In 2021, it was estimated that around 1.2 percent of white, non-Hispanic adults in the United States were living with active epilepsy. Epilepsy is a brain disorder that causes recurring seizures and can lead to life-long disability. This statistic displays the percentage of adults with active epilepsy in the United States as of 2021, by ethnicity and race.

In 2021, around 1.9 percent of adults in the United States with less than a high school education or GED were estimated to be living with active epilepsy. Epilepsy is a brain disorder that causes recurring seizures and can lead to life-long disability. This statistic displays the percentage of adults with active epilepsy in the U.S. as of 2021, by education level.

Introduction

Epileptics Statistics: Epilepsy, a neurological disorder, manifests through recurrent seizures caused by abnormal brain activity. These seizures vary from partial, affecting specific body parts, to generalized, involving the entire body.

Causes include brain injuries, genetic factors, infections, and developmental issues. Diagnosis involves medical history, physical exams, EEG tests, and imaging.

Treatment includes antiepileptic drugs, surgery for severe cases, and lifestyle adjustments such as stress management and regular sleep.

Ongoing research aims to enhance treatments and understanding of epilepsy's mechanisms, improving outcomes and quality of life for those affected.

This statistic displays the number of active epilepsy cases in the United States as of 2015, by age. As of this time, it was estimated that around 54,100 people in Alabama were living with epilepsy, compared to 9,700 in Delaware. Epilepsy is a brain disorder that causes recurring seizures and can lead to life-long disability.

In 2021, it was estimated that almost 1.2 million adults in the United States aged 18 to 44 years were living with active epilepsy. Epilepsy is a brain disorder that causes recurring seizures and can lead to life-long disability. This statistic displays the number of active epilepsy cases in the United States as of 2021, by age.

Financial overview and grant giving statistics of Epilepsy Awareness of America

The global epilepsy treatment drug market is a significant and rapidly evolving sector, characterized by a substantial market size and promising growth trajectory. While precise figures for market size and CAGR aren't provided, considering the presence of major pharmaceutical players like Pfizer, UCB, and Novartis, along with a diverse range of drug types (traditional and new generation anti-epileptic drugs), a reasonable estimation places the 2025 market size at approximately $15 billion USD. The market's growth is driven by rising prevalence of epilepsy globally, an aging population (increasing susceptibility to epilepsy), growing awareness and improved diagnosis rates, and continuous innovation in drug development leading to more effective and better-tolerated treatments. Key trends include the increasing adoption of new generation anti-epileptic drugs due to their improved efficacy and reduced side effects compared to traditional medications. Furthermore, the market is witnessing a shift towards personalized medicine, with a focus on tailoring treatment plans based on individual patient characteristics and genetic profiles. Despite these positive trends, market restraints include the high cost of treatment, potential side effects associated with some drugs, and challenges in managing drug resistance in certain patients. The market is segmented geographically, with North America and Europe currently holding significant market share, reflecting higher healthcare expenditure and established healthcare infrastructure in these regions. However, emerging markets in Asia-Pacific are expected to exhibit robust growth in the coming years due to rising prevalence rates and increasing healthcare access. The future of the epilepsy treatment drug market is bright, driven by ongoing research and development efforts focusing on novel drug mechanisms and improved delivery systems. The focus on personalized medicine and advancements in diagnostic techniques will further fuel market expansion. Companies are increasingly investing in clinical trials to explore new treatment options and expand their product portfolios. This will lead to a competitive landscape, with pharmaceutical companies vying for market share through innovative drug development, strategic collaborations, and aggressive marketing campaigns. The focus on patient support programs and improved access to treatment will be critical in ensuring that patients receive optimal care and improve outcomes. This market is expected to experience significant growth, driven by a combination of technological advancements and increasing patient need.

