Chronic Diseases

Chronic diseases, in general, are conditions that last one year or more and require ongoing medical attention and/or limit the daily living activities of someone with the disease. According to the U.S. Centers for Disease Control and Prevention (CDC), chronic diseases such as heart disease, cancer, and diabetes are the leading causes of death and disability in the United States.

Learn how you can prevent chronic diseases.

Examples of data showing disparities

• 6 in 10 adults in South Carolina have a chronic disease, and 4 in 10 have two or more chronic diseases (Source: DHEC Behavior Risk Factor Surveillance System (BRFSS) 2019)
• 44.4% of non-Hispanic Black adults in South Carolina have obesity compared to 33.9% of Hispanics and 33% of non-Hispanic Whites (Source: DHEC BRFSS 2020)
• Chronic diseases represent 7 of the top 10 causes of death in the United States (Source: Centers for Disease Control and Prevention, National Center for Health Statistics. Leading causes of death. Updated March 1, 2021)
• Chronic diseases also are the leading cause of disability in the United States and the leading driver to the nation’s $3.8 trillion annual health care costs (Source: Buttorff C, Teague R, Bauman M. Multiple chronic conditions in the United States. Santa Monica (CA): RAND Corporation; 2017)
• A person’s risk of severe illness from COVID-19 increases as the number of underlying medical conditions that they have increases. National estimates show that among patients hospitalized for COVID-19 from March 2020 through March 2021, 95% had at least one underlying medical condition. (Source: Medical University of South Carolina [MUSC]; December 3, 2021)

Diabetes and Heart Disease Management

Examples of data showing disparities

• 20.1% of non-Hispanic Black adults report having diabetes, higher than what is reported among non-Hispanic Whites (12.2%). (Source: DHEC BRFSS, 2020)
• Non-Hispanic Blacks had a 2.4 times higher age-adjusted death rate from diabetes compared to non-Hispanic Whites. (Source:  SC DHEC Vital Statistics 2019)
• The prevalence of prediabetes is higher among non-Hispanic Black adults (14.3%) than non-Hispanic Whites (10%). (Source: DHEC BRFSS 2018)
• 2 out of 5 non-Hispanic Black adults have hypertension (Source: DHEC BRFSS 2019)
• Non-Hispanic Blacks had a 20% higher death rate from heart disease compared to non-Hispanic Whites in 2019. (Source: DHEC Vital Statistics)
• From 2016-2020, the rate of lower limb amputations related to diabetes in Zip Code 29203 was double the state average; most (81%) of the residents of 29203 are non-Hispanic Black and 28.5% live in poverty. (Source: SC RFA, 2016-2020; US Census Data, 2019 ACCS 5-year estimates)
• 26.8% of all COVID-19 deaths as of March 1, 2022 were among individuals with diabetes. (Source: DHEC SCION)

Cancer

Examples of data showing disparities

• The age-adjusted incidence of female breast cancer is 2.4% higher in White women than among Black women.  However, the age-adjusted female breast cancer death rate for Black women is 43% higher than that for White women. (DHEC Cancer Registry, 2015-2019)
• The age-adjusted prostate cancer incidence rate for Black men is 73% higher than the rate for White men. (DHEC Cancer Registry, 2015-2019)
• The age-adjusted prostate cancer death rate for Black men is 144% higher than the rate for White men. (DHEC Cancer Registry, 2015-2019)

Tobacco Use

Examples of data showing disparities

• 20.2% of male adults in South Carolina report being a current smoker, 24.7% higher than their female counterparts (16.2%). (DHEC BRFSS 2020)
• 35.9% of South Carolina adults who have less than a high school diploma report being a current smoker, 5.7 times higher than those with a college degree (6.3%). (DHEC BRFSS, 2020)
• Among current smokers, the percentage of South Carolina adults who report currently using menthol cigarettes is 2.2 times higher among non-Hispanic Blacks (84.1%) when compared to their non-Hispanic White counterparts (38.1%). (SC Adult Tobacco Survey, 2017-2018)
• 30.9% of White high school students report currently using e-Cigarettes, 3.5 times higher than their Black counterparts (8.8%), and 12.0% higher than their Hispanic counterparts (27.6%). (SC Youth Tobacco Survey, 2019)

