Chronic disease is defined by the Centers for Disease Control and Prevention (CDC) as a condition lasting longer than a year that requires ongoing medical attention and often limits daily activities. According to the CDC, about 60% of Americans have at least one chronic disease, and about 40% have two chronic diseases or more.
Of the annual $4.5 trillion spent nationally on health care, chronic diseases such as heart disease, cancer and diabetes make up 90% of the spending. Chronic disease impacts a large portion of the population and weighs heavily on the spending burden for states and territories.
Governors are tasked with finding ways to reduce chronic disease incidence to improve population health and save on health care spending.
In recent decades, progress on reducing chronic diseases and mortality rates in the United States has been mixed. While some chronic conditions have declined thanks to advancements in medical care such as improved screenings and treatments for heart disease and certain cancers, rates of other chronic diseases have remained stable or increased. Reducing the incidence of chronic diseases is a significant challenge due to the prevalence and complexity of the underlying factors contributing to those conditions, including lifestyle factors, nutrition, environmental exposures, and quality healthcare access.
The NGA Center for Best Practices Health Team (NGA Health), with funding supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), launched the Rx for a Healthier America Initiative in June 2025 to support Governors’ efforts to reduce the incidence of chronic disease through the four pillars described above. Project teams from American Samoa, Maryland, Missouri, US Virgin Islands, and West Virginia will engage in strategic planning through action planning sessions, a knowledge exchange network, and real-time technical assistance with peers and subject matter experts. Please reach out to Anna Heard to learn more.