The U.S. Antiepileptic Drugs (AED) Market size was valued at USD 17.13 Billion in 2023 and is projected to reach USD 24.85 Billion by 2032, exhibiting a CAGR of 4.8 % during the forecast period. Antiepileptic drugs are the drugs used in the treatment of epilepsy, the brain disorder that results in seizures or fits. AEDs have the effect of maintaining the resting properties of neuronal membranes, regulating neuronal excitability, and concerting the tendency of neurons to generate spike discharges during seizures. They do this through various channels, like increasing inhibition of action through the activation of inhibitory neurotransmission, augmenting inhibitory function by increasing or decreasing the activity of neurotransmitters or influencing ion channels. One of the crucial characteristics of an AED is the kind of seizures that can be affected in patients since they may dramatically differ from one another. Typical antimanic medications include lithium carbonate, valproate salts, carbamazepine, and newer medications such as Lamictal and Keppra. These types of drugs can be prescribed depending on the type of seizure, the age of the patient, the existence of comorbid conditions, and the intolerance to potential side effects. Prospective AEDs include the capability to lower seizure frequency and severity, which can in turn reduce the number of unpleasant effects and products of epileptic seizures. The increasing prevalence of epilepsy is driving the need for highly effective medications, putting pressure on market players to develop new AEDs. The crucial decisions made by the U.S. FDA instill confidence in these companies, encouraging enhanced research and development efforts that ultimately benefit patients. Recent developments include: October 2022: Biohaven Ltd. launched as a new publicly traded company focused on delivering innovative life-changing treatments for neurological and neuropsychiatric diseases. The company’s primary focus will be developing treatments for epilepsy, pain and mood disorders, obsessive-compulsive disorder, spinocerebellar ataxia, and spinal muscular atrophy., August 2022: UCB collaborated with Le Bonheur Children's Hospital, the Wisconsin Health Information Organization (WHIO), and Yale University to examine the impact of seizure clusters on patients' and caregivers' quality of life., January 2021: UCB launched Nile AI, Inc., a new independent company created to improve care for people living with epilepsy, their caregivers, and healthcare providers (HCPs).. Key drivers for this market are: Significant FDA Product Approvals to Propel Market Growth. Potential restraints include: Various Side Effects Associated with Antiepileptic Drugs is Limiting Market Growth. Notable trends are: Introduction of Effective Third Generation Drugs.

The global epilepsy therapeutic market, valued at $4,194.9 million in 2025, is projected to experience steady growth, exhibiting a compound annual growth rate (CAGR) of 3.1% from 2025 to 2033. This growth is fueled by several key factors. The increasing prevalence of epilepsy, particularly in developing nations, coupled with advancements in diagnostic techniques and the development of novel, more effective anti-epileptic drugs (AEDs) are significant drivers. The market is segmented by drug generation (first and second), reflecting the ongoing innovation in treatment approaches, and by application (hospital, retail, and online pharmacies), highlighting the evolving distribution channels for these pharmaceuticals. The rising awareness of epilepsy and improved access to healthcare in certain regions further contribute to market expansion. However, challenges remain, including the high cost of advanced therapies and the potential for adverse effects associated with long-term AED use. These factors influence the varying growth trajectories across different geographical segments. North America and Europe are expected to retain significant market share due to established healthcare infrastructure and higher per capita healthcare spending, while Asia-Pacific is poised for substantial growth driven by expanding access to healthcare and increasing awareness. The competitive landscape is marked by the presence of major pharmaceutical companies such as Abbott Laboratories, GlaxoSmithKline, and Pfizer, among others, continuously engaged in research and development of new AEDs and improved delivery systems. The strategic focus of key players is likely to center on expanding product portfolios, strengthening their market presence in high-growth regions, and exploring innovative treatment approaches to address unmet medical needs. This includes advancements in personalized medicine aimed at tailoring treatment to individual patient profiles, improving efficacy and minimizing adverse events. The market's future growth trajectory will depend on sustained investments in research and development, regulatory approvals for new drugs, and initiatives aimed at raising awareness and improving access to diagnosis and treatment, particularly in underserved communities. The consistent introduction of new, more effective treatments, along with a better understanding of epilepsy subtypes, will continue to shape the market's evolution and create new opportunities for growth in the forecast period.

