Chronic conditions such as cancer, chronic respiratory problems and diabetes are not only the leading causes of death across OECD countries but also represent a major disability burden among the living. Many chronic conditions are preventable, by modifying major risk factors such as smoking, alcohol use, obesity and physical inactivity. The COVID‑19 pandemic further underscored the impact of chronic conditions on health outcomes from other diseases, as data show that people with underlying health conditions are at higher risk of dying from COVID‑19 (OECD, 2023[1]). The pandemic also contributed to the increase in multimorbidity of chronic conditions and to their late diagnosis and control.
More than one‑third of people aged 16 and over reported living with a longstanding illness or health problem on average across 24 OECD countries in 2021 (Figure 3.15). This figure ranges from more than one in two in Finland to just under one in four in Italy. As populations age, the prevalence of chronic conditions – including multimorbidity – rises. Health systems increasingly need to be prepared to deliver high-quality chronic care management to meet the needs of ageing populations.
Socio‑economic disparities are also large: on average across OECD countries, 43% of people in the lowest income quintile report a longstanding illness or health problem compared to 27% of people in the highest income quintile (Figure 3.15). This income gap is largest in Lithuania, Belgium, Estonia and Ireland, where people in the lowest income quintile are 2 or more times as likely to have at least one longstanding illness or health problem compared to people in the highest income quintile. The income gap is smallest in Italy and Türkiye, where individuals in the lowest income quintile are slightly less likely to report living with a longstanding illness or health problem compared to individuals in the highest income quintile.
One of the most significant chronic conditions is diabetes. It has a particularly large disability burden, causing cardiovascular disease, blindness, kidney failure and lower limb amputation. It occurs when the body is unable to regulate excessive glucose levels in the blood. In 2021, 6.9% of the adult population were living with diabetes on average across OECD countries (age‑standardised data). In addition, a further 48 million adults across OECD countries were estimated to have undiagnosed diabetes (IDF, 2021[2]).
Among OECD member countries, diabetes prevalence is highest in Mexico, Türkiye, Chile, the United States and Spain, with over 10% of adults living with diabetes (age‑standardised data). For OECD partner countries, diabetes prevalence is also high in South Africa, Indonesia and China, also at around 10% or higher (Figure 3.16).
Age‑standardised diabetes prevalence rates have stabilised in many OECD member countries over the last decade, especially in western Europe. However, they have increased markedly in Türkiye, Iceland and Spain, with a rise of 60% or more, as well as in OECD partner countries such as Indonesia and South Africa. Such upward trends are due in part to rising rates of obesity, poor nutrition and physical inactivity, as well as to their interactions with population ageing (Kotwas et al., 2021[3]).
Diabetes is much more common among older people, and slightly more men than women have the condition. It also disproportionately affects those from disadvantaged socio‑economic groups. The economic burden of diabetes is substantial: in OECD countries, an estimated USD 650 billion was spent on treating diabetes and preventing complications in 2021 (IDF, 2021[2]).
