@article {King503, author = {Dana E. King and Jun Xiang and Courtney S. Pilkerton}, title = {Multimorbidity Trends in United States Adults, 1988{\textendash}2014}, volume = {31}, number = {4}, pages = {503--513}, year = {2018}, doi = {10.3122/jabfm.2018.04.180008}, publisher = {The Journal of the American Board of Family Medicine}, abstract = {Importance: The simultaneous presence of multiple conditions in one patient (multi-morbidity) is a key challenge facing primary care.Objective: The purpose of this study was to determine the prevalence of multi-morbidity and to document changes in prevalence during the last 25 years.Design/Setting: Cross-sectional study using multiple years (1988{\textendash}2014) of the National Health and Nutrition Examination Survey (NHANES) were analyzed.Setting: Multiple years (1988 to 2014) of the National Health and Nutrition Examination Survey (NHANES) from the United States were analyzed.Participants: Noninstitutionalized adults.Main Outcomes and Measures: Number of chronic conditions per individual analyzed by age, race, gender, and socioeconomic factors.Results: A total of 57,303 individuals were surveyed regarding the presence of multi-morbidity in separate surveys spanning 1988{\textendash}2014. The overall current prevalence in 2013{\textendash}2014 of \>2 morbidities was 59.6\% (95\% CI 58.1\%{\textendash}61.1\%), 38.5\% had 3 or more, and 22.7\% had 4 or more morbidities, which was significantly higher than in 1988 (45.7\%, 95\% CI 43.5\%{\textendash}47.8\%, with \>2 morbidities). Among individuals with 2 or more morbidities, 54.1\% have obesity compared to 41.9\% in 1988. Among adults age \>65, prevalence was 91.8\% for 2 or more morbidities. Whites and Blacks had significantly higher prevalence (59.2\% and 60.1\%) than Hispanic or {\textquotedblleft}other{\textquotedblright} race (45.0\%, P \< .0001). Women (58.4\%) had more current multi-morbidities (\>2) than men (55.9\%, P = .01).Conclusions and Relevance: Multimorbidity is common and has been increasing over the last 25 years. This finding has implications for public health policy and anticipated health costs for the coming years.}, issn = {1557-2625}, URL = {https://www.jabfm.org/content/31/4/503}, eprint = {https://www.jabfm.org/content/31/4/503.full.pdf}, journal = {The Journal of the American Board of Family Medicine} }