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Share on Pinterest The number of people dealing multiple chronic conditions is on the rise in the U.S.Hero Images Inc/Getty ImagesA study has found that adults in the U.S. are increasingly dealing with multiple chronic conditions.These cardiac, renal, and metabolic conditions include type 2 diabetes, heart disease, and kidney disease.These conditions are the leading cause of morbidity and mortality in the United States, and are estimated to account for every 1 in 3 deaths.

A new study found that the number of Americans with multiple cardiac, renal, and metabolic conditions is rising.

Approximately one in four adults have a cardiac, renal, or metabolic conditions condition and nearly 1 in 10 have multiple cardiac, renal, or metabolic conditions, according to the report, which published in JAMA Cardiology on September 27.

The risk of also increased with ageone in three adults 65 and older had a cardiac, renal, or metabolic condition, while almost 1 in 4 had overlapping conditions.

These conditions are the leading cause of morbidity and mortality in the United States and are estimated to account for every 1 in 3 deaths, according to study authors.

We have medications to treat the underlying mechanisms that contribute to co-existing cardiac, renal, and metabolic (CRM) conditions, however, they arent being prescribed or taken nearly as frequently as they should be.

The new report sheds light on how significantly the incidence of these conditions has grown over the past two decades along with the urgent need to address the situation.

The findings are doubly concerning as they demonstrate both an increase in the prevalence of cardiac, renal, and metabolic disease and concurrent high levels of undertreatment, Dr. Dmitriy Nevelev, Associate Director of Cardiology at Staten Island University Hospital, told Healthline. Nevelev wasnt involved in the study. Chronic conditions have become much more common since 1999

To determine the prevalence of CRM conditions in the U.S., the researchers evaluated health data from January 2015 through March 2020 sourced from the National Health and Nutrition Examination Survey (NHANES).

They compared those trends against NHANES health data collected between 1999 and 2002.

The analysis included 11,607 non-pregnant adults aged 20 and over.

Of the data pooled from 2015 to 2020, 26.3% had at least 1 CRM condition, 8% had at least two, and 1.5% had three CRM conditions.

The most common comorbid conditions were type 2 diabetes plus chronic kidney disease (3.2%), followed by cardiovascular disease plus type 2 diabetes (1.7%) and cardiovascular disease plus chronic kidney disease (1.6%).

The burden was greatest among non-hispanic Black individuals along with people who reported they were unemployed, of low socioeconomic status, or had no high school degree.

Disparities in access to healthcare services can result in delayed diagnosis and treatment of cardiac, renal, and metabolic conditions, leading to worse outcomes, said Dr. David Cutler, board certified family medicine physician at Providence Saint Johns Health Center in Santa Monica, CA. Cutler was not involved in the study.

Of those with three CRM conditions, roughly one-third (30.5%) did not report statin use, only 4.8% used medication common for weight loss and diabetes called glucagon-like peptide-1 receptor agonists (GLP1 agonists.) Additionally only 3% took medication commonly used to treat high blood sugar called sodium-glucose cotransporter 2 inhibitors (SGLT2).

Newer medications like GLP1 agonists for example, semaglutide and SGLT2 inhibitors which have been found to improve these conditions are very expensive and were found to be prescribed at a very low rate in this study, says Cutler.

The proportion of U.S. adults with multiple CRM conditions has grown significantly over the past few decades from 5.3% in 1999 to 8% in 2020.

The proportion of Americans with three CRM conditions also grew, from 0.7% in 1999 to 1.5% in 2020. How to combat the rising prevalence of multiple CRM conditions

Research shows that heart, kidney, and metabolic functions are intertwined and share the same risk factors, including obesity, hypertension, blood sugar that is too high or low, and cholesterol imbalance.

Diet and lack of physical activity can contribute to metabolic disorders and obesity, says Cutler.

Genetics, age, and access to healthcare play a role, too.

In addition, stress can affect health behaviors and contribute to the development of these conditions, he added.

