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Diabetes dodges diagnosis in some statesDisease goes undiagnosed more often in the South and California September 25, 2009–The rate of diabetes in the US varies widely state to state, as does the rate of diagnosis, depending in part on which state a person lives in, race, and whether the person has insurance, according to new research from the Harvard School of Public Health and the Institute for Health Metrics and Evaluation (IHME) at the University of Washington. IHME and Harvard researchers evaluated data from two national health surveys – the National Health and Nutrition Examination Survey (2003 to 2006) and the Behavioral Risk Factor Surveillance System (2003 to 2007) – to estimate state-level prevalence of both diagnosed and undiagnosed diabetes cases. This is the first study to examine the impact of diabetes state by state — both the total prevalence of the disease and the proportion of undiagnosed diabetes. The study, “Diabetes prevalence and diagnosis in US states: analysis of health surveys,” was published Sept. 25, 2009, in the journal Population Health Metrics. Researchers found that men in every state were more likely to have diabetes than women. Diabetes rates were highest in the Southern and Appalachian states: Mississippi, West Virginia, Louisiana, Texas, South Carolina, Alabama, and Georgia (12% to 17%). Vermont, Minnesota, Montana, and Colorado had the lowest prevalence (7% to 12%). Researchers dug further into the data to estimate the number of people who have diabetes but have not been diagnosed with the disease. They found that being obese, being Hispanic, not having insurance, and being age 60 or older were significantly associated with a higher risk of having undiagnosed diabetes. The rate of undiagnosed cases of diabetes also varied by state. Prevalence was the highest in New Mexico, Texas, Florida, and California and lowest in Montana, Oklahoma, Oregon, Alaska, Vermont, Utah, Washington, and Hawaii. Diabetes mellitus is the sixth leading cause of death in the US, accounting for approximately 70,000 annual deaths. A Harvard-IHME study in 2008 showed that age-standardized adult diabetes death rates across US states ranged from approximately 2 per 10,000 people in Arizona and Florida to about 5 in West Virginia and the District of Columbia. The wide variation in mortality is driven partly by the state-to-state differences in risk factors for diabetes. A 2006 study by the same authors found that, for example, obesity in the South is almost 60% higher than in Colorado. The researchers suggest that government agencies work toward gathering more reliable information on diagnosed and undiagnosed diabetes at the state level, and that states consider the findings in designing, implementing, and evaluating diabetes prevention and control programs. Read the article: Danaei G, Friedman AB, Oza S, Murray CJL, Ezzati M. Diabetes prevalence and diagnosis in US states: analysis of health surveys. Population Health Metrics 2009; 7:16. |