BackgroundEpilepsy is a common chronic neurological disease, and identifying modifiable risk factors for epilepsy and seizure is extremely important. Currently, the relationship between tobacco exposure and epilepsy or seizure is controversy.ObjectiveThe objective of this study is to test the relationship between tobacco smoke exposures and epilepsy in United States (US) participants of the National Health and Nutrition Examination Survey (NHANES).MethodsThis is a cross-sectional study using data from NHANES 2013–2018. We included all participants in these cycles and excluded those with missing variables. Weighted logistic regression models, weighted sensitivity analysis and weighted subgroup analysis were conducted to estimate the association between active and passive tobacco smoke exposures and epilepsy.ResultsWe included 15,277 participants in NHANES, of whom 131 reported with epilepsy [taking at least one antiseizure medication (ASM) for epilepsy and recurrent seizures]. The weighted mean age of individuals is 42.35 years, 49.08% (95% confidence interval [CI] 48.03–50.12) were male, 64.56% (95%CI 63.70–65.41) were Non-Hispanic White, and 59.95% (95%CI 58.98–60.92) were private insurance. The weighted prevalence of epilepsy was 0.82% (95%CI 0.60–1.11) and 0.60% (95%CI 0.42–0.86) in those with and without tobacco smoke exposures, respectively. After adjusting for covariates, active and passive tobacco smoke exposure was not associated with epilepsy [weighted adjusted odd ratio (OR) 1.16, 95% CI 0.68–1.98, p-value = 0.576] and the results remained in multiple sensitivity analyses. However, we found that tobacco exposure was a protective factor for epilepsy in those aged 40–50 (OR 0.23, 95%CI 0.10–0.53, p-value < 0.001).ConclusionIn summary, tobacco exposure was not associated with epilepsy in the US population and this result remained after adjusting for confounding factors, and the sensitivity analysis was robust. However, in stratified analysis, tobacco exposure was a protective factor for epilepsy patients aged 40–50.

In 2023, there were around 2,454 deaths caused by epilepsy, compared to 1,800 deaths in 2018. This statistic shows the number of deaths in the U.S. with epilepsy as the underlying cause from 2018 to 2023.

Overview

New York, NY – May 02, 2025 – Global Epilepsy Monitoring Devices Market size is expected to be worth around USD 1085.2 Million by 2033 from USD 562.1 Million in 2023, growing at a CAGR of 6.8% during the forecast period from 2024 to 2033.

The global Epilepsy Monitoring Devices Market is witnessing steady expansion, driven by the rising prevalence of epilepsy and the growing need for advanced diagnostic solutions. Epilepsy affects over 50 million individuals globally, according to the World Health Organization (WHO). Early and accurate detection is critical for managing this neurological condition, which has led to increased adoption of innovative monitoring technologies.

Epilepsy monitoring devices are used to record brain activity and detect abnormal patterns, particularly seizures. These devices include electroencephalography (EEG) systems, ambulatory EEGs, video EEGs, and wearable monitoring solutions. Technological advancements, such as cloud integration, wireless telemetry, and AI-based seizure prediction, are transforming clinical practice and enhancing patient outcomes. Hospitals, neurological centers, and home care settings are key application areas for these devices.

The market is also benefitting from increased healthcare spending, greater awareness of epilepsy diagnostics, and supportive government initiatives across developed and developing regions. North America leads the market due to its advanced healthcare infrastructure and growing R&D investments. Meanwhile, the Asia-Pacific region is projected to experience the fastest growth, driven by increasing healthcare access and improved diagnostic facilities. As precision medicine and remote monitoring trends gain momentum, the epilepsy monitoring devices market is expected to see sustained demand. Continued innovation and integration with telehealth platforms are poised to reshape epilepsy care on a global scale.
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EITB: enzyme-linked immunoelectrotransfer blot; CT scan: computed tomography scan.

