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The South, which swept a 2009 survey for fattest region, has achieved that dubious honor again when it comes to prevalence of type 2 diabetes. According to a recent study published in Population Health Metrics, it's the region with the highest percentage of type 2 diabetes when both diagnosed and undiagnosed cases are included. Mississippi is at the very top of the heap, followed by West Virginia, Louisiana, Texas, South Carolina, Alabama, and Georgia (15.8 to 16.6 percent for men and 12.4 to 14.8 percent for women).
The lowest prevalence of type 2 is found in the Northern plains, the Northeast, and the Midwest. Of individual states, Vermont, Minnesota, Montana, and Colorado have the lowest prevalence (11.0 to 12.2 percent for men and 7.3 to 8.4 percent for women). The prevalence of diabetes in the U.S. as a whole is 13.7 percent among men and 11.7 percent among women 30 years or older.
When the research group Trust for America's Health reported on the nation's state of plumpitude in 2009, the results were remarkably similar. Mississippi took the cake as the fattest state in the nation for the fifth year in a row. The four states with rates of obesity above 30 percent included not only Mississippi (32.5 percent), but also Alabama (31.2 percent), West Virginia (31.1 percent), and Tennessee (30.2 percent). Eight of the 10 states with the highest percentage of obese adults were in the South. Colorado had the lowest percentage of obese adults at 18.9 percent.
Prior to the Population Health Metrics study, the only source of information on diabetes prevalence in individual states was the Behavioral Risk Factor Surveillance System (BRFSS). Because the BRFSS was a telephone survey based totally on self-reports, it could not include the people with undiagnosed diabetes. To arrive at their state-by-state estimates of overall type 2 prevalence, Goodarz Danaei, from the Harvard School of Public Health, and his colleagues analyzed the BRFSS data based upon more complete data from the National Health and Nutrition Examination Survey (NHANES). NHANES used laboratory measurements and therefore could estimate the national prevalence of diagnosed and undiagnosed diabetes combined.
According to Danaei, Southern states like Mississippi and Alabama have not only the most type 2, but also the highest blood pressure and cardiovascular disease risk. Clearly, the South is facing a big fat problem. Don't look away, Dixieland.
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