Oral Health

Examples of data showing disparities

• In 2020, South Carolina females (70.9%) reported going to the dentist in the past year 10.4% more times than their male counterparts (64.2%). (Source: DHEC BRFSS, 2020)
• South Carolina individuals who had a household income greater than $50,000 (79.7%) reported going to the dentist in the past year, 72.9% more than those with a household income of < $15,000 (46.1%). (Source: DHEC BRFSS, 2020)
• In 2020, non-Hispanic Black South Carolinians (54.3%) reported having adult permanent teeth removed more than their non-Hispanic White counterparts (43.5%). (Source: DHEC BRFSS, 2020)
• From the 2017-2018 Statewide Oral Health Needs Assessment, over one-quarter of third graders assessed had sealants (i.e., thin coatings painted on the chewing surfaces of teeth that can prevent cavities). (Source: Statewide Oral Health Needs Assessment, 2017–2018)
• 1 in 5 students assessed had untreated tooth decay. (Source: Statewide Oral Health Needs Assessment, 2017–2018)
• Almost half (46.57%) of students assessed had tooth decay, and 2.98% of students had an urgent need for dental treatment. (Source: Statewide Oral Health Needs Assessment, 2017–2018)

Injury Prevention

Examples of data showing disparities

• Males in South Carolina had a 2.7 times higher rate of injury deaths when compared to their female counterparts in 2019. (Source: DHEC Vital Statistics, 2019)
• Non-Hispanic Black males saw the highest rate of homicides, 7.1 times higher than the rate seen among non-Hispanic White males, 7.3 times higher the rate seen in non-Hispanic Black females, and 17.9 times higher the rate seen in non-Hispanic White females. (Source: DHEC Vital Statistics, 2019)
• South Carolina residents aged 18–34 have the highest rates of homicide in the state. (Source: DHEC Vital Statistics, 2019)
• In 2019, non-Hispanic White South Carolina residents died by suicide 2.3 times higher than non-Hispanic Black residents. (Source: DHEC Vital Statistics, 2019)
• Males see a 4.5 higher rate of suicide when compared to females in the state. (Source: DHEC Vital Statistics, 2019)

Drug Use

Examples of data showing disparities

• The total drug overdose death rate has more than doubled over the last six years. (Source: DHEC Vital Statistics, 2020)
• Males saw a 2.1 times higher rate of total drug overdose deaths when compared to females in 2020. (Source: DHEC Vital Statistics, 2020)

Alzheimer’s Disease and Related Dementias (ADRD)

Examples of data showing disparities

• Black and Hispanic populations are at greatest risk for developing ADRD, but Whites make up the highest proportion of those living with ADRD in South Carolina. However, these statistics are among those that have been diagnosed.
• Black and Hispanic populations are less likely to be diagnosed with ADRD and when they are, it is at a more advanced stage of disease with greater associated costs. 
• According to the University of South Carolina’s OSA’s Alzheimer’s Disease Registry, at ages 65 and older, Black South Carolinians are 64% more likely to have ADRD.

Data source: University of South Carolina Alzheimer’s Disease Registry, 2021

Transportation and Injury

Examples of data showing disparities

• In 2019, the rate of deaths from MVCs for men in rural counties was estimated to be 60.7% higher than the state average. (Source: DHEC Vital Statistics, 2019)

Adverse Childhood Experiences (ACEs)

According to the CDC, adverse childhood experiences, or ACEs, are potentially traumatic events that occur in childhood, from ages 0-17 years. Examples of ACEs include experiencing violence, abuse, or neglect; witnessing violence in the home or community; or having a family member attempt or die by suicide.

Examples of data showing disparities

• According to the South Carolina Office of Rural Health, the fastest growing population in rural areas is the Hispanic population. Hispanic adults experience ACEs at a higher rate. (Source: DHEC BRFSS)
• Rural populations in general may see higher rates of ACEs. (Source: Radcliff E, Crouch E, Strompolis M. Rural-urban differences in exposure to adverse childhood experiences among South Carolina adults. Rural Remote Health. 2018 Feb;18(1):4434. doi: 10.22605/RRH4434. Epub 2018 Feb 21. PMID: 29471666.)
• Hispanic adults in South Carolina reported a higher prevalence of ACEs compared to other race/ethnicity groups. Hispanic adults experienced a higher prevalence of household dysfunction (63.1%), emotional and physical abuse (50.6%), and sexual abuse (16.5%) compared to non-Hispanic counterparts. (Source: DHEC BRFSS)