Many Young Adults Struggle to Manage Multiple Chronic Conditions

Latinos, lower-income Californians with chronic conditions most in need of help with care


A recent statewide survey of Californians with chronic conditions, commissioned by the California HealthCare Foundation (CHCF), uncovered surprising statistics regarding the prevalence of and lack of resources for caring for chronic diseases. In addition, due to the economic downturn, many of these Californians, most notably Latinos, are delaying proper health care and not getting the support they need to properly manage their conditions, especially those with lower incomes.

The California survey of adults ages 18 and older, conducted in partnership with the nonprofit National Council on Aging (NCOA), explored specifics on quality of life, health needs, and experiences of people with chronic diseases within the health care system. The survey paid particular attention to identifying barriers to self-care and what tools California residents need to better manage their overall health and wellness.

Younger Adults Find Caring for Their Conditions a Challenge

Chronic conditions pose challenges for not just older Californians, but younger adults as well. A full 40% of those surveyed between the ages of 18 and 34 reported having two or more chronic conditions. In addition, those under age 50 were among the most likely (43%) to postpone proper care for their conditions due to cost.

“Our survey uncovered a strikingly high number with chronic disease for such a young age group. It also shows that they are not getting the care they need,” said Veenu Aulakh, M.P.H., senior program officer for CHCF’s Better Chronic Disease Care program. “These findings bring to light the growing burden on California’s health care system and also highlight the potential opportunities to use online and community resources for self-care.”

Latinos Hardest Hit

The survey findings paint an even graver picture of the status of chronic disease in the Latino community. Latinos with chronic conditions currently face disproportionate challenges due to income level, lack of coverage, and challenges with navigating the health care system, among other factors. Survey respondents also reported higher instances of chronic pain, depression, stress, and anger. Nearly half (46%) of Latinos with chronic conditions have postponed health care due to cost. In addition, Latinos are among the least likely (53%) to get the help and support they need to manage their health conditions.

Californians Not Getting Necessary Support

While most Californians with chronic conditions primarily look to their health care providers for support, many feel they are not getting the help they need. Nearly half (48%) of those surveyed reported only occasionally, rarely, or never getting the help and support they need, with many (46%) feeling alone in taking care of their health. Many reported being frustrated by too little time with their doctor and tired of describing their conditions and problems every time they see a doctor.

Although assuming control over managing their care is fundamental to achieving better health, the survey found many Californians don’t understand what it takes to take control of their conditions. In fact, many (44%) say their health care providers rarely or have never told them about local support services such as dieticians, educators, and classes.

Programs Available to Support Self-Care

Survey respondents expressed interest in obtaining information and support online and at community events. Two thirds of Californians with chronic conditions are Internet users and 44% of those visit blogs, discussion groups, or other Web sites to read about people’s experiences with health problems similar to their own.

“In California, evidence-based community programs have been tailored to individual patients needs to help them take control of their day-to-day health,” said Kate Lorig, director of the Stanford University School of Medicine Patient Education Research Center and creator of the Chronic Disease Self-Management Program. “We find that by introducing patients to a range of skills to address living with chronic disease, patients are empowered to find a fit that works best for them. Patients enrolled in these programs have shown significant improvements in energy, health status, social activities, self-efficacy and also use less health care. Similar programs are available throughout the United States and in 20 countries.”

About the Survey

Nearly half of adult Americans nationwide (133 million) have chronic conditions such as high blood pressure, arthritis, respiratory diseases, and high cholesterol. As part of the overall effort to better understand the struggles of all Americans suffering from chronic conditions, CHCF worked with the NCOA to poll Americans nationwide, as well as in California. The details on the findings from national survey are available at www.ncoa.org/selfcaresurvey.

This survey was conducted via telephone January 14 to 30, 2009, among 855 adults age 18 and older in California, who have at least one chronic condition. The survey included an oversample of Latinos (n=364 total). The data were weighted by race. Interviewing was conducted using a random digit dialing (RDD) sample. For the Latino oversample, a combination of targeted RDD and listed sample was used. Interviews were conducted in both English and Spanish. The margin of sampling error for the results is +/- 3.4 percentage points. Margin of error is greater when analyzing smaller subgroups within the sample.

Respondents were screened for chronic condition(s) using with the following question(s): “Q. Have you ever been told by a doctor, nurse or other health professional that you have ____: [diabetes or high blood sugar, arthritis, asthma, chronic bronchitis or emphysema, hypertension or high blood pressure, heart disease, cancer, depression or an anxiety disorder, had a stroke, any other serious or chronic health condition.]” Only respondents who reported “yes” to at least one of these items were included in the survey.


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About the California Health Care Foundation

The California Health Care Foundation is dedicated to advancing meaningful, measurable improvements in the way the health care delivery system provides care to the people of California, particularly those with low incomes and those whose needs are not well served by the status quo. We work to ensure that people have access to the care they need, when they need it, at a price they can afford.