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Why Diabetes is a Concern for Rural Communities

As of 2015, 23.1 million people had been diagnosed with diabetes in the United States. The diabetes belt is a region of the United States that spans over 644 counties in 15 states, most of which have significant rural populations. Rural residents experience a 17% higher rate of type 2 diabetes than urban residents. Many of the counties in the diabetes belt have populations at high-risk of developing diabetes. Diabetes is an increased concern for rural communities than urban communities because of risk factors that are prevalent in rural communities and access to a variety of services.

Risk Factors

There are many risk factors associated with diabetes. Having one or more risk factors increases the likelihood of developing diabetes. Common risk factors include:

  • Obesity
  • Physical inactivity
  • Poor diet
  • Older age
  • Family history
  • Race/ethnicity

Rural residents have higher rates of the lifestyle habits that increase their likelihood of being obese and developing diabetes, such as consuming greater amounts of dietary fats and lesser amounts of fruits and vegetables. Rural communities often have populations that are at an increased risk of developing type 2 diabetes. At-risk groups include older adults and individuals of Alaskan Native, American Indian, African American, Hispanic, and Asian/Pacific Islander descent.


Rural barriers to access to healthcare and health education include:

  • Shortages of physicians and providers in rural areas. Despite the fact that 16% of the US population (almost 50 million Americans) live in rural areas, only 10% of physicians practice there. These workforce shortages make it difficult to provide diabetes education, retain dietitians and nutritionists, and replace retiring physicians.
  • Low health literacy of residents
  • Inadequate access to health insurance to cover medical appointments, medications and diabetic supplies
  • Low incomes that result in deferring care for financial reasons
  • Limited access to transportation to travel to appointments with primary care or specialty care providers

Resources to Learn More

Centers for Disease Control and Prevention: Diabetes
This page provides more details, data & statistics about diabetes. The CDC also provides programs and initiatives that prevent and support diabetes efforts across populations such as the National Diabetes Prevention Program, National Diabetes Education Program, and Native Diabetes Wellness Program.
Organization(s): Centers for Disease Control and Prevention

Diabetes National Data
Here you can find specific statistics about diabetes including incidence, age at diagnosis, duration, treatment, and complications.
Organization(s): Centers for Disease Control and Prevention