Chronic Disease Management, Preventive Care Improved in 2019

In recent years, the US has experienced significant improvements in certain preventive care metrics and chronic disease management victories, United Health Foundation found in its America’s Health Rankings of 2020 Annual Report.

“The America’s Health Rankings Annual Report paints a picture of the Nation’s ongoing public health successes and challenges, but also provides a deeper understanding of the health of the Nation at the outset of the global COVID-19 pandemic,” the report’s executive summary explained.

In 2019, the US saw improvements in the prevalence of multiple chronic conditions. The percentage of Americans struggling with multiple chronic conditions dropped from 10.3 percent in 2018 to 9.5 percent in 2019.

Seniors aged 65 and older saw the greatest improvement in this category. From 2018 to 2019, this population saw a decline in multiple chronic condition prevalence of five percent.

The drop is largely due to a decline in cardiovascular disease, one of the most expensive chronic conditions in the US. Prevalence of cardiovascular disease dropped seven percent from 9.0 percent in 2018 to 8.4 percent in 2019.

However, among those who lived with multiple chronic conditions in 2019, the report discovered some disturbing trends.

Adults who are 25 years or older and who do not have a high school graduate degree were highly more likely to have multiple chronic conditions, as were American Indians and Alaska Natives, and adults who were 25 years or older with an annual household income of under $25,000.

This is a particularly important metric in light of the increased likelihood that those with multiple chronic conditions will contract more severe symptoms of the coronavirus and they are also a population that heavily uses healthcare services.

The country also saw improvements in flu vaccination rates, particularly in 46 states that saw significant increases.

Nationally, in 2018 the flu vaccination rate for adults was 35 percent. In 2019, the vaccination rate was 43.7 percent.

The report noted that these levels did not meet the Department of Health and Human Services’s Health People 2030 goal of a 70 percent flu vaccination rate nationwide. Payers are going to great lengths to promote flu vaccinations in 2020, in light of the pandemic.

The 18 to 44 year-old age group saw the biggest jump in flu vaccination rates, rising 41 percent from 2018 to 2019. Adults aged 45 to 64 years and 65 years and older all saw increases as well.

Additionally, more than half of the US received their HPV vaccination in 2019. The vaccination rate rose six percent and rose eight percent among white teens who have historically low HPV vaccination rates.

However, the report was not a landslide victory. Obesity rates have continued to rise nationwide to hit a new national high.

From 2011 to 2019, obesity rates rose 15 percent. Almost a third of American adults are obese (31.9 percent). The increases happened in every subcategory, from gender to income to race.

States that have the lowest obesity rates still have nearly a quarter of their populations that suffer from obesity (23.8 percent). Meanwhile, in Mississippi the obesity rate is highest at 40.8 percent.

Mental health challenges continued gaining strength in 2019 as well across the US.

Frequent mental distress increased 11 percent in prevalence nationwide from 2018 to 2019 and 25 percent in five years since 2014. Iowa, Utah, and Washington saw some of the highest increases. The suicide rate likewise has continued increasing, rising 23 percent in one decade.

Mental healthcare needs have no doubt continued to rise in 2020, as evidenced by the record-breaking mental healthcare telehealth claims due to the coronavirus.

One positive finding related to America’s mental health status was the increase in mental healthcare provider access. Mental healthcare providers for every 100,000 individuals increased nine percent from 2019 to 2020. This boost occurred across every state.

“As we head into the next decade, we encourage communities to engage with one another in meaningful dialogue about the findings of this report, especially by exploring local solutions to community challenges,” the report’s executive summary concluded.

“We also hope public health leaders and experts will leverage the data included in this report to enhance and broaden the understanding of the current state of health in the Country as we navigate the evolving pandemic.”