Research Alert: March 27, 2018

Diabetes-Related Hospital Mortality in Rural America: A Significant Cause for Concern

It has been reported that diabetes prevalence is higher in rural areas than in urban areas. Other studies have shown that rural persons with diabetes have higher morbidity from diabetes-related complications than urban persons with diabetes. This study used data from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample (2009-2014) to examine hospital-based diabetes-related mortality and whether there were urban-rural differences across census regions. On average 2.63% of all diabetes-related urban hospital admissions resulted in death, while 2.73% of all diabetes-related rural hospital admissions resulted in death (p<0.001). Mortality rates were highest within rural areas of the South and Midwest (21.0 and 15.1 deaths per 100,000 population, respectively) compared to other areas in both regions. The noncore, micropolitan, and small metropolitan areas of the South had the highest average diabetes-related hospital mortality rates (21.0, 20.3, and 14.0 deaths per 100,000 population, respectively) compared to corresponding areas in the Northeast, Midwest, and West regions. Results suggest that substantial differences exist between rural and urban diabetes-related hospital mortality. Furthermore, the burden is especially pronounced for rural residents in the South and Midwest census regions.

Additional Resources of Interest:

• Diabetes and Forgone Medical Care Due to Cost in the U.S. (2011-2015): Individual-level and Place-Based Disparities
• Diabetes Mortality in Rural America: 1999-2015
• More information about the Southwest Rural Health Research Center
• More information from the Rural Health Information Hub's topic guides: Rural Health Disparities, Social Determinants of Health