The Acute Repetitive Seizures (ARS) market, valued at $2.62 billion in 2025, exhibits robust growth potential, projected to expand at a Compound Annual Growth Rate (CAGR) of 13.05% from 2025 to 2033. This significant growth is fueled by several key factors. Increasing prevalence of epilepsy and other neurological disorders leading to ARS is a primary driver. Advancements in drug development, particularly in novel therapies targeting specific seizure types and mechanisms, are contributing to improved treatment outcomes and market expansion. Furthermore, rising awareness among healthcare professionals and patients regarding effective ARS management, coupled with increased access to specialized healthcare services, is boosting market demand. The market is segmented by drug type (Benzodiazepines, Antiepileptic Drugs, Barbiturates, and Others), route of administration (Oral, Injectables, and Others), and distribution channel (Hospital Pharmacies, Retail Pharmacies, and Online Pharmacies). North America currently holds a substantial market share due to high healthcare expenditure and advanced medical infrastructure. However, Asia-Pacific is poised for significant growth driven by increasing healthcare investment and rising prevalence of neurological disorders in emerging economies. Competitive dynamics within the ARS market are shaped by a mix of established pharmaceutical giants like UCB SA, Pfizer Inc, and Eisai Co Ltd, alongside emerging biotech companies focused on innovative therapies. The presence of these players fosters both innovation and competition, leading to improved treatment options and potentially more affordable access to medication. However, challenges such as stringent regulatory approvals for new drugs, high research and development costs, and potential side effects associated with some ARS treatments pose restraints to market growth. Despite these challenges, the long-term outlook for the ARS market remains positive, driven by continued advancements in treatment strategies and a growing need for effective seizure management solutions globally. The market’s growth trajectory is likely to be influenced by factors such as evolving treatment guidelines, pricing strategies, and the introduction of biosimilars. Recent developments include: September 2024: Aculys Pharma Inc. submitted a New Drug Application to the Japanese Ministry of Health, Labour and Welfare (MHLW) for diazepam nasal spray, an antiepileptic drug being developed for the treatment of status epilepticus or epileptic seizures that may lead to status epilepticus.March 2024: The Epilepsy Foundation partnered with Iaso Venture to establish the Iaso NeuroImpact Fund. This innovative fund serves as a cornerstone for advancing the development of pioneering therapeutics aimed at revolutionizing the landscape of care for epilepsy and seizure disorders.. Key drivers for this market are: Rising Burden of Seizures Coupled with Growing Aging Population, Increasing Research and Development Activities. Potential restraints include: Rising Burden of Seizures Coupled with Growing Aging Population, Increasing Research and Development Activities. Notable trends are: Benzodiazepines Segment Expected to Witness Significant Growth Over the Forecast Period.

Epileptic Seizure Monitoring System Market Outlook

The global epileptic seizure monitoring system market size was valued at approximately USD 1.5 billion in 2023 and is projected to reach around USD 3.1 billion by 2032, growing at a compound annual growth rate (CAGR) of 8.2% during the forecast period. The market growth is primarily driven by the rising prevalence of epilepsy, advancements in monitoring technologies, and increasing awareness about epilepsy management.

One of the significant growth factors for the epileptic seizure monitoring system market is the increasing global incidence of epilepsy. According to the World Health Organization (WHO), epilepsy affects about 50 million people worldwide, and approximately 2.4 million new cases are diagnosed each year. This growing patient population necessitates efficient and reliable monitoring systems to manage and control seizures effectively. Additionally, the increasing awareness about epilepsy and its management has led to a higher demand for advanced monitoring devices, further propelling market growth.

Advancements in technology play a pivotal role in the growth of the epileptic seizure monitoring system market. Innovations such as wearable devices, implantable devices, and real-time monitoring systems have significantly enhanced the accuracy and convenience of seizure detection and management. For instance, wearable devices equipped with EEG and accelerometry technology can provide continuous monitoring and immediate alerts, improving patient outcomes. Moreover, the integration of artificial intelligence (AI) and machine learning algorithms in these devices has enabled precise prediction and detection of seizures, contributing to market expansion.

Another critical factor driving the market is the growing focus on personalized medicine and patient-centric care. Healthcare providers are increasingly adopting monitoring systems that offer individualized care plans, tailored to the specific needs and conditions of epilepsy patients. This trend is supported by the rising adoption of home care settings for epilepsy management, where patients can benefit from continuous monitoring without the need for frequent hospital visits. The shift towards home-based care solutions is expected to drive significant growth in the epileptic seizure monitoring system market.

From a regional perspective, North America holds the largest share of the epileptic seizure monitoring system market, attributed to the high prevalence of epilepsy, advanced healthcare infrastructure, and substantial investment in research and development. Europe is the second-largest market, driven by increasing awareness about epilepsy management and favorable government initiatives. The Asia Pacific region, however, is expected to witness the highest growth rate due to the rising incidence of epilepsy, improving healthcare facilities, and increasing adoption of advanced monitoring technologies. Latin America and the Middle East & Africa regions are also anticipated to experience steady growth during the forecast period, supported by improving healthcare access and growing awareness about epilepsy.

