County-Level "Diabetes Belt" Carves a Swath through U.S. South

Going past national statistics, a new map shows more than 640 counties in mostly southern states had higher-than-average rates of diabetes, suggesting the need for more targeted prevention















Share on Tumblr


Not every county with rates of diagnosed diabetes above 11.2 percent lies within the newly designated region—some are as far afield as Washington and Montana. But regardless of location, the new information should help local officials have a better understanding of their areas' problems—and make a better case for additional resources for prevention and management programs. "When you give the [local] number itself, that's more of a motivation for action," Mokdad says.

Mokdad and some of his colleagues at IHME hope to provide even more county-level data by combining the phone survey information with findings from smaller, national clinical studies. Their findings, published in 2010 in Population Health Metrics, include additional risk factors such as the prevalence of fast-food restaurants, in addition to data about how well people's diabetes are being managed. "That's the next wave of what we need to provide to these counties," he says.

But Barker calls attention back to the national diagnosed diabetes rate of 8.5, suggesting it is not exactly the best target to have in mind—even for counties that currently have the highest prevalence rates. "While diabetes is more of a problem in the diabetes belt, it's a problem everywhere, and we shouldn't overlook that."



23 Comments

Add Comment
View
  1. 1. EyesWideOpen 07:18 PM 3/8/11

    Sigh, this is not rocket science. One metric to compare is sales of MacDonald's and other fast food outlets in the "Diabetes Belt."

    If people are living in poverty, they are eating for next to nothing at fast food joints like MacDonalds -- and pumping nothing but greasy lard into their bodies. Although that might provide a short fix if trying to stave off starvation in a disaster (i.e. you survive a plane crash and must hike out of the Rockies on foot), long-term ingestion of the toxic smorgasbord of fats and chemicals dished out by fast food corporations is like going on the program "Get Diabetes in Less Than a Year!"

    The United States and other developing nations have turned into a fast food nightmare guaranteed to bankrupt their healthcare systems in the coming decades.

    Reply | Report Abuse | Link to this
  2. 2. andyinannarbor 08:24 PM 3/8/11

    This map is remarkably similar to the "food dessert" map that appeared at http://www.slate.com/id/2287061/slideshow/2287079/device/simpleHtml/fs/0//entry/2287071/.
    EyesWideOpen's comment reinforces this point of the lack of accessible quality food.

    Reply | Report Abuse | Link to this
  3. 3. vmfenimore 08:39 PM 3/8/11

    With the exception of Florida this map also represents all of the very hot and muggy states where going outside to lead and active lifestyle is miserable.

    Reply | Report Abuse | Link to this
  4. 4. Semiahmoo 09:16 PM 3/8/11

    I hardly think "hot and muggy" has anything to do with it. The "cold and miserable" states would be the same but they are not.

    Reply | Report Abuse | Link to this
  5. 5. Happy Phil 10:43 PM 3/8/11

    The southern diet is based on "If it ain't fried - it ain't food". This catchy slogan has put generations of poor southerners in perilous health since the civil war.

    One will have to overcome ignorance, poverty, and southern traditions in order to alter the unhealthy habits of the people who live in the diabetes belt.

    Reply | Report Abuse | Link to this
  6. 6. kayakr 10:48 PM 3/8/11

    Food choice is an existential issue for the US middle class. Democracy as implemented with lobbies and a public in denial is sinking the nation in a self reinforcing whirlpool of entrenched food, drug, health care provider and tax interests.

    Agg lobbies -> Food lobbies -> bad, cheap food -> disease -> drugs / healthcare -> benefits / taxes -> lobbies -> bankrupt / uncompetitive USA

    Please read "The china study" and "Food Revolution" and chat them up with everyone you can. Sad.

    Reply | Report Abuse | Link to this
  7. 7. aidel 11:02 PM 3/8/11

    Maybe. BUT it is also true that raising one's body temperature is metabolically expensive (more than cooling), not to mention shoveling snow. And of course fast food is a problem but so are the traditional regional foods. Lack of infrastructure makes driving necessary and, at least in rural areas, walking - almost impossible. If you do want to walk, not only is it true that the heat (for most of the year) is unbearable but also treacherous (ticks, snakes, tall grasses) AND besides the mailbox, you really don't have anywhere to go. Poverty and poor education are also BIG issues (THE real problem?). Food is cheap and the constant feeling of insecurity about the next paycheck, the next meal, etc., can cause one to 'put a little in the bank' when there is plenty. Most people desire a certain level of physical and psychological comfort. Unfortunately, down here too often that means sitting in the AC and watching Fox "news" while eating a box of ding-dongs.

