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  • CDC: 1 in 4 Americans Have Multiple Chronic Conditions, With Wide Variation Among States

    According to the US Centers for Disease Control and Prevention (CDC) one-quarter of the US adult population has multiple chronic conditions (MCCs), but that average doesn't reflect regional differences, which include state MCC rates as low as 1 in 5 residents to a high of more than 1 in 3.

    The report, based on results of a 2014 National Health Interview Survey of 36,697 results, tracks the prevalence of adults who reported having 2 or more of 10 chronic conditions: arthritis, cancer, chronic obstructive pulmonary disease, coronary heart disease, diabetes, hepatitis, hypertension, stroke, or weak or failing kidneys. Respondents included Medicare beneficiaries and the privately insured.

    Researchers analyzed the data by state and region, sex, and age groupings (18-44, 45-64, 65 and older). Here's what they found:

    • The national average doesn't tell the whole story. The national rate of 25.7% for MCCs contains significant variations when broken down by the 9 regions used in the study. Regionally, the Pacific area (Alaska, Hawaii, Washington, Oregon, California) registered the lowest MCC average at 21.4%, while the East South Central region (Alabama, Kentucky, Mississippi, Tennessee) reported the highest rate, with 1 in 3 residents (34.5%) experiencing MCCs. Other regions above the national average were East North Central (28.4%), New England (26.5%), South Atlantic (26.5%), and West South Central (26.4%). The Middle Atlantic, Mountain, and West North Central regions reported averages lower than the national rate (24.1%, 24.9%, and 23.4%, respectively).
    • States reported wide variation. This is where things got even more dramatic: researchers found that in Colorado, the MCC rate was less than 1 in 5 (19.0%)—the lowest in the country. Kentucky, the state with the nation's highest rate of MMCs, was slightly more than double that rate, with 38.2% of residents reporting MCCs. Kentucky was followed by Alabama (35.8%), West Virginia (34.6%), Mississippi (34.2%), and Montana (33.2%) as the states with the 5 highest rates in the country. At the low end, the District of Columbia (19.2%), Alaska (19.6%), California (20.1%), and Wyoming (20.4%) reported rates close to Colorado's.
    • Rates varied by sex, with the margin varying by region. Nationally, women experienced a higher prevalence of MCCs than men, at 27.2% compared with 24.1% for men, but regionally those differences fluctuated. Differences were widest in the Mountain region (women at 28.1% compared with men at 21.5%) and East North Central region (women at 31.4% compared with men at 25.3%). For both sexes, the East Central region reported the highest rates (36.3% for women, 32.3% for men), with the lowest rates coming from the Pacific region (women at 21.9%, men at 20.9%).
    • Age distribution wasn't surprising. Prevalence of MCCs was lowest for the 18-44 age group (7.3%) and highest among adults 65 and older (61.6%). The 45-64 group reported a 32.1% rate. The rate for the oldest group is consistent with an earlier Medical Expenditure Panel Survey that estimated the presence of MCCs at 66% for adults 65 and older in 2012.
    • MCC prevalence tends to echo other disease patterns. The CDC researchers also found that MCC prevalence overlapped with both the "stroke belt" (all of Mississippi, parts of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and West Virginia) and the "diabetes belt" (all of Mississsippi and parts of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, and West Virginia).

    APTA has actively advocated for the physical therapy profession's role in addressing chronic conditions, and earlier this year provided comments to a US Senate work group focused on improving the health care system's response to the issue. In addition, the 2015 House of Delegates adopted the position Health Priorities for Populations and Individuals (RC 11-15) "to guide [APTA's] work in the areas of prevention, wellness, fitness, health promotion, and management of disease and disability." The priorities include active living, injury prevention, and secondary prevention in chronic disease and disability management. APTA highlights the role of the physical therapist and physical therapist assistant in the treatment of chronic conditions through its prevention, wellness, and disease management webpage.

    The APTA Learning Center offers several resources to learn more about the physical therapy's role in addressing chronic disease, including offerings on developing exercise programs for individuals with chronic heart disease, management models for individuals with diabetes and chronic heart disease, physical therapy for cancer survivors, and the role of home health physical therapy in addressing chronic conditions.

    Comments

    • It is about time that PT's start counseling pts. on nutrition. Many of the chronic conditions in this country are lifestyle issues that well not be fixed by just exercise. We also need to be addressing the stress many of our pts. are under. Many techniques are out there that we can learn. We just can't get paid for working on these things with our pts. If we want to be the wellness experts we need to broaden our scope.

      Posted by Richard Fowler on 8/3/2016 5:28 PM

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