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. 2010 Sep;7(5):A104.
Epub 2010 Aug 15.

Residence in a distressed county in Appalachia as a risk factor for diabetes, Behavioral Risk Factor Surveillance System, 2006-2007

Lawrence Barker  1 , Richard Crespo, Robert B Gerzoff, Sharon Denham, Molly Shrewsberry, Darrlyn Cornelius-Averhart
Affiliations

Residence in a distressed county in Appalachia as a risk factor for diabetes, Behavioral Risk Factor Surveillance System, 2006-2007

Lawrence Barker et al. Prev Chronic Dis. 2010 Sep.

Abstract

Introduction: We compared the risk of diabetes for residents of Appalachian counties to that of residents of non-Appalachian counties after controlling for selected risk factors in states containing at least 1 Appalachian county.

Methods: We combined Behavioral Risk Factor Surveillance System data from 2006 and 2007 and conducted a logistic regression analysis, with self-reported diabetes as the dependent variable. We considered county of residence (5 classifications for Appalachian counties, based on economic development, and 1 for non-Appalachian counties), age, sex, race/ethnicity, education, household income, smoking status, physical activity level, and obesity to be independent variables. The classification "distressed" refers to counties in the worst 10%, compared with the nation as a whole, in terms of 3-year unemployment rate, per capita income, and poverty.

Results: Controlling for covariates, residents in distressed Appalachian counties had 33% higher odds (95% confidence interval, 1.10-1.60) of reporting diabetes than residents of non-Appalachian counties. We found no significant differences between other classifications of Appalachian counties and non-Appalachian counties.

Conclusion: Residents of distressed Appalachian counties are at higher risk of diabetes than are residents of other counties. States with distressed Appalachian counties should implement culturally sensitive programs to prevent diabetes.

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Figures

Map
Figure.
Map of Appalachia showing county development level, 2007. Source: Appalachian Regional Commission (ARC). The ARC uses an index-based county economic classification system to identify and monitor the economic status of Appalachian counties. Data sources: US Bureau of Labor Statistics, Local Area Unemployment Statistics, 2002-2004; US Bureau of Economic Analysis, Regional Economic Information System, 2003; US Census Bureau, 2000 Census, Summary File 3.
See this image and copyright information in PMC

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