County-level association of diabetes and obesity with premature mortality
George W Hafzalla1, Dmitry Abramov2, Ahmed Sayed3
1Department of Medicine, Loma Linda University Health, Loma Linda, CA, United States.
Objective:
The association between the prevalence of diabetes and obesity and premature mortality at the county-level has not been well characterized. This study aims to elucidate the relationship between county-level prevalence of diabetes and obesity and premature mortality.
Methods:
We utilized the data from the 2022 County Health Rankings which obtained the data from Behavioral Risk Factor Surveillance System in 2019, and National Center for Health Statistics Mortality Files 2018-2020. The county prevalence of diabetes and obesity was determined, and univariable and multivariable associations with premature mortality were identified.
Results:
Among 3082 counties, the percentage of individuals with diabetes ranged from 5.5 to 21.0 % and the percentage of individuals with obesity ranged from 16.4 to 51.0 %. Our analysis revealed a stepwise increase in premature age-adjusted death rates (AADR) with rising deciles of county-level diabetes (P < 0.001) and obesity (P < 0.001) in both univariable and multivariable models.
Conclusions:
These findings underscore the significance of addressing diabetes and obesity at the county-level to reduce premature mortality and improve population health outcomes across varied communities in the United States.
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