The report says that issues with one body system may lead to dysfunction of others and the development of multiple morbidities.

Fortunately, we can use the common link between these conditions to personalize treatment and prevent their onset, says Nevelev.

There are drugs that target the underlying pathways involved in the development of comorbidities, such a SGLT2 inhibitors, and may help lower the prevalence of multiple conditions, however, they are being prescribed at a low rate.

Several factors are at play, including insurance coverage and the associated insurance authorizations burden, overall cost to the patient, prescriber comfort in using newer medications, fear of medication side effects, and in the case of GLP-1 antagonists availability, says Nevelev.

The rising prevalence of multiple conditions are expected to accelerate due to the COVID-19 pandemic.

We now have good data demonstrating pandemic-related decreases in physical activity and increases in sedentary activity and weight gain, he said.

The findings highlight the need to improve the situation and promote public health efforts, such as promoting healthy lifestyles, improving access to healthcare, and raising awareness about risk factors and early detection.

We have the tools to lower rates of these diseases. We have to make better use of them, says Cutler. The bottom line:

A new study found that the number of adults in the U.S. with multiple cardiac, renal, and metabolic (CRM) conditions is rising. There are medications to treat the underlying mechanisms that contribute to these co-existing conditions. However, they arent being prescribed or taken as frequently as they should be. The research sheds light on the urgent need to address the situation, ideally through awareness, screening, and improved access to healthcare.

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‘Shameful’ that black boys in London more likely to die than white boys, says Met Police chief

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'Shameful' that black boys in London more likely to die than white boys, says Met Police chief

It is “shameful” that black boys growing up in London are “far more likely” to die than white boys, Metropolitan Police chief Sir Mark Rowley has told Sky News.

In a wide-ranging interview with Sunday Morning with Trevor Phillips, the commissioner said that relations with minority communities are “difficult for us”, while also speaking about the state of the justice system and the size of the police force.

Sir Mark, who came out of retirement to become head of the UK’s largest police force in 2022, said: “We can’t pretend otherwise that we’ve got a history between policing and black communities where policing has got a lot wrong.

“And we get a lot more right today, but we do still make mistakes. That’s not in doubt. I’m being as relentless in that as it can be.”

He said the “vast majority” of the force are “good people”.

However, he added: “But that legacy, combined with the tragedy that some of this crime falls most heavily in black communities, that creates a real problem because the legacy creates concern.”

Sir Mark, who also leads the UK’s counter-terrorism policing, said black boys growing up in London “are far more likely to be dead by the time they’re 18” than white boys.

“That’s, I think, shameful for the city,” he admitted.

“The challenge for us is, as we reach in to tackle those issues, that confrontation that comes from that reaching in, whether it’s stop and search on the streets or the sort of operations you seek.

“The danger is that’s landing in an environment with less trust.

“And that makes it even harder. But the people who win out of that [are] all of the criminals.”

Met Police Commissioner Sir Mark Rowley said racism is still an issue in the force
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Met Police Commissioner Sir Mark Rowley

The commissioner added: “I’m so determined to find a way to get past this because if policing in black communities can find a way to confront these issues, together we can give black boys growing up in London equal life chances to white boys, which is not what we’re seeing at the moment.

“And it’s not simply about policing, is it?”

Sir Mark said: “I think black boys are several times more likely to be excluded from school, for example, than white boys.

“And there are multiple issues layered on top of each other that feed into disproportionality.”

‘We’re stretched, but there’s hope and determination’

Sir Mark said the Met is a “stretched service” but people who call 999 can expect an officer to attend.

“If you are in the middle of the crisis and something awful is happening and you dial 999, officers will get there really quickly,” Sir Mark said.

“I don’t pretend we’re not a stretched service.

“We are smaller than I think we ought to be, but I don’t want to give a sort of message of a lack of hope or a lack of determination.”

“I’ve seen the mayor and the home secretary fighting hard for police resourcing,” he added.

“It’s not what I’d want it to be, but it’s better than it might be without their efforts.”

