health conditions include:
While risk factors vary with age and gender, many of the common chronic diseases in the US are caused by dietary, lifestyle and metabolic risk factors. Therefore, these conditions might be prevented by behavioral changes, such as quitting smoking, adopting a healthy diet, and increasing physical activity. Social determinants are important risk factors for chronic diseases. Social factors, e.g., socioeconomic status, education level, and race/ethnicity, are a major cause for the disparities observed in the care of chronic disease. Lack of access and delay in receiving care result in worse outcomes for patients from minorities and underserved populations. Those barriers to medical care complicate patients monitoring and continuity in treatment. In the US, minorities and low-income populations are less likely to seek, access and receive preventive services necessary to detect conditions at an early stage.
The majority of US health care and economic costs associated with medical conditions are incurred by chronic diseases and conditions and associated health risk behaviors. Eighty-four percent of all health care spending in 2006 was for the 50% of the population who have one or more common chronic medical conditions. There are several psychosocial risk and resistance factors among children with chronic illness and their family members. Adults with chronic illness were significantly more likely to report life dissatisfaction than those without chronic illness. Compared to their healthy peers, children with chronic illness have about a twofold increase in psychiatric disorders. Higher parental depression and other family stressors predicted more problems among patients. In addition, sibling problems along with the burden of illness on the family as a whole led to more psychological strain on the patients and their families.
Africa
African countries are currently grappling with a double health burden—while infectious diseases continue to be a major cause of death, chronic illnesses are increasingly becoming more deadly, particularly in sub-Saharan Africa. This region reports some of the highest chronic disease mortality rates globally, impacting both men and women alike.
The surge in chronic conditions such as diabetes, hypertension, and cardiovascular disease is being driven by poor lifestyle choices like unhealthy diets, physical inactivity, smoking, and obesity. These modifiable behaviors are becoming widespread across both rural and urban areas. In addition to lifestyle factors, genetics also plays a role in the region's chronic disease profile, particularly for conditions like high blood pressure and diabetes. Compounding the problem is the state of healthcare systems, which often lack the infrastructure, funding, and public awareness needed to respond effectively to this growing crisis.
Asia
Asia's chronic disease burden is rising sharply, driven by a mix of aging populations, genetic predispositions, and fast-paced urbanization. The transition to more sedentary lifestyles and Westernized diets brought on by industrialization and economic growth—has contributed significantly to the growing number of non-communicable diseases. South Asians, in particular, are at greater risk, developing these conditions earlier in life and often at lower body weights compared to global norms, resulting in higher healthcare costs and lower productivity. Tobacco use remains a critical risk factor across South Asia, with a strong link to chronic illnesses. For instance, the Maldives has reported some of the highest rates of NCD-related deaths among women. Poor diets and smoking rank among the top contributors to early death and disability, made worse by limited access to healthcare and low levels of health awareness in many communities.
Latin America and the Caribbean
In Latin America and the Caribbean, changing lifestyles and environmental conditions are key contributors to the rise in chronic diseases. Many young people, including students, are engaging in habits such as poor nutrition, high consumption of processed foods and sugary drinks, and low levels of physical activity all of which increase their vulnerability to conditions like diabetes and heart disease. The region's rapid urban growth and influence from global food and media trends have also shifted daily routines toward more sedentary and unhealthy patterns. Combined with existing social and economic challenges, these changes are putting additional pressure on public health systems, underscoring the urgent need for prevention strategies and stronger public policies.

Prevention

A growing body of evidence supports that prevention is effective in reducing the effect of chronic conditions; in particular, early detection results in less severe outcomes. Clinical preventive services include screening for the existence of the disease or predisposition to its development, counseling and immunizations against infectious agents. Despite their effectiveness, the utilization of preventive services is typically lower than for regular medical services. In contrast to their apparent cost in time and money, the benefits of preventive services are not directly perceived by patient because their effects are on the long term or might be greater for society as a whole than at the individual level.
Public health programs are important in educating the public, and promoting healthy lifestyles and awareness about chronic diseases. While those programs can benefit from funding at different levels their implementation is mostly in charge of local agencies and community-based organizations. Studies have shown that public health programs are effective in reducing mortality rates associated to cardiovascular disease, diabetes and cancer, but the results are somewhat heterogeneous depending on the type of condition and the type of programs involved. For example, results from different approaches in cancer prevention and screening depended highly on the type of cancer.
The rising number of patient with chronic diseases has renewed the interest in prevention and its potential role in helping control costs. In 2008, the Trust for America's Health produced a report that estimated investing $10 per person annually in community-based programs of proven effectiveness and promoting healthy lifestyle could save more than $16 billion annually within a period of just five years.
A 2017 review found that it is uncertain whether school-based policies on targeting risk factors on chronic diseases such as healthy eating policies, physical activity policies, and tobacco policies can improve student health behaviours or knowledge of staffs and students. The updated review in 2022 did determine a slight improvement in measures of obesity and physical activity as the use of improved strategies lead to increased implementation interventions but continued to call for additional research to address questions related to alcohol use and risk. Encouraging those with chronic conditions to continue with their outpatient medical care and attend scheduled medical appointments may help improve outcomes and reduce medical costs due to missed appointments. Finding patient-centered alternatives to doctors or consultants scheduling medical appointments has been suggested as a means of improving the number of people with chronic conditions that miss medical appointments, however there is no strong evidence that these approaches make a difference.