644 counties in mostly 15 southern states have diabetes rates considerably higher than the rest of the population, significantly due to two preventable factors – physical inactivity and obesity and overweight – researchers have revealed in the American Journal of Preventive Medicine. In the 1960s we had the stroke belt, today there is the diabetes belt.

Lead researcher, Lawrence E. Barker, PhD, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, said:

“Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type 2 diabetes and to manage existing cases of the disease. Although many risk factors for type 2 diabetes can’t be changed, others can. Community design that promotes physical activity, along with improved access to healthy food, can encourage the healthy lifestyle changes that reduce the risk of developing type 2 diabetes.”

Obesity and physical activity were the cause of almost one third of the difference between diabetes rates in the rest of the country compared to the 15 southern states, the authors wrote. 30% of the difference was linked to risk factors which can be addressed, and 37% with nonmodifiable factors, such as ethnicity and age.

According to data gathered by the researchers, diabetes prevalence rates in the belt area are at least 11%. After taking into account factors such as obesity, race, ethnicity, age, sedentary lifestyle, education, gender and age, the following four factors stood out in the diabetes belt:

  • A much higher proportion of people with diabetes in those southern states were neither Hispanic nor African-Americans compared to the rest of the USA – 23.8% versus 8.6%.
  • Obesity prevalence was 32.9% in the belt area compared to 26.1% in the rest of the nation
  • 30.6% of those in the belt states led a sedentary lifestyle, compared to 24.8% elsewhere in the USA
  • 24.1% of those in these southern states have a college degree, versus 34.3% in the other states

Map highlighting diabetes belt areas

The 644 counties that make up the diabetes belt are found in parts of W Virginia, Texas, Tennessee, S Carolina, Pennsylvania, Ohio, North Carolina, Louisiana, Kentucky, Georgia, Florida, Arkansas, Alabama, and the whole of Mississippi.

Dr. Barker said:

“People who live in the diabetes belt will reduce their chance of developing type 2 diabetes if they are more active physically and, for those who are overweight or obese, if they lose weight. Taking these steps will eventually lower the prevalence of diabetes within the diabetes belt.”

“Geographic Distribution of Diagnosed Diabetes in the U.S.: A Diabetes Belt”
Lawrence E. Barker, PhD, Karen A. Kirtland, PhD, Edward W. Gregg, PhD, Linda S. Geiss, MA, and Theodore J. Thompson, MS.
American Journal of Preventive Medicine – Volume 40, Issue 4 (April 2011) . doi: 10.1016/j.amepre.2010.12.019.

Written by Christian Nordqvist