Diabetes has become a major public health challenge across the United States, affecting millions of individuals and placing a substantial strain on the nation’s healthcare system. The chronic condition involves problems with how the body regulates blood sugar, accounting for significant morbidity and mortality nationwide. While the disease affects people in every region, its impact is not evenly distributed across the country. Understanding which areas face the heaviest burden of the disease is an important step in directing public health resources effectively.
How State Diabetes Prevalence is Measured
Determining the rate of diabetes across different states relies on precise surveillance methods to create comparable estimates. The primary measurement used is “prevalence,” defined as the percentage of the adult population currently living with a diagnosed case of diabetes. This is distinct from “incidence,” which tracks only the number of new cases diagnosed within a specific time frame.
The Centers for Disease Control and Prevention (CDC) largely relies on data collected through the Behavioral Risk Factor Surveillance System (BRFSS). This system is an ongoing, state-based telephone survey that gathers self-reported information from non-institutionalized adults across the U.S. Respondents are considered to have diagnosed diabetes if they answer affirmatively to the question about receiving a diagnosis from a health professional. This methodology excludes cases of prediabetes and gestational diabetes, focusing specifically on individuals with a formal diagnosis.
The State with the Highest Diabetes Rate
The state with the highest rate of diagnosed diabetes among adults is West Virginia. The most current data indicates that the prevalence of diagnosed diabetes in West Virginia is 18.2% of its adult population. This figure is considerably higher than the national average, underscoring a significant concentration of the disease in the Appalachian region.
The high-prevalence areas in the U.S. form a noticeable pattern, often clustering in the South and parts of Appalachia. Following West Virginia, other states that consistently rank among the highest include Mississippi, with an adult prevalence rate of 17.0%. These states face a disproportionate burden of the disease, reflecting underlying structural challenges in health and wellness.
To illustrate the geographical range of the disease’s impact, the rate in West Virginia stands in stark contrast to the state with the lowest prevalence. Utah holds the lowest rate of diagnosed diabetes, recorded at 7.8% of its adult population. This comparison reveals a substantial geographical disparity, with the highest-burden state reporting a rate more than twice that of the lowest-burden state.
Socioeconomic and Environmental Drivers of High Rates
The significant geographical variation in diabetes prevalence is closely linked to differences in socioeconomic and environmental factors across states. States with the highest rates of the disease often share characteristics such as lower median household income and reduced educational attainment. A strong inverse relationship exists where lower socioeconomic status is consistently associated with higher diabetes prevalence.
Communities in these high-burden areas frequently face structural limitations in their daily environments. Access to healthy food options is a major concern, with many residents living in areas considered food deserts, where grocery stores offering fresh produce are scarce. The physical environment, including the availability of safe sidewalks or parks, can also limit opportunities for regular physical activity.
Limited access to preventative healthcare services also contributes to the high prevalence and poor management of diabetes in these regions. Residents with lower incomes are more likely to be uninsured or underinsured, making routine screenings and consistent management of chronic conditions more difficult. Furthermore, states with high rates of poverty often have a higher proportion of adults who rely on public health insurance programs, which can sometimes present additional barriers to specialized care. These compounded factors—economic hardship, poor access to nutrition, and limited healthcare infrastructure—create an environment where diabetes is more likely to develop and less likely to be effectively controlled.