subject: Will Increasing Physical Activity And Decreasing Obestity Reduce Daibetes Rates In The South? [print this page] Preliminary data from the Centers for Disease Control and others point to a trend toward higher incidence rates of diabetes and obesity in southeast United Staes but lower rates of obesity and diabetes are found in Vermont and Northwest United States.
Incidence in these states was 10 to 12 cases per 1000 when compared to 4 to 6 cases in the Northwest. Similar data was reported for obesity and physical inactivity.
A study of variation in incidence rates of diseases such as goiter points to environmental factors. Similar, preliminary data are being reported for diabetes and obesity.
Diabetes is a major public health problem in the United States and the world.
One in twelve americans and one in twenty people in the world suffer from diabetes
What is the difference between prevalence and incidence of a disease?
The term prevalence of a disease indicates all cases of the disease (e.g., diabetes), expressed as x number of cases per 1000 population. Incidence, on other hand, incidence of a disease refers to only new cases of the disease (usually new cases per year).
Geographical variations in occurence of new cases of diabetes
States with lowest incidence of diabetes (4 to 6 cases per thousand) are Oregon, Colorado, Vermont, etc. Highest incidence rates (10.8 to 12.8 per thousand) wre reported for states which comprise the south - Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee and West Virginia and states which border these - Delaware, District of Columbia, Maryland Oklahoma and Texas. The exception is Virginia, which has the same lower incidence of diabetes as states in the northeast.
Relationship between prevalence of physical inactivity and obesity and high incidence of diabetes in the south
Impact of treatment to reduce diabetes incidence would presumably be highest in the south because (preliminary) data indicate that the prevalence of risk factors which we can modify such as obesity and physical inactivity are highest in the south - 27%. Similarly, since the northwest has lowest prevalence of obesity and physical inactivity (23.1%) the effect of a program to reduce obesity would be least. The midwest and northeast, with obesity prevalence rates of 25.5% would then be in the middle with regard to impact of programs to reduce obesity (and resulting in reduction of diabetes rates). Physical inactivity was also highest in the south (17.4%), less so in the northeast (15.7) and least in the west (11.2%).
Brief Note
Diabetes statistics reveal regional imbalances. The causes of these regional imbalances (primarily higher incidence in the south) are not known. However, an inference ccan be made from statistics which reveal higher incidence of modifiable risk factors for diabetes (obesity and physical inactivity) in the same geographical area.
Relevant Publications
1. Centers for Disease Control (CDC),MMWR 2008; 57(43);1169-1173 (http://cdc.gov). 2. Geiss LS, Pan L, Cadwell B, Gregg EW, Benjamin SM, Engelgau MM. Changes in incidence of diabetes in U.S. adults, 1997--2003. Am J Prev Med 2006;30:371-7 (http://www.ajpm-online.net/). 3. Diabetes mellitus handbook, Morristown Publishing Company, P.O. Box 672, Livingston, New Jersey 07039, 2009. 4. Knowler WC, Barrett-Conner E, Fowler SE, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention. N Engl J Med 2002;346:393-403 (http://content.nejm.org/). 5. United Nations - Department for Economic and Social Information - Population Division. World urbanization prospects: the 1994 revision. Estimates and projections of urban and rural populations and of urban agglomerations. United Nations, New York, 1995(http://www.un.org/esa/population/publications/wup2007/2007wup.htm). 6. CDC. State-specific prevalence of obesity among adults---United States, 2007. MMWR 2008;57:7658 (http://www.cdc.gov/mmwr/). (http://www.un.org/esa/population/publications/wup2007/2007wup.htm).
