Seeking to Understand the Challenge

Given the lack of an agreed upon definition of chronic illness, it is difficult to estimate with any precision the aggregate numbers and costs. In addition to the confounding element of what to include as a chronic condition, each possible candidate has its own life course and associated costs. However, all agree there are large numbers of people with chronic illnesses. In fact, virtually all who die in old age will have one or more chronic conditions.

Having noted the imprecision of definitions and insurmountable difficulty of quantifying the extent and costs of chronic illness, some representative statements can contribute to an understanding of the dimensions of the problem:

• Almost one-half of the U.S. population of 276 million people in the year 2000 had a chronic condition in some form (Partnership for Solutions, 2001).

• In 2020, about 157 million people will live with chronic conditions, and about 81 million, more than half of these people, will have multiple chronic conditions (Partnership for Solutions 2002a, pp. 6-7).

• In one listing, thirty-seven conditions are characterized as chronic illnesses (Fred Friendly Seminars, 2001a). There may be more.

• Each chronic condition has its own etiology and course history and is experienced by a person unique in his or her personhood and cultural/social milieu.

• Each person has greater or less access to, or is in command of, a different array of help.

• Chronic conditions may be more or less debilitating at different parts of the course of the illness.

• About 60 million people experience comorbidity, and more than 3 million of these have five chronic conditions (Partnership for Solutions, 2001).

• Some chronic conditions can be ameliorated for long periods of time with medications and/or prosthetic devices; others may have a decided trajectory in which increasing, albeit sometimes periodic, disability requires hands-on assistance or a more supportive environment.

• The various treatment regimens for people with multiple chronic conditions can interact to diminish health and increase disability (Partnership for Solutions, 2002b).

• Some chronic conditions can render a person more vulnerable to disease or accidents.

• Not only do poor and disadvantaged people experience greater prevalence of chronic conditions, those who are unemployed, less educated, and uninsured suffer more from these conditions (Bethell, Lansky, and Fiorillo).

• According to a 1998 Medical Expenditure Panel Survey, 78 percent of healthcare dollars was spent on care of chronic conditions for noninstitutionalized persons, and approximately 58 percent of healthcare dollars was spent on the 21 percent of those suffering from more than one chronic condition (Partnership for Solutions 2002a, pp. 17 and 19).

Anxiety and Depression 101

Anxiety and Depression 101

Everything you ever wanted to know about. We have been discussing depression and anxiety and how different information that is out on the market only seems to target one particular cure for these two common conditions that seem to walk hand in hand.

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