Diabetes in Western NC

Why is diabetes a key health issue in western North Carolina?

The percentage of adults in WNC diagnosed with diabetes has risen from 13% in 2012 to 14% in 2021.

(WNCHN – WNC Healthy Impact Community Health Survey, 2021)

Diabetes Prevalence, By Year

Source: WNC Healthy Impact Community Health Survey, 2012-2021

What do the numbers say about diabetes?

Western North Carolina (WNC) Data:

Approximately 14% of adults in WNC have been diagnosed with diabetes. The following adult populations were significantly more likely to have been diagnosed with diabetes  in 2021:

  • Adults aged 65+ (22.5%)
  • Very low income (18.6%)
  • Those identifying as AI/AN, Indigenous (37.3%)
(WNCHN – WNC Healthy Impact Community Health Survey, 2021)

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/ or discrimination. See our data story on the social determinants of health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families.

Borderline or Pre-Diabetes Prevalence, By Year

Source: WNC Healthy Impact Community Health Survey, 2012-2021

In 2021, 4.6% of adults in WNC have been told by a doctor or other health professional that they have Borderline or Pre-Diabetes.

Overweight or Obese, By Year

Source: WNC Healthy Impact Community Health Survey, 2012-2021

Obesity has been associated with increased risk for Type 2 diabetes.

Approximately two thirds (68.7%) of adults in WNC were considered overweight or obese in 2021.

Only about 23% of adults in WNC were meeting current physical activity recommendations in 2021.

Percent Meeting Physical Activity Recommendations, By Year

Source: WNC Healthy Impact Community Health Survey, 2012-2021

“Meeting physical activity recommendations” includes adequate levels of both aerobic and strengthening activities: Aerobic activity is one of the following: at least 150 minutes per week of light to moderate activity, 75 minutes per week of vigorous activity, or an equivalent combination of both.

Strengthening activity is at least 2 sessions per week of exercise designed to strengthen muscles.

Forty-five percent of adults in WNC report being insufficiently active or inactive and 68% of adults in WNC report not performing any strengthening activity during the week.

Percent Consuming 5+ Servings Fruits & Veggies Per Day, By Year

Source: WNC Healthy Impact Community Health Survey, 2012-2021

The percent of adults in WNC consuming 5+ fruits and vegetables per day has decreased from 8% in 2012 and 2015 to 5.6% in 2021.

State and National Findings:

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/ or discrimination. See our data story on the social determinants of health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families.

(N.C. State Center for Health Statistics, 2020)

In 2014-2018 the age-adjusted rate per 100,000 population for diabetes mortality in North Carolina was 19.6 for White, non-Hispanic, 44.0 for African American, non-Hispanic, 40.4 for American Indian/ Alaska Native (AI/AN), non-Hispanic and 12.2 for Hispanic.

(N.C. State Center for Health Statistics, 2020)

Approximately 1,075,855 people in North Carolina, or 13.1% of the adult population, have diabetes.

(CDC, 2014)

More than 100 million Americans are living with diabetes or pre-diabetes.

(CDC, 2017)

Diabetes and pre-diabetes cost an estimated $10.9 billion in North Carolina each year.

(CDC, 2017)

What did the region say is the story behind the diabetes numbers?

Source: WNCHN – Online Key Informant Survey, 2018

The items below are paraphrased themes that emerged from a 2018 regional survey of key informants. These responses do not necessarily:

  • Reflect accurate or scientifically validated information about health determinants, outcomes, and/or strategies for change,
  • Represent an exhaustive list of factors that can help or hurt efforts to address this key regional health issue.

The information in this section should be interpreted and used with care. It should be used only to help local health departments and agencies begin to understand community perceptions about local health issues. Communities are strongly encouraged to collect their own, local-level data to inform local planning and evaluation activities.

What’s Helping?

  • Access to diabetes prevention classes
  • More tele-health opportunities
  • Education around healthy foods and access to these foods
  • Increased awareness
  • Community collaborations
  • Wellness in the workplace
  • Pre-diabetes program and diabetes management classes

What’s Hurting?

  • Cost and access to diabetes medications
  • Cost and access to healthy foods
  • Lack of willingness to commit to lifestyle changes to improve health
  • School nutrition may not be healthy
  • Food scarcity
  • Cultural food habits
  • Lack of endocrinologist access in rural communities
  • Education not covered by insurance
  • Lack of knowledge regarding impact of diabetes

What we are hearing:

“Awareness of the genetic and heritage factors associated with this disease. Access to quality medical care.”

“Education being done in preschools and the schools around healthy eating and healthy weight.”

“A number of factors, including: cost of processed, unhealthy foods vs healthier fresh foods; proliferation of fast food restaurants; and the fact that many people live in areas with no sidewalks/unsafe conditions to just get out and walk.”

“Non-compliance by patients; don’t see the need to do anything different than before.”

How is the region prioritizing this issue?

The western North Carolina region includes 17 communities: 16 counties and Eastern Band of Cherokee Indians (EBCI)

In the 2021 CHA cycle

  • 3 communities chose diabetes as a priority.
  • 10 communities selected priorities related to obesity, healthy eating, & active living.
  • 5 communities selected chronic disease.

What is already happening regionally?

The list below represents a sample of what is happening in the region around this key health issue. Visit www.nc211.org for more resources.