Socioeconomic Determinants and Diabetes in Colorado

 The Diabetes Epidemic: A National and Local Perspective

Diabetes affects 11.6% of the U.S. population, according to the CDC, and is recognized as a growing global epidemic, imposing significant individual and public health burdens (Spencer, 2016). In the United States alone, more than 30 million people are living with diabetes, and those with lower socioeconomic status face increased risks of complications (Berkowitz, 2018).

In Colorado, an estimated 34,456 people are diagnosed with diabetes each year (American Diabetes Association). Our study focused on understanding how socioeconomic factors—such as food insecurity, poverty, and access to healthcare—contribute to the prevalence and outcomes of diabetes in the state.

 Socioeconomic Factors and Diabetes

Socioeconomic determinants play a critical role in diabetes risk and management:

• Food Insecurity and Limited Budgets: Food-insecure individuals often rely on cheaper, higher-calorie foods, which can lead to weight gain and chronic conditions like type 2 diabetes (Gucciardi, 2014). Access to healthy food is frequently limited by financial constraints, lack of transportation, and availability of resources.

• Income Inequality and Stress: Financial instability can exacerbate lifestyle challenges and stress, further increasing the risk of diabetes.

• Healthcare Access: Limited access to healthcare prevents individuals from receiving timely diagnoses and management of the disease, resulting in worse outcomes.

Mapping Diabetes in Colorado

Visualizing Geographic Disparities

One of the most striking aspects of diabetes in Colorado is its uneven distribution across the state. Our interactive map (embedded above) highlights diabetes prevalence by county, revealing distinct patterns:

• High-Risk Counties: Costilla, Saguache, Kit Carson, and Pueblo counties show the highest rates of diabetes, which correlate with lower incomes and higher levels of food insecurity.

• Urban vs. Rural: Urban counties with better access to healthcare and healthy food options tend to have lower diabetes rates, while rural areas face significant disparities.

Socioeconomic Drivers of Diabetes: A Closer Look

While factors like obesity and physical inactivity often dominate discussions about diabetes, socioeconomic variables such as housing burden, access to healthcare, and