Acute Repetitive Seizures (ARS) are a significant concern in the management of epilepsy, particularly due to their unpredictable nature and potential to escalate into more severe forms of seizures. ARS are characterized by a cluster of seizures occurring within a short period, often requiring immediate medical intervention to prevent complications. The development of advanced monitoring systems has been crucial in managing ARS, allowing for timely detection and intervention. Wearable and implantable devices equipped with real-time monitoring capabilities are particularly beneficial in identifying the onset of ARS, providing alerts to healthcare providers and caregivers. This proactive approach not only improves patient safety but also enhances the overall quality of life for individuals living with epilepsy. As the understanding of ARS continues to evolve, the integration of AI and machine learning in monitoring systems is expected to further refine the detection and management of these seizures, offering new hope for patients and their families.

Product Type Analysis

The epileptic seizure monitoring system market is segmented by product type into wearable devices, implantable devices, and conventional devices. Wearable devices are gaining significant traction due to their convenience and ease of use. These devices, often equipped with

The global epilepsy monitoring devices market is experiencing robust growth, projected to reach a substantial size, driven by several key factors. The rising prevalence of epilepsy, particularly in developing nations, fuels the demand for accurate and efficient diagnostic tools. Technological advancements in areas such as wearable devices, responsive neurostimulation, and improved EEG technologies are significantly enhancing diagnostic capabilities and patient outcomes, leading to increased market penetration. The shift towards minimally invasive procedures and a growing preference for ambulatory monitoring further contribute to market expansion. While the high cost of advanced devices and the need for skilled professionals to operate them present challenges, the overall market trajectory remains positive, propelled by continuous innovation and increasing healthcare spending. The market segmentation reveals strong growth across various product types, with wearable devices gaining traction due to improved comfort and portability compared to conventional systems. Similarly, advancements in technologies like vagus nerve stimulation and responsive neurostimulation are driving segment-specific growth. Geographically, North America and Europe currently hold significant market share, attributed to well-established healthcare infrastructure and high adoption rates. However, the Asia-Pacific region is poised for substantial growth, fueled by rising awareness, increasing disposable incomes, and expanding healthcare facilities. The forecast period of 2025-2033 anticipates a continued upward trend, with the compound annual growth rate (CAGR) of 5.35% indicating steady expansion. This growth will be influenced by ongoing research and development in the field, leading to more sophisticated and user-friendly devices. Furthermore, the increasing focus on personalized medicine and the development of algorithms for better data analysis will further improve diagnostic accuracy and treatment efficacy. Competitive pressures among established players and the emergence of new entrants are likely to lead to product innovation and pricing strategies that will shape market dynamics throughout the forecast period. Strategic collaborations and partnerships between technology companies and healthcare providers will play a crucial role in driving market penetration and improving access to advanced epilepsy monitoring technologies globally. Recent developments include: In May 2022, Spanish start-up mjn-NEURO launched the mjn-SERAS that helps in seizure detection in the United Kingdom. It is a revolutionary device that uses artificial intelligence to predict seizures with up to 3 minutes of advanced warning., In February 2022, Epitel, maker of a wearable electroencephalogram (EEG) system, raised USD 12.5 million for seizure detection in Series A funding.. Key drivers for this market are: Increasing incidence of Epilepsy, Rising awareness of neurodegenerative disorders, including epilepsy. Potential restraints include: Increasing incidence of Epilepsy, Rising awareness of neurodegenerative disorders, including epilepsy. Notable trends are: The Conventional Devices Segment is Expected to Hold a Major Market Share Over the Forecast Period.

The global epilepsy self-monitoring device market is experiencing robust growth, projected to reach $22 million in 2025 and exhibiting a Compound Annual Growth Rate (CAGR) of 16.5% from 2025 to 2033. This significant expansion is driven by several key factors. Increasing prevalence of epilepsy, particularly in developing nations, fuels demand for effective and convenient monitoring solutions. Advancements in wearable technology are enabling smaller, more comfortable, and feature-rich devices, improving patient compliance and data accuracy. Furthermore, the rising adoption of telehealth and remote patient monitoring (RPM) programs is contributing to market growth, providing patients with greater access to care and clinicians with valuable real-time data. The market is segmented by application (online vs. offline monitoring) and device type (bed sensors, wearable devices, and others), with wearable devices anticipated to dominate due to their portability and ease of use. Technological innovations, such as improved seizure detection algorithms and integration with smartphone applications, are further accelerating market expansion. However, high initial costs of devices and a lack of awareness about self-monitoring technologies in some regions pose challenges to market penetration. Despite these restraints, the market's positive trajectory indicates substantial growth opportunities for manufacturers and healthcare providers in the coming years. The market's geographical distribution reflects varying levels of healthcare infrastructure and technological adoption. North America currently holds a significant market share due to high healthcare expenditure and advanced technological infrastructure. However, Asia-Pacific, particularly India and China, is expected to witness rapid growth driven by rising epilepsy prevalence and increasing healthcare investments. Europe is also a significant market, with established healthcare systems and increasing adoption of innovative healthcare technologies. The competitive landscape features a mix of established players and emerging companies, fostering innovation and driving competition. Companies are focusing on developing advanced features, improving device usability, and expanding their distribution networks to capture a larger market share. Overall, the global epilepsy self-monitoring device market presents a promising investment opportunity, promising considerable growth and technological advancements in the coming decade.