    Reply | Report Abuse | Link to this
  8. 8. aidel in reply to vmfenimore 11:04 PM 3/8/11

    Yes, but despite it's geography, most of Florida is NOT a Southern state, culturally speaking.

    Reply | Report Abuse | Link to this
  9. 9. aidel in reply to vmfenimore 11:04 PM 3/8/11

    Yes, but despite it's geography, most of Florida is NOT a Southern state, culturally speaking.

    Reply | Report Abuse | Link to this
  10. 10. Sculptor3509 05:20 AM 3/9/11

    It is often forgotten that late onset Type 2 diabetes can also have a strong inheritance factor. A healthy lifestyle and good BMI do not give immunity in such cases. A control regime is then more constrained - with only minor adjustments being possible via lifestyle options.

    The description of the affected communities in this study suggests that genetic inheritance should not be discounted.

    A recent study also links poor nutrition during pregnancy to genetic changes for the offspring developing Type 2. The genetic effect it has can also be passed down through more than one generation.

    Reply | Report Abuse | Link to this
  11. 11. biyofizika 06:49 AM 3/9/11

    This map is the negative print of the map of corporate America. No more comments!

    Reply | Report Abuse | Link to this
  12. 12. michaeltdeans 08:51 AM 3/9/11

    Like most pandemic diseases, diabetes could be controlled by attention to trace element nutrition - in this case zinc deficiency. See www.scienceuncoiled.co.uk, for the background science. Zinc interacts with the hormones insulin and glucagon to regulate cellular uptake of glucose, also with vitamin C. Associated conditions treatable with zinc are neonatal jaundice, anorexia nervosa, infection by colds and flu and the various skin, eye and reproductive side-effects of diabetes.

    Zinc supplements are cheap and safe at the recommended dosage, commonly marketed in association with vitamin C. Along with a sensible balanced diet and exercise, this small change could make a big difference.

    Reply | Report Abuse | Link to this
  13. 13. KRAYA2 11:02 AM 3/9/11

    How about a 1850 map of the slave population and a breakdown of the racial percentages of diabetes cases.

    Might help understand the problem.

    Reply | Report Abuse | Link to this
  14. 14. EyesWideOpen 02:21 PM 3/9/11

    Clearly the FDA needs to establish a public health crisis case against "junk foods" including many "fast foods," banning combinations of foods not fit for safe human consumption, thereby forcing corporations (such as MacDonald's, Kentucky Fied Chicken and other name brands I find most offensive) to reform or get shutdown.

    To avoid the complete collapse of our healthcare system that will cost countless TRILLIONS, the FDA needs to clean house in a multi-trillion dollar "food" industry whose elite few wealthy executives get rich off the destruction of human health. This toxic industry needs to get slapped down (or rather punched down with a clenched fist) by the government -- similarly to what the tobacco industry had coming and abundantly got -- to avoid a mass health collapse as threatening as the unleashing of dirty bombs in major cities and urban areas nationwide.

    Reply | Report Abuse | Link to this
  15. 15. robert schmidt in reply to EyesWideOpen 02:38 PM 3/9/11

    A fat, sugar and salt tax might help. Making it an offense to cause your children to become obese may also help. I would also recommend subsidizing nutritious foods for low income families, like food stamps but that can only be used on fresh foods rather than processed. School breakfasts are also helpful and ensure that at risk children are given the food they need to function properly at school. This also means that schools should provide nutritious meals rather than the crap they serve. Ultimately this will never pass because greedy individuals will complain that taking care of the nation's children gets in the way of them stuffing their wallets.

    Reply | Report Abuse | Link to this
  16. 16. noretreat 06:17 PM 3/9/11

    If you took the map of sweet tea consumption plus regular soft drink consumption and overlayed it on the diabetes map, you'd have a pretty close match. The answers to this are obvious and the problem is largely self-induced. The cost is an outrage.

    Reply | Report Abuse | Link to this
  17. 17. noretreat in reply to andyinannarbor 06:20 PM 3/9/11

    Lack of accessible quality food?...I don't think so. There are some very nice supermarkets with quality produce sections, excellent farmer's markets and lots of family vegetable farms. The problem has more to do with adding sugar to everything, in my opinion.

