Chronic Disease Self-Management: Fact Sheet
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Chronic Disease Self-Management: Fact Sheet


NCOA Fact Sheets

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Diabetes, arthritis, hypertension, lung disease. Chronic conditions like these make life unmanageable for millions of older adults—and force them to give up their independence too soon.

The Challenges of Chronic Disease

Every day, millions of people with chronic conditions struggle to manage their symptoms.

  • Nearly 92% of older adults have at least one chronic condition, and 77% have at least two.
  • Four chronic conditions—heart disease, cancer, stroke, and diabetes—cause almost two thirds of all deaths each year.
  • Diabetes affects 12.2 million Americans aged 60+, or 23% of the older population.
  • An additional 57 million Americans aged 20+ have pre-diabetes, which increases their risk of developing type 2 diabetes, heart disease, and stroke.
  • 90% of Americans aged 55+ are at risk for hypertension, or high blood pressure. 77% of women aged 75+ have this condition, as do 64% of men aged 75+.

The Cost of Chronic Conditions

The traditional medical model of caring for people with chronic conditions—which focuses more on the illness than on the patient—is expensive and often ineffective.

  • Chronic diseases account for 75% of the money our nation spends on health care.
  • Yet only 1% of health dollars are spent on public efforts to improve overall health.

NCOA’s Role

Addressing chronic conditions requires new strategies to delay health deterioration, improve function, and address the problems that people confront in their day-to-day lives.

NCOA and Stanford University have collaborated for nearly a decade to distribute proven programs in-person and online that empower individuals with chronic conditions to manage their own care and improve their quality of life. 

Probably the best known and mosthighly regarded self-management program for people with chronic conditions is Stanford's Chronic Disease Self-Management Program (CDSMP). Through a partnership with the U.S. Administration for Community Living, NCOA promotes CDSMP through community-based workshops. CDSMP is also supported in communities by grants from the Centers for Disease Control and Prevention.

As a result of NCOA’s highly successful track record with evidence-based approaches and online services, Stanford has granted NCOA an exclusive U.S. license to distribute the online version of the CDSMP program, called Better Choices, Better Health®.

What is the Chronic Disease Self-Management Program?

CDSMP is a low-cost program that helps individuals with chronic conditions learn how to manage and improve their own health, while reducing health care costs. The program focuses on problems that are common to individuals dealing with any chronic condition, such as pain management, nutrition, exercise, medication use, emotions, and communicating with doctors.

Led by a pair of trained facilitators, one or both of whom manage a chronic condition themselves, the workshops cover 15 hours of material over a six-week period. During the program, approximately 10-15 participants focus on building the skills they need to manage their conditions by sharing experiences and providing mutual support. CDSMP:

  • Helps people with diverse medical diagnoses such as diabetes, arthritis, and hypertension develop the skills and coping strategies they need to manage their symptoms.
  • Employs action planning, interactive learning, behavior modeling, problem-solving, decisionmaking, and social support for change.
  • Is offered in two venues—online and through in-person, community-based settings such as senior centers, churches, community health clinics, and libraries.
  • Is available in Spanish for the chronic disease and diabetes self-management programs, and the Stanford-developed CDSMP trainer manual is available in over 19 different languages.

How Effective is CDSMP?

Based on a review of major published studies, CDSMP results in significant, measurable improvements in the health and quality of life of people with chronic conditions. CDSMP also appears to save enough through reductions in health care expenditures to pay for itself within the first year. Studies have indicated:

Cost Savings

  • $714 per person savings in emergency room visits and hospital utilization.
  • $364 per person net savings after considering program costs at $350 per participant.
  • Potential savings of $6.6 billion by reaching 10% of Americans with one or more chronic conditions.

Health Benefits

  • Improvement in exercise and ability to participate in one’s own care over a two-year period.
  • Improved health status in seven of nine variables: fatigue, shortness of breath, pain, social activity limitation, illness intrusiveness, depression, and health distress.
  • Improved health behaviors and self-efficacy in variables related to exercise, cognitive symptom management, communication with physicians, and self-efficacy.

Learn more about chronic conditions.


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