Diabetes-Related Deaths Not Decreasing in Rural Areas in the U.S.

Women and older adults experience more consistent decreases in diabetes-related deaths

Decreases in U.S. diabetes-related mortality during the past two decades have been concentrated in urban areas, according to a study published online in Diabetologia.

Ofer Kobo, M.D., from Hillel Yaffe Medical Centre in Hadera, Israel, and colleagues used the U.S. Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research Multiple Cause of Death database to examine trends in diabetes-related mortality (as the underlying or contributing cause of death) in urban and rural U.S. areas (1999 to 2019)..

The researchers found that the age-adjusted mortality rate (AAMR) of diabetes was higher in rural than urban areas across all subgroups. There was a significant decrease in the AAMR of diabetes in urban areas, as the underlying (−16.7 percent) and contributing (−13.5 percent) cause of death, which was not observed in rural areas (2.6 and 8.9 percent, respectively).

Decreases in AAMRs of diabetes were more significant in women than men in rural and urban areas. There was a temporal increase in diabetes-related AAMR among people younger than 55 (13.8 to 65.2 percent). Among American Indian patients, the diabetes-related AAMRs decreased in all areas (−19.8 to −40.5 percent).

However, among Black and White patients, diabetes-related AAMRs significantly reduced in urban areas (−26.6 to −28.3 percent and −10.7 to −15.4 percent, respectively) but not in rural areas (−6.5 to 1.8 percent and 2.4 to 10.6 percent, respectively).

“A synchronized effort is required to improve cardiovascular health indices and healthcare access in rural areas and to decrease diabetes-related mortality,” the authors write.

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