Diabetes Demographics

According to the Centers for Disease Control and Prevention (CDC), the percentage of individuals with Type II diabetes is approximately 13%, where 2.8% may be undiagnosed. It is understood that the prevalence of diabetes increases with age reaching 26.8% among those who are 65 or older. Evaluating trends, while the estimated percentage of undiagnosed individuals may not have increased, evidence suggests that during the period of 1999-2016, the prevalence of diagnosed diabetes has significantly increased (CDC, 2020). What does this mean? When we look at only adults 18 and older, Type II diabetes in the United States appears to be increasing. Diabetes-related hospital deaths have been linked to place-based disparities (Ferdinand, et al., 2019). Studies have also reported significantly higher mortality rates associated with diabetes, in areas experiencing shortages of healthcare providers (Ferdinand et al., 2018). Handedly, while trends indicating a decrease in mortality rate for diabetes may be evident in urbanized areas, the rate of diabetes mortality remains largely unchanged in rural areas (Callahan et al., 2019).

Analyzing the Data

The purpose of this analysis is to compare diabetes rates and poverty, race, age, education level, insurance rates, unemployment rates, access to primary care providers, Medicare reimbursement rates, and the number of Medicare enrollees for each county and state.

This data is also available in a text-based table format.

Tutorial: Using the Data

Data Sources

County Health Ranking (data released 2020)

Dartmouth Health Atlas - Medicare Reimbursements/Enrollee (data released 2017)

Defining the Columns

A blank entry indicates unreported data. A value of zero is a defined value and does not represent unreported data.

State: The abbreviated name of the state where the county is located.

County: The name of the county where the information was collected. County names are listed as provided on the U.S. Census Bureau's list of 2019 FIPS Codes for Counties and County Equivalent Entities.

Population Size: The total number of individuals residing in the county. This data is derived from the Census Population Estimates from 2018.

Medicare Enrollees: The total number of Medicare beneficiaries age 65-99 in the county for 2017 enrolled in both Medicare Parts A and B. Patients enrolled in risk-bearing health maintenance organizations (HMOs) are excluded.

Medicare Reimbursements/Enrollee: The average Medicare reimbursement for 100% of the claims for each county in 2017.

Diabetes Rate: The percentage of the county’s population that have diabetes. The measure is provided by the CDC Diabetes Interactive Atlas from 2016.

Child Poverty Rate: The percentage of children in the population who fall below the poverty level obtained from Small Area Income Poverty Estimates (SAIPE) in 2017.

Percent Asian: The proportion of the county’s population that falls into the race or ethnicity category of Asian from the US Census Bureau Population Estimates from 2018.

Percent Black: The proportion of the county’s population that falls into the race or ethnicity category of Black from the US Census Bureau Population Estimates from 2018.

Percent Hispanic: The proportion of the county’s population that falls into the race or ethnicity category of Hispanic from the US Census Bureau Population Estimates from 2018.

Percent Native Hawaiian or Other Pacific Islander: The proportion of the county’s population that falls into the race or ethnicity category of Native Hawaiian or Other Pacific Islander from the US Census Bureau Population Estimates from 2018.

Percent Native American: The proportion of the county’s population that falls into the race or ethnicity category of Native American from the US Census Bureau Population Estimates from 2018.

Percent White: The proportion of the county’s population that falls into the race or ethnicity category of White from the US Census Bureau Population Estimates from 2018.

Percent Age <18: The proportion of the county’s population that falls into the age category of less than 18 years old from the US Census Bureau Population Estimates from 2018.

Percent Age 65 and Older: The proportion of the county’s population that falls into the age category of 65 years old and older from the US Census Bureau Population Estimates from 2018.

Percent With HS Diploma: The estimated number of individuals in the county with a high school (HS) diploma from the US Department of Education's EDFacts data from 2017-2018.

Percent Uninsured: The estimated percentage of individuals in the county under age 65 without health insurance. Data is from the Small Area Health Insurance Estimates Program (SAHIE) from 2017.

Percent Unemployed: The estimated percentage of individuals in the county who had no employment, were available for work, and had made specific efforts to find employment. The number is from the annual US Bureau of Labor Statistics’ Labor Force Data in 2018.

Primary Care Physicians: The number of primary care providers per 100,000 population. The data is derived from the Small Area Resource File and the American Medical Association from 2018.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,009,121 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.