Rural-Urban Disparities in State-Level Diabetes Prevalence Among US Adults, 2021

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Diabetes mellitus is a significant public health concern in the United States.
• Geographic disparities in health outcomes, particularly between rural and urban populations, are well-documented.
• Understanding these disparities is crucial for targeted public health interventions.

Purpose of the Study:

• To assess state-level disparities in diabetes prevalence among adults in rural versus urban areas within the United States.
• To identify specific states exhibiting significant rural-urban differences in diabetes rates.
• To explore the influence of sociodemographic characteristics and obesity on these disparities.

Main Methods:

• Utilized data from the 2021 Behavioral Risk Factor Surveillance System for 41 states.
• Defined rural areas using the 2013 National Center for Health Statistics Urban-Rural Classification Scheme.
• Employed logistic regression to estimate odds ratios (ORs) for diabetes in rural vs. urban areas, adjusting for sociodemographic factors and obesity.

Main Results:

• Overall diabetes prevalence was 14.3% in rural areas and 11.2% in urban areas.
• Significant rural-urban diabetes disparities (OR > 1) were observed in 19 states before adjustments.
• After full adjustments for sociodemographic factors and obesity, significant disparities remained in North Carolina and Oregon.

Conclusions:

• Significant geographic disparities in diabetes prevalence between rural and urban areas were identified in 19 US states.
• Sociodemographic characteristics and obesity rates largely explained these rural-urban differences in most states.
• Findings can guide policymakers in developing targeted strategies to reduce rural-urban diabetes disparities.