Appalachian Region and Diabetes

According to the Appalachian Regional Commission (ARC), the Appalachia region is a 200,000-square-mile region that follows the Appalachian Mountains from southern New York to northern Mississippi. It includes all of West Virginia and parts of 12 other states: Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, and Virginia. Appalachian counties within Virginia include: Alleghany, Bath, Bland, Botetourt, Buchanan, Carroll, Craig, Dickenson, Floyd, Giles, Grayson, Highland, Lee, Montgomery, Pulaski, Rockbridge, Russell, Scott, Smyth, Tazewell, Washington, Wise/Norton, and Wythe. The following independent cities in Virginia are also within the Appalachian Region: Bristol, Buena Vista, Covington, Galax, Lexington, Norton, and Radford.
Appalachia is unique in terms of its geography, culture, and focus on coal and other natural resources as the mainstay of its economy. Persons living in Appalachia have difficulty in accessing healthcare due to geography, lack of such resources, and low socioeconomic status. According to research conducted by ARC, persons living in Appalachia also experience higher disease prevalence rates, morbidity, and mortality rates than persons living in non-Appalachian regions.
Appalachians also experience higher disease prevalence, morbidity, and mortality rates than persons living in non-Appalachian regions.

• Virginians living in the Appalachian region have a higher prevalence of diabetes than those living in non-Appalachian areas. In 2006, Appalachians had a diabetes prevalence of 11.0%, as compared to non-Appalachians with a rate of 7.2%.

Prevalence of Diabetes in Appalachian vs. Non-Appalachian Counties, 2006

• This is a striking example of a geographic disparity. In the Appalachian counties of Virginia, diabetes is 65% more prevalent than in non-Appalachian counties.

Significant* contributing factors to the higher diabetes prevalence rate in the Appalachian region in 2006 are:

• Less than half (48.5%) of Appalachians reported having some college education or more as compared to 64.8% of non-Appalachians.
• 31.9% of Appalachians reported earning a household income of less than $25,000 as compared to only 15.4%% of non-Appalachians.
• 30.4% of Appalachians were obese as compared to 24.6% of non-Appalachians.
• 35.5% of Appalachians had high blood pressure as compared to 30.1% of non-Appalachians.
• 44.3% of Appalachians had high cholesterol as compared to 39.7% of non-Appalachians

Sources: Appalachian Regional Commission- www.arc.gov/; VA BRFSS, 2006
Data Note: Percents are weighted towards annual population estimates; *Person Chi-square tests were run on all Appalachia-related data points with resulting p-values of <.001.

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