According to the CDC, chronic diseases account for most illness, disability, and death in the United States and are the leading drivers of health care costs.
Ninety percent of the nation's $4.5 trillion in annual health care expenditures are for people with chronic and mental health conditions.
But many of those suffering from these diseases are not telling their employers, according to a national poll, U.S. Employee Perspectives on Managing Chronic Conditions in the Workplace released on Feb. 11, by the Harvard T.H. Chan School of Public Health and the de Beaumont Foundation. The poll found that three-fourths (76%) of those with chronic conditions—such as hypertension, heart disease, diabetes, and asthma—need to manage their conditions during work hours.
Yet the majority (60%) have not formally disclosed their conditions to their employer.
While more than half of those polled, 58%, report having physical chronic health conditions, they are struggling with getting treatment and managing their jobs. More than one-third, 36%, reported either skipped medical appointments or delaying care to avoid interfering with work in the past year. And about half of those with chronic conditions say, in the past year, they felt they could not take time off work (49%) or take a break while at work (49%), even though they needed to because of their conditions.
Medical conditions are also affecting work opportunities. One-third said that in the past year, they have missed out on opportunities for more hours or projects because of their conditions, while 25% report missing out on opportunities for promotion and 21% report receiving bad reviews or negative feedback as a result of their chronic health conditions.
“Though employers may think they know their employees’ needs, poll results suggest there are widespread and frequently hidden challenges facing workers with chronic conditions,” said survey lead Gillian SteelFisher, director of the Harvard Opinion Research Program and principal research scientist at Harvard Chan School. “Workers commonly feel stigmatized by their conditions, and this can have a profound effect on both their work and their health. To help retain employees in a tight job market, employers may want to have more conversations with employees about ways that they can make work ‘work’ for everyone.”
While workers say their current employer is very supportive of key measures that allow employees to manage their conditions, including allowing employees to take breaks when they feel they need it (44%) or take paid leave (44%). Fewer than four in ten say their employer is very supportive of flexible schedules or working remotely more often if the work can be done offsite (37% and 27%, respectively).
In addition to managing their own chronic illnesses, employees are also helping out family members. One-third of employees are helping family members with chronic disease and 45% report having to attend to family during working hours. However, 37% said it’s difficult to take time off work to do that and 25% have found that they have had to reduce work hours to manage chronic conditions for family members or themselves.
Fourteen percent of these employees have also run out of paid leave in the past year, and 12% don’t have any paid leave as part of their job.
“There is a major opportunity for employers to play a greater role in supporting employees who are managing their own or their family’s chronic conditions,” said Brian Castrucci, president and CEO of the de Beaumont Foundation, in a statement. “Not only will this improve the health of employees and their families, but it will also provide employers a way to distinguish themselves, as well as improve retention and reduce absenteeism.”
The CDC higlights the most common chronic diseases as follows:
Heart disease and stroke
Nothing kills more Americans thanheart disease and stroke. More than 944,800 Americans die of heart disease or stroke every year—that's more than 1 in 3 deaths. These diseases take an economic toll, as well, costing our health care system $254 billion per year and causing $168 billion in lost productivity on the job. Costs from cardiovascular diseases are projected to hit roughly $2 trillion by 2050
Cancer
Each year in the United States, 1.7 million people are diagnosed with cancer, and more than 600,000 die from it, making it the second leading cause of death. The cost of cancer care continues to rise and is expected to reach more than $240 billion by 2030.
Diabetes
More than 38 million Americans have diabetes, and another 98 million adults in the United States have prediabetes, which puts them at risk for type 2 diabetes. Diabetes can cause serious complications, including heart disease, kidney failure, and blindness. In 2022, the total estimated cost of diagnosed diabetes was $413 billion in medical costs and lost productivity.
Obesity
Obesity ffects 20% of children and 42% of adults, putting them at risk of chronic diseases such as type 2 diabetes, heart disease, and some cancers. Just over 1 in 3 young adults aged 17 to 24 are too heavy to join the U.S. military.1 Obesity costs the U.S. health care system nearly $173 billion a year.
Arthritis
Arthritis affects 53.2 million adults in the United States, which is about 1 in 5 adults. It is a leading cause of disability in the United States, and a leading cause of chronic pain. Arthritis-attributable medical costs and earning losses were over $300 billion in 2013.
Alzheimer's disease
Alzheimer's disease a type of dementia, is an irreversible, progressive brain disease that affects nearly 7 million Americans, including 1 in 9 adults aged 65 and older. Two-thirds of these older adults (4.2 million) are women. Deaths due to Alzheimer's disease more than doubled between 2000 and 2021, increasing 141%. The cost of caring for people with Alzheimer's and other dementias is an estimated $360 billion in 2024, with projected increases to nearly $1 trillion (in today's dollars) by 2050.
Epilepsy
In the United States, about 3 million adults and about half a million children and teens younger than 18 have active epilepsy—meaning that they have been diagnosed by a doctor, are taking epilepsy medicines, had a recent seizure, or both.Adults with epilepsy report worse physical and mental health, and more work limitations c compared to adults without epilepsy. In 2019, total health care costs (epilepsy-attributable and other health-related costs) for noninstitutionalized people with epilepsy was $13.4 billion, of which $5.4 billion were directly attributable to epilepsy.
Tooth decay
Cavities (also called tooth decay) are one of the most common chronic diseases in the United States. One in six children aged 6 to 11 years and 1 in 4 adults have untreated cavities. Untreated cavities can cause pain and infections that may lead to problems eating, speaking, and learning. On average, 34 million school hours are lost each year because of unplanned (emergency) dental care, and almost $46 billion is lost in productivity due to dental disease.