America’s Health Rankings’ 2022 Senior Report ranks North Carolina 34th nationwide in a combined assessment of many strengths, challenges and trends. Several of the measures that are used to determine North Carolina’s overall ranking are related to the prevalence of eight chronic conditions across the state and the number of NC older adults with more than one of these conditions. 

According to the North Carolina State Center for Health Statistics, 83.7% of North Carolina adults aged 65+ have at least one chronic condition, and 21.8% have three or more. Among participants who were enrolled in NC CDSME programs from 2019 to 2022, the top three health conditions reported were hypertension, arthritis and high cholesterol, with 46% of participants reporting two or more chronic conditions. 

Chronic conditions are medical conditions that last more than a year, require ongoing medical attention and/or limit daily life activities. Adults with multiple chronic conditions represent one of the highest-need segments of the population, since each chronic condition is likely to require extra medication and monitoring. As the number of chronic conditions an individual has increases, their risk of other poor health outcomes also increases: 

• Physical, social and cognitive limitations
• Mortality
• Unnecessary hospitalizations
• Adverse drug events
• Depression

In addition to the increased risk of unnecessary hospitalizations and early death associated with chronic conditions and the impact chronic conditions can have on older adults’ physical and mental health, the economic burden of chronic conditions is also substantial. The Centers for Disease Control and Prevention report that chronic diseases are the leading causes of death and disability and are the leading drivers of the nation’s $4.1 trillion in annual health care costs. America’s Health Rankings also reports that adults who have five or more chronic conditions spend 14 times more on health services compared with adults who have no chronic conditions. It is estimated that 71 cents of every dollar of health care spending goes toward treating people with multiple chronic conditions.