Climbing Incomes May Raise Diabetes Rate

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Diabetes epidemic in the South may be partially related to rapid economic growth

August 19, 2013 / Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

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(dailyRx News) Southerners have a higher rate of diabetes than people in the North or West. Income growth may have played a role, as people consumed more processed foods and became less active.

In previous studies, low incomes have been linked to a rise in diabetes rates. Many in these low-income households may not be eating healthy foods or exercising regularly. New research, however, shows that prosperity may be a contributor to diabetes as well.

A study of Southern states between 1950 and 1980 found that the improvement of economic conditions during those decades may have led to habits that helped to trigger diabetes in that population.

"Avoid processed foods to help lower risk of diabetes."

Richard Steckel, PhD, professor of economics, anthropology and history at The Ohio State University in Columbus, authored this study, which looked at the relationship between state-based per-capita income growth and diabetes prevalence in each state.

His review of data from the Bureau of Economic Analysis and the Centers for Disease Control and Prevention (CDC) revealed that dramatic improvements in household income between 1950 and 1980 were linked with higher rates of type 2 diabetes.

Southern states experienced the greatest rise in incomes as well as the biggest spike in diabetes patients.

The researchers pointed out that many people in the South lived in poverty for generations until industrialization during the 1950s and 1960s sparked fast economic growth in that region. As prosperity grew, the diabetes rate climbed.

Dr. Steckel theorized that the children of parents who were once poor were unprepared biologically to manage the riches of processed foods and the more sedentary life that came with higher incomes.

The results of this study lend support to the theory that if economic conditions during fetal development improve dramatically during a person's childhood, the prospects of poor health in adulthood increase.

African Americans, who have a higher rate of diabetes than other populations, may have been particularly affected by this economic boom.

Dr. Steckel underscored that the growth rate of median income between 1953 and 2001 in the South was 191 percent for African Americans and 84 percent for whites. In the entire country, those figures were 97 percent and 54 percent, respectively.

In 2009, more than 10 percent of the adult population had type 2 diabetes in many areas of the South, stretching from Oklahoma to West Virginia, according to the CDC.

Percentages were lower in all other states, except in some areas in Western states and in pockets of Ohio, Indiana, Michigan and Pennsylvania.

The research suggested that more food was available during a period of economic growth. Mothers may have entered the labor market and were less likely to monitor children's eating habits and physical activity. Industrialization brought mechanization, which lowered physical effort at work.

Higher incomes reduced the need for such manual labor as chopping wood and farm chores around a home. Health club memberships also were lower in the South than in other parts of the country, according to this investigation.

Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas, told dailyRx News, “Many Southerners, especially those living in poverty, traditionally worked in jobs requiring physical labor. They burned hundreds more calories per day and had less time and money to spend on meals and snacks. Furthermore, fast food was not widely available in the rural South until the past couple of decades.

"Now, with greater prosperity, more people are working indoors in sedentary jobs and going out for lunch instead of bringing their own food from home.”

All these factors may have contributed to the rise of diabetes in the South.

Dr. Steckel highlighted that socioeconomic data could be useful during a physical exam in a way that could make preventive medicine more effective.

“You can probably identify the people most at risk for diabetes based on their socioeconomic history, and those are the ones clinicians should target,” he said in a press release.

“Although it may become more prevalent as people become more prosperous, diabetes itself can cause serious economic hardship,” said Dr. Samaan. “It raises the risk for heart disease, stroke, kidney failure, blindness, amputation and dementia. Ironically, this means that those with new-found prosperity may be at higher risk to cycle back into poverty.”

This research was published in the July/August issue of the American Journal of Human Biology.

The research was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.