Diabetes prevalence is approximately 17 percent higher in rural areas than urban areas, with previous studies showing that rural adults were more likely to report a diagnosis of diabetes than urban adults. A primary aim of this project was to compare urban-versus-rural Type 2 diabetes prevalence, morbidity and mortality, and investigate the influence of selected demographics. Included was a comparison of border versus non-border states, with regard to type 2 diabetes and its complications. The study examined data from the Behavioral Risk Factor Surveillance System, Healthcare Cost and Utilization Project state emergency department and inpatient survey databases (years 2007 – 2014), and CDC-Wonder Mortality Data.

Publications

• Assessing Diabetes and Factors Associated With Foregoing Medical Care Among Persons With Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in the U.S. (2011-2015)
  Journal Article
  Southwest Rural Health Research Center
  Date: 04/2017
  The purpose of this project was to identify individual- and place-based factors associated with diagnosed diabetes and foregone medical care among those diagnosed with diabetes. Diabetes prevalence and foregone medical care were found to be higher for those with lower incomes, for several racial/ethnic groups, and in the South versus other regions.
• The Changing Landscape of Diabetes Mortality in the United States Across Region and Rurality, 1999-2016
  Journal Article
  Southwest Rural Health Research Center
  Date: 02/2019
  This brief report examines place-based differences in diabetes mortality to understand whether disparities in diabetes mortality have changed across U.S. Census regions and levels of rurality over time. Reductions in diabetes mortality are lagging in rural areas, and the rural South in particular, relative to other areas of the country.
• Diabetes and Forgone Medical Care Due to Cost in the U.S. (2011-2015): Individual-level and Place-Based Disparities
  Policy Brief
  Southwest Rural Health Research Center
  Date: 08/2017
  This brief is the first in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The two aims of this study were to identify trends in diabetes rates and forgone medical care among persons with diabetes in the U.S. and to identify geographic determinants and other social determinants of health disparities.
• Diabetes Mortality in Rural America: 1999-2015
  Policy Brief
  Southwest Rural Health Research Center
  Date: 08/2017
  This brief is the second in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The primary aim of this study was to understand the scope of diabetes-related mortality in urban and rural America. We analyzed mortality caused by diabetes over a 16-year period and explored the roles played by rurality and race.
• Diabetes-Related Hospital Mortality in Rural America: A Significant Cause for Concern
  Policy Brief
  Southwest Rural Health Research Center
  Date: 03/2018
  This brief is the third in a series prepared by the Southwest Rural Health Research Center on the topic of diabetes. The aim of this study was to examine trends and rates of diabetes-related deaths for persons hospitalized in the U.S., with emphasis on differences across the urban-rural continuum and across census regions.
• Diabetes-Related Hospital Mortality in the U.S.: A Pooled Cross-Sectional Study of the National Inpatient Sample
  Journal Article
  Southwest Rural Health Research Center
  Date: 02/2019
  This study examined place-based and individual-level variations in diabetes-related hospital deaths using the 2009-2015 National Inpatient Sample. Results show that place-based disparities exist. Targeted focus should be placed on the control of diabetic complications in the South, West, and Midwest census regions and among rural residents.
• Factors Affecting the Likelihood of a Hospitalization Following a Diabetes-Related Emergency Department Visit: A Regional and Urban-Rural Analysis
  Journal Article
  Southwest Rural Health Research Center
  Date: 05/2020
  This study examines place-based and individual-level predictors of diabetes-related hospitalizations using 2009-2014 data from the National Inpatient Sample. Our findings indicate a higher incidence of these hospitalizations in residents of noncore areas in the South and Midwest, racial and ethnic minorities, and the uninsured population.
• Racial, Rural, and Regional Disparities in Diabetes-Related Lower-Extremity Amputation Rates, 2009–2017
  Journal Article
  Southwest Rural Health Research Center
  Date: 09/2021
  This study examines race, rurality, and regional disparities in diabetes-related lower-extremity amputations (LEA) among adult hospitalizations from 2009-2017. Findings indicate rising minor LEA rates among Asians/Pacific Islanders and rising major LEA rates among hospitalized diabetes patients in the Midwest.