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How police tracked and chased suspected phone thief

‘Close to broken’ justice system ‘frustrating’ and ‘stressed’

Sir Mark said the criminal justice system was “close to broken” and can be “frustrating” for others.

“The thing that is frustrating is that the system – and no system can be perfect – but when the system hasn’t managed to turn that person’s life around and get them on the straight and narrow, and it just becomes a revolving door,” he said.

“When that happens, of course that’s frustrating for officers.

“So the more successful prisons and probation can be in terms of getting people onto a law-abiding life from the path they’re on, the better.

“But that is a real challenge. I mean, we’re talking just after Sir Brian Leveson put his report out about the close-to-broken criminal justice system.

“And it’s absolutely vital that those repairs and reforms that he’s talking about happen really quickly, because the system is now so stressed.”

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Leveson explains plans to fix justice system

Challenge to reform the Met

The Met chief’s comments come two years after an official report found the force is institutionally racist, misogynistic and homophobic.

Baroness Casey was commissioned in 2021 to look into the Met Police after serving police officer Wayne Couzens abducted, raped and murdered Sarah Everard.

She pinned the primary blame for the Met’s culture on its past leadership and found stop and search and the use of force against black people was excessive.

At the time, Sir Mark, who had been commissioner for six months when the report was published, said he would not use the labels of institutionally racist, institutionally misogynistic and institutionally homophobic, which Baroness Casey insisted the Met deserved.

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However, London Mayor Sadiq Khan, who helped hire Sir Mark – and could fire him – made it clear the commissioner agreed with Baroness Casey’s verdict.

A few months after the report, Sir Mark launched a two-year £366m plan to overhaul the Met, including increased emphasis on neighbourhood policing to rebuild public trust and plans to recruit 500 more community support officers and an extra 565 people to work with teams investigating domestic violence, sexual offences and child sexual abuse and exploitation.

Watch the full interview on Sunday Morning with Trevor Phillips from 8.30am on Sunday.

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Unite votes to suspend Angela Rayner over Birmingham bin strike

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Unite votes to suspend Angela Rayner over Birmingham bin strike

Labour’s largest union donor, Unite, has voted to suspend Deputy Prime Minister Angela Rayner over her role in the Birmingham bin strike row.

Members of the trade union, one of the UK’s largest, also “overwhelmingly” voted to “re-examine its relationship” with Labour over the issue.

They said Ms Rayner, who is also housing, communities and local government secretary, Birmingham Council’s leader, John Cotton, and other Labour councillors had been suspended for “bringing the union into disrepute”.

There was confusion over Ms Rayner’s membership of Unite, with her office having said she was no longer a member and resigned months ago and therefore could not be suspended.

But Unite said she was registered as a member. Parliament’s latest register of interests had her down as a member in May.

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The union said an emergency motion was put to members at its policy conference in Brighton on Friday.

More on Angela Rayner

Unite is one of the Labour Party’s largest union donors, donating £414,610 in the first quarter of 2025 – the highest amount in that period by a union, company or individual.

The union condemned Birmingham’s Labour council and the government for “attacking the bin workers”.

Mountains of rubbish have been piling up in the city since January after workers first went on strike over changes to their pay, with all-out strike action starting in March. An agreement has still not been made.

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Rat catcher tackling Birmingham’s bins problem

Ms Rayner and the councillors had their membership suspended for “effectively firing and rehiring the workers, who are striking over pay cuts of up to £8,000”, the union added.

‘Missing in action’

General secretary Sharon Graham told Sky News on Saturday morning: “Angela Rayner, who has the power to solve this dispute, has been missing in action, has not been involved, is refusing to come to the table.”

She had earlier said: “Unite is crystal clear, it will call out bad employers regardless of the colour of their rosette.

“Angela Rayner has had every opportunity to intervene and resolve this dispute but has instead backed a rogue council that has peddled lies and smeared its workers fighting huge pay cuts.

“The disgraceful actions of the government and a so-called Labour council, is essentially fire and rehire and makes a joke of the Employment Relations Act promises.

