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The federal government’s recent promotion of new dietary guidelines, featuring a striking black-and-white Super Bowl ad with Mike Tyson urging Americans to eat “real food,” has come under scrutiny for a misleading health statistic that forms a cornerstone of its messaging campaign.
Visitors to the RealFood.gov website, promoted during the ad, encounter the claim that “90% of U.S. healthcare spending goes to treating chronic disease — much of which is linked to diet and lifestyle.” This statistic has been prominently featured not only on the website but also in the dietary guidelines themselves and on the CDC’s website.
Health and Human Services Secretary Robert F. Kennedy Jr. amplified this message in his January announcement, stating that “The CDC reports that 90% of healthcare spending treats chronic disease.”
The claim caught the attention of podcaster Michael Hobbes, who noted on his show “Maintenance Phase” that he couldn’t find any fact-checking of this striking figure. Upon investigation, the statistic appears to significantly misrepresent the research it purportedly cites.
The 90% figure originates from a 2017 report by the Rand Corporation, a respected nonpartisan research organization. However, Christine Buttorff, a Rand health policy researcher and co-author of the study, told PolitiFact that Kennedy’s statement and the RealFood.gov claim don’t accurately reflect their findings.
The Rand report actually calculated that 90% of all health spending goes toward people who have chronic illnesses — not toward treating those chronic illnesses specifically. With approximately 60% of Americans having at least one chronic condition at the time of the study, this distinction is crucial.
“A person in a year spends or incurs health care costs for multiple related things,” Buttorff explained. “It could be their chronic disease, but it also could be something as simple as an acute illness where they had to go to the doctor or go to the emergency room for something totally unrelated to the chronic disease.”
In other words, if someone with asthma breaks a leg or needs eyeglasses, those expenses were counted in the 90% figure despite having nothing to do with treating their chronic condition.
Estimating the actual percentage of healthcare spending specifically devoted to treating chronic illnesses is considerably more complex. It requires analyzing insurance claims data spread across government databases and private insurers, and distinguishing between expenses related to chronic versus acute conditions presents significant methodological challenges.
Recent research from the University of Washington’s Institute for Health Metrics and Evaluation analyzed healthcare spending across 148 health conditions between 2010 and 2019, finding that in 2019, the most expensive conditions were Type 2 diabetes ($143.9 billion), musculoskeletal disorders ($108.6 billion), and oral disorders ($93 billion).
“Reality is, we spend a ton of money on things that people don’t associate with chronic diseases,” noted Joseph L. Dieleman, a health metrics sciences professor involved in the study.
A 2025 report from GlobalData and the Partnership to Fight Chronic Disease projected medical costs for chronic diseases at approximately $2.2 trillion annually over the next 15 years. With current U.S. healthcare spending exceeding $5.3 trillion annually, this would place chronic disease spending at around 42% of the total — still substantial, but less than half of the 90% figure claimed in the government’s messaging.
The prevalence of chronic conditions in America is undeniably rising. In 2010, about 50% of Americans had at least one chronic condition, a figure that has climbed closer to 75% in recent years. This increase is attributed partly to improved diagnostic capabilities and longer lifespans.
“Chronic conditions linked to lifestyle choices such as physical inactivity or diet are a huge issue in the U.S., even if their use of this statistic isn’t quite right,” Buttorff acknowledged.
While many common chronic conditions like hypertension, Type 2 diabetes, heart disease, and high cholesterol have established links to diet and lifestyle factors, many others—including mental health conditions, asthma, Type 1 diabetes, cancer, rheumatoid arthritis, and dementia—cannot always be attributed to lifestyle choices.
The Department of Health and Human Services did not respond to requests for comment about the misleading statistic, though they did present the research more accurately in certain sections of the dietary guidelines document and on the CDC website.
Given the significant misrepresentation of the Rand research findings, PolitiFact rated Kennedy’s statement and the corresponding RealFood.gov claim as “False.”
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10 Comments
This statistic on chronic disease costs is frequently cited, but it’s important to scrutinize the source and look for potential biases or limitations. I appreciate the fact-checking effort to understand where this number comes from and whether it accurately reflects the landscape of U.S. healthcare spending.
Agreed, good to see journalists taking a closer look at the accuracy of this often-repeated claim. Nuance and context are important when discussing complex healthcare cost drivers.
This is an important issue to investigate. Chronic diseases undoubtedly account for a large portion of U.S. healthcare spending, but the 90% figure seems questionable. I appreciate the efforts to unpack the research behind this statistic and provide a more accurate, contextual understanding.
Well said. Fact-checking is crucial, especially for high-profile statistics that are being used to drive policy and public discourse. Looking forward to seeing the full analysis on the origins and validity of this 90% claim.
Curious to learn more about the origins of this 90% statistic. While chronic conditions are a major driver of costs, that number seems high and potentially exaggerated. Looking forward to seeing the fact-checking results to get a more nuanced understanding of the issue.
Agree, the 90% figure warrants further scrutiny. Even if it’s in the ballpark, the details around methodology and scope could significantly impact the interpretation. Fact-checking is important to avoid oversimplification on complex healthcare topics.
Interesting claim about chronic illness driving 90% of U.S. healthcare spending. I’d be curious to see the underlying research on this. Seems like a high percentage, but chronic conditions like heart disease, diabetes, and cancer do account for a major portion of costs.
You’re right, the 90% figure does seem high. It would be good to dig into the original Rand report to understand their methodology and data sources.
The government’s promotion of this 90% figure is concerning if it’s not well-supported by the research. Dietary and lifestyle factors are undoubtedly important, but healthcare costs have many interrelated drivers. I hope the fact-checking uncovers a more balanced picture.
You raise a fair point. Simplistic soundbites around healthcare spending can be misleading, even if the underlying concept has some truth to it. Rigorous analysis is needed to understand the full picture.