WHY DO PREVALENCE RATES FOR DIABETES MELLITUS DIFFER BETWEEN VIRGINIA HEALTH DISTRICTS WITH DIFFERENT ECONOMIES?

Reports have associated coal mining, the basis of the economy in many areas of Virginia (VA), with higher health disparities, i.e., diabetes mellitus (DM), without evidence for a cause-effect relationship. This study assessed factors associated with rates of DM in selected health districts (HD) of VA. The state average DM prevalence rate VA was 10% from 2005-2009 and for coal dependent Cumberland Plateau HD, 14.8%. The prevalence rates of DM were lower in other VA HDs, less dependent or not dependent on coal; Mount Rogers (11.3%), Chickahominy (6.7%), and Loudon (3.4%). Similarly, the prevalence rates of obesity were 34-40% in Cumberland Plateau and Mount Rogers compared to 24-28% in Chickahominy and 13-23% in Loudon (VA, 28%). Economic factors, such as a population below the federal poverty line (FPL), exhibited geographically specific disparities as well. In the Cumberland Plateau 13.2% of the population was below the FPL. The FPL for Mount Rogers was 11.5%, for Chickahominy 11.2% and Loudon, 15.1%. Additional factors impacting economic status, such as the percentage of the population without a vehicle, were also reported for Cumberland Plateau 9%, Mount Rogers 7.1%, Chickahominy 2.6% and Loudon 1.8%. To conclude, in southwest VA the importance of the economy (i.e., coal production) must be placed in perspective with confirmed factors that contribute to DM, obesity adn physical inactivity. Health care teams can contribute to improved prevalence rates of DM by extending services, improving access and offering health education in these communities. Funding source: This study was sponsored by the Appalachian Research Initiative for Environmental Science (ARIES). ARIES is an industrial affiliates program at Virginia Tech, supported by members that include companies in the energy sector. The research under ARIES is conducted by independent researchers in accordance with the policies on scientific integrity of their institutions. The views, opinions and recommendations expressed herein are solely those of the authors and do not imply any endorsement by ARIES employees, other ARIES-affiliated researchers or industrial members. Information about ARIES can be found at http://www.energy.vt.edu/ARIES.”