“People up and down the country are asking whose side is the Labour government on and coming up with the answer not workers.”

SN pics from 10/04/25 Tyseley Lane, Tyseley, Birmingham showing some rubbish piling up because of bin strikes
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Piles of rubbish built up around Birmingham because of the strike over pay

Sir Keir Starmer’s spokesman said the government’s “priority is and always has been the residents of Birmingham”.

He said the decision by Unite workers to go on strike had “caused disruption” to the city.

“We’ve worked to clean up streets and remain in close contact with the council […] as we support its recovery,” he added.

A total of 800 Unite delegates voted on the motion.

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Dozens of MPs call for UK government to recognise Palestine as state

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Dozens of MPs call for UK government to recognise Palestine as state

Nearly 60 Labour MPs have called on David Lammy and the Foreign Office to immediately recognise Palestine as a state.

A mix of centrist and left-wing MPs, including some committee chairs, wrote to the foreign secretary this week to say “by not recognising [Palestine] as a state, we undermine our own policy of a two-state solution and set an expectation that the status quo can continue and see the effective erasure and annexation of Palestinian territory”.

The 59 MPs suggest the government pursue five different measures to prevent the Israeli government from carrying out its Rafah plan, adding that they believed Gaza was being “ethnically cleansed” – a claim vehemently denied by Israel.

The letter was organised by Labour Friends of Palestine and the Middle East group.

Palestinians react as they ask for food from a charity kitchen, amid a hunger crisis, in Gaza City, July 7, 2025. REUTERS/Ebrahim Hajjaj
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Palestinians ask for food from a charity kitchen in Gaza on 7 July. Pic: Reuters

It states that the Israeli plan, which would see the “population transfer to the southern tip of Gaza in preparation for deportation outside the strip”, is an accurate description, but that they believe a clearer way to describe it is the “ethnic cleansing of Gaza”.

Israeli officials have said they want to separate the civilian population from Hamas, which still controls parts of Gaza and holds dozens of hostages abducted in the October 7 attack that triggered the war 21 months ago.

Emmanuel Macron discussed recognising Palestine as a state at a joint news conference with Sir Keir Starmer on Thursday – the same day the letter was signed.

The French president said: “Today, working together in order to recognise the state of Palestine and to initiate this political momentum is the only path to peace.”

While France has not yet recognised a Palestinian state yet, Norway, Ireland and Spain coordinated their recognition last year.

The letter demands ministers take five different measures to:

• Recognise the state of Palestine
• Continue support for the UN Agency for Palestinian Refugees (UNRWA)
• Secure the release of hostages
• Press for the full and unhindered resumption of humanitarian aid
• Fully review and place restrictions on trade with and financial support of illegal Israeli settlements in the West Bank

The government says it is already providing funding for the UNRWA and working to secure the release of hostages held by Hamas, but immediate recognition of Palestinian statehood will be a much more controversial move.

Sky News understands this is the second time MPs have formally called on the government to immediately recognise the state of Palestine, with previous letters signed by some parliamentary aides and even junior ministers.

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Ministers have indicated their plan to recognise Palestine would be “at a time that is most conducive to the peace process” without further clarity of when that might be.

They have also indicated that it would not be suitable to speculate about future sanctions, as this could reduce their impact.

A Foreign Office spokesperson said: “Since day one, this government has been clear that we need to see an immediate ceasefire, the release of all hostages cruelly detained by Hamas, better protection of civilians, much-needed food aid, medicines, shelter and other supplies immediately being allowed to enter Gaza, and a path to long-term peace and stability.

“The situation on the ground in Gaza is horrendous – for the hostages and for Palestinians – and we urgently want to see a deal done, to end the suffering on all sides.

“We are committed to recognising a Palestinian state and to doing so when will have most impact in support of a peace process. We continue to provide lifesaving aid to supporting Palestinians in Gaza and the West Bank, and to work closely in support of the Palestinian Authority.”

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