Diabetes prevalence is a public health metric used to track the percentage of a population diagnosed with the condition, including both Type 1 and Type 2 diabetes. Tracking these statistics across all states allows public health officials to monitor the progression of this chronic metabolic disorder. This data is essential for the effective allocation of resources and the development of targeted prevention programs where intervention efforts are most urgently needed.
The State with the Highest Diabetes Prevalence
The state with the highest prevalence of diagnosed adult diabetes in the United States is consistently West Virginia. Based on recent data, the adult diabetes prevalence rate in West Virginia stands at 18.2% of the population. This figure represents the percentage of adults who have been told by a health professional that they have diabetes, excluding prediabetes or gestational diabetes.
This rate is significantly higher than the national average for diagnosed adult diabetes, which typically hovers around 11.5%. This difference highlights a substantial disparity in metabolic health across the country. Other states reporting similarly high rates include Mississippi (17.0%) and Louisiana (16.1%). The concentration of these elevated rates points to regional challenges that exceed the national norm.
Regional Patterns of Diabetes Prevalence
The disproportionately high rates found in West Virginia and its neighbors are part of a broader geographic trend known as the “Diabetes Belt.” This region is defined by a cluster of counties, primarily across the southeastern United States and Appalachia, that exhibit prevalence rates significantly higher than the rest of the nation. The Diabetes Belt encompasses parts of 15 states, including the entire state of Mississippi and large portions of Alabama, Kentucky, Louisiana, and Tennessee.
The elevated rates in this area suggest that shared historical, environmental, and cultural factors play a major role in disease risk. In contrast, states with the lowest rates are generally found in the Mountain West and parts of the Northeast. States like Utah and Colorado frequently report some of the lowest prevalence figures in the country, often falling below 9%. This pattern illustrates a clear geographical divide in the nation’s diabetes burden, with the Southeast facing the most concentrated challenge.
Underlying Factors Contributing to Elevated Rates
The elevated diabetes rates in certain states are tied to a complex set of socioeconomic and environmental health determinants. One of the strongest correlations exists with socioeconomic status, as communities with lower educational attainment and higher poverty levels tend to have higher prevalence rates. Lower income often restricts access to nutrient-dense foods and affordable healthcare, complicating both prevention and disease management. This strain contributes to a higher rate of undiagnosed or poorly managed cases, driving up the overall prevalence figures.
Environmental factors also play a substantial role, particularly in the overlap between high diabetes rates and areas classified as “food deserts.” These are regions where residents have limited access to supermarkets offering fresh, healthy produce, often relying instead on convenience stores and fast-food establishments. Furthermore, many high-prevalence communities lack adequate infrastructure for physical activity, such as safe sidewalks or parks. A sedentary lifestyle combined with a diet high in processed foods significantly increases the risk of developing Type 2 diabetes, which accounts for up to 95% of all cases.
Demographic composition also contributes to the observed disparities, as certain racial and ethnic groups face higher genetic and systemic risks. Non-Hispanic Black adults, American Indian/Alaska Native adults, and Hispanic adults all experience higher rates of diabetes compared to non-Hispanic white adults. This is compounded by the fact that many states within the Diabetes Belt have a higher proportion of these at-risk populations. The combination of these factors creates a challenging landscape for diabetes prevention and control in these regions.
Data Collection and Reporting Methods
The state-level prevalence figures cited by public health organizations are primarily derived from the Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is an ongoing, state-based, telephone survey conducted by the Centers for Disease Control and Prevention (CDC). It collects self-reported data from non-institutionalized adults regarding their health behaviors and chronic conditions, including whether a doctor has ever given them a diabetes diagnosis.
While this method provides reliable state-specific estimates, it generally captures only diagnosed cases of diabetes. The CDC estimates that a significant portion of adults who meet the laboratory criteria for diabetes remain undiagnosed, meaning the true total prevalence is higher than the self-reported figures. Therefore, the reported state rankings rely on the standardized measure of diagnosed prevalence.