Before the coronavirus disease 2019 (COVID-19) pandemic, about 6 in 10 adults in the United States had a chronic condition; 90% of the nation’s health care expenditures were for people with chronic and mental health conditions, and chronic conditions accounted for 7 of the 10 leading causes of death in the United States (1–3). The COVID-19 pandemic has only further emphasized the importance of chronic disease prevention and care — especially because many chronic conditions increase the severity of COVID-19 outcomes. For example, cancer, heart conditions, diabetes, and chronic kidney disease, in addition to being among the top 10 causes of death in the United States, are also established risk factors for severe illness from COVID-19 (4). A study from 12 states reported that 73% of people hospitalized for COVID-19 had at least one underlying chronic condition, and rates of hospitalization increased as the number of conditions increased (5). Additional chronic conditions or risk factors such as obesity and smoking also increase the severity of COVID-19 outcomes (4). COVID-19 may also contribute to social isolation and mental health challenges such as anxiety and depression (6). Finally, chronic diseases, risk factors for chronic disease, and COVID-19 all tend to disproportionately affect people of lower socioeconomic status and certain racial and ethnic minority populations. As a result, African American, Hispanic or Latino people, and American Indian and Alaska Native people are all at higher risk than non-Hispanic White people of getting sick, being hospitalized, or dying of COVID-19 (4).
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