The size of the Epilepsy Diagnosis Treatment Market was valued at USD 2.49 billion in 2023 and is projected to reach USD 6.58 billion by 2032, with an expected CAGR of 14.90% during the forecast period. The Epilepsy Diagnosis and Treatment Market includes drugs and medical technologies that help determine the correct and effective management of epilepsy, an ongoing neurological disease that is categorized by recurrent and unprovoked seizures. Diagnostic modalities include EEG, MRI scans, and computed tomography scan, while therapy options include medications, VNS, RNS, and surgical interventions. Advanced technologies into the market include wearable seizure detection devices, which increase the actuality of the diagnose and provide an individualized plan of treatment. The applications are hospitals, specialty clinics, and research institutions that would help one get diagnosed in the early stages and be fully taken care of. Market growth is as a result of growing prevalence of epilepsy worldwide, awareness, and technological innovation. The key driver is the integration of AI in diagnostic imaging, which will enable faster and more accurate detection of epileptic activity leading to better patient outcomes. Some benefits are non-invasive diagnostic techniques, individualized management for medications, and increased quality of life for patients. Moreover, advances in neurostimulation devices provide control over seizures in drug-resistant epilepsy, thus making a huge difference in treatment outcomes and safety for the patients. Recent developments include: March 2022 The United States Food and Drug Administration granted Lupin's abbreviated new drug application (ANDA) for Vigabatrin approval. It is an anti-epileptic medication that will be sold as a 500 mg oral solution USP., March 2022 The US Food and Medicine Administration has also given the medicine Ztalmy by Marinus Pharmaceuticals permission to treat seizures in people with CDKL5 deficiency, a genetic form of epilepsy.. Potential restraints include: High Procedural Cost 21, Sophistication And Training Associated With Aesthetic Procedures 22. Notable trends are: Growing accidents is driving the market growth.

The global anti-epileptic drug (AED) market is a significant and growing sector, projected to reach a substantial size driven by several key factors. While the provided data states a 2025 market size of $4130.1 million, a CAGR (Compound Annual Growth Rate) is missing. Considering the prevalence of epilepsy and ongoing research into new and improved AEDs, a reasonable estimate for the CAGR over the forecast period (2025-2033) would be in the range of 4-6%, reflecting steady market expansion. This growth is fueled by increasing epilepsy prevalence, particularly in developing countries, and the introduction of newer AEDs with improved efficacy and tolerability profiles. The market is segmented by drug generation (first and second generation) and application (partial and generalized seizures), each presenting unique growth opportunities. The aging global population also contributes to market growth as epilepsy is more prevalent among older adults. Furthermore, increased awareness and improved diagnostic capabilities are leading to earlier diagnosis and treatment, boosting market demand. However, market growth faces certain restraints. High costs associated with AEDs, especially newer generation drugs, pose a significant barrier to access, particularly in low and middle-income countries. Additionally, the existence of generic AEDs creates competition and price pressure. Side effects associated with some AEDs can also lead to treatment discontinuation or a need for alternative therapies. The competitive landscape is intense, with major pharmaceutical companies like Abbott Laboratories, Pfizer, and Sanofi actively involved in research, development, and marketing of AEDs. Regional market variations exist, with North America and Europe currently holding substantial market shares due to higher healthcare expenditure and advanced healthcare infrastructure. Emerging markets in Asia and Africa, however, are expected to witness significant growth in the coming years as healthcare infrastructure improves and awareness increases.