Diabetes belt stretches across 15 states

A so-called "diabetes belt" reflecting a far higher prevalence of diabetes than in the rest of the US exists and includes the entire state of Mississippi; much of Alabama, Georgia, Kentucky, Louisiana, South Carolina, Tennessee, and West Virginia; parts of Arkansas, North Carolina, and Virginia; and bits of Florida, Ohio, Pennsylvania, and Texas.

Data from the 2007 and 2008 Behavioral Risk Factor Surveillance System was combined with county-level diagnosed diabetes prevalence estimates to identify 644 counties in 15 mostly southern states with an estimated prevalence of diagnosed diabetes of 11.0% or higher. Prevalence of diabetes within the belt was 11.7% (95% CI, 11.4%-12.0%), while the prevalence in the rest of the country was 8.5% (95% CI, 8.3%-8.6%).

People in the belt were more likely to be non-Hispanic African American (23.8% vs 8.6%), lead a sedentary lifestyle (30.6% vs 24.8%), and be obese (32.9% vs 26.1%) than people in the rest of the US. They also were less likely to have a college degree (24.1% vs 34.3%). Thirty percent of the excess risk was associated with modifiable risk factors and 37% with nonmodifiable factors.

The authors of the study note that much of the area in the diabetes belt was formerly agricultural. People there may have continued to consume high-calorie diets appropriate for agricultural labor after the need no longer existed.

Barker LE, Kirtland KA, Gregg EW, Geiss LS, Thompson TJ. Geographic distribution of diagnosed diabetes in the U.S. A diabetes belt. Am J Prev Med. 2011;40(4):434-439.