    Reply | Report Abuse | Link to this
  18. 18. rtaylortitle in reply to EyesWideOpen 09:02 PM 3/9/11

    Fats are not the problem...carbs (sugar) is the problem and our governmental pro-sugar lobbyists are hard at work confusing the issue. Almost everything has sugar in it...especially milk.
    No one is forcing mom and dad to take their kiddos or give them the money to eat at McDonalds. How about some healthier foods (fruits and vegetables and ground meat) prepared at home.
    Proper food and fitness are a lifestyle choice...a choice many people have made on their own. Laziness is rampant in both areas. Stop blaming others for your personal frailties.
    How many of these "poor" kids have a cell phone, cable TV, food provided by food stamps (other taxpayers) and/or W.I.C. cards or other government programs? Answer: a veritable plethora.

    Reply | Report Abuse | Link to this
  19. 19. robert schmidt in reply to rtaylortitle 09:58 PM 3/9/11

    @rtaylortitle, "How many of these "poor" kids have a cell phone..." you forgot to mention driving their Porsches to private school or taking their private jets to the Bahamas for March break. I do agree that it is a matter of choice. Unfortunately the children are either unable or incapable of making the proper choices themselves. That is why society as a whole needs to take steps to incentivize proper nutrition.

    Reply | Report Abuse | Link to this
  20. 20. vagirl in reply to Happy Phil 10:54 PM 3/9/11

    I am from the diabetes belt (foothills of the Blue Ridge) and poverty is often used as a scapegoat for so many issues, but I feel it is more simple in this case. My grandparents were dirt poor, but their diet would be the envy of many a foodie. Grass fed beef, free range chicks, fresh veggies.... They worked very hard each and everyday for that food and enjoyed the labor. They both lived in to their 90's and my grandfather was 6 months shy of 100. The majority of the people in this area have become lazy. Nothing is cheaper than 1 tomato seed and get a bushel of tomatoes and there is plenty of land to grow it. The greatest generation saved us from the Germans, but not from ourselves. Post war prosperity not poverty has made folks lazy and fat.

    Reply | Report Abuse | Link to this
  21. 21. skybluskyblue 11:31 PM 3/9/11

    "How many of these "poor" kids have a cell phone, cable TV, food provided by food stamps (other taxpayers) and/or W.I.C. cards or other government programs?"
    Where is my cable tv and cell phone? I am on food stamps and I have lost weight; maybe by being near a big grocery store and choosing fresh food? Although, when I only buy fresh food I have no food stamps left by the 15th. Maybe if I ate more beans I would not run out?

    Reply | Report Abuse | Link to this
  22. 22. Quinn the Eskimo in reply to EyesWideOpen 08:36 PM 3/10/11

    My instant thoughts were the same, just by looking at the map.

    It's not just what we cook, but what we buy.

    I'd also like to point out 1979. The year both Coke and Pepsi went to high fructose corn syrup. Oh, I can hear the corn ag guys screaming now.

    Corn syrup has a major responsibility in this epidemic.

    Reply | Report Abuse | Link to this
  23. 23. quatra 06:41 PM 3/12/11

    Maybe callous, but healthcare should be abolished. The weak and sick go to the wrecker (of course humanely helped out). We're too many anyway. If a "being" would have been above us on the feeding chain it certainly would have exterminated us long ago, like we try to do with the rats, competing for resources. We should invest in development of nuclear fusion and thus liberating us from that scourge of a chronical lack of expensive energy. Of course the energy companies, presidents, investors and other interested mafias lobby furiously against that.

    Reply | Report Abuse | Link to this
Leave this field empty

Add a Comment

You must sign in or register as a ScientificAmerican.com member to submit a comment.
Click one of the buttons below to register using an existing Social Account.

More from Scientific American

See what we're tweeting about

Scientific American Editors

More »

Free Newsletters


Get the best from Scientific American in your inbox

Solve Innovation Challenges

Powered By: Innocentive

  SA Digital

Latest from SA Blog Network

  SA Digital

Science Jobs of the Week

Email this Article

County-Level "Diabetes Belt" Carves a Swath through U.S. South

X
Scientific American Magazine

Subscribe Today

Save 66% off the cover price and get a free gift!

Learn More >>

X

Please Log In

Forgot: Password

X

Account Linking

Welcome, . Do you have an existing ScientificAmerican.com account?

Yes, please link my existing account with for quick, secure access.



Forgot Password?

No, I would like to create a new account with my profile information.

Create Account
X

Report Abuse

Are you sure?

X

Institutional Access

It has been identified that the institution you are trying to access this article from has institutional site license access to Scientific American on nature.com. To access this article in its entirety through site license access, click below.

Site license access
X

Error

X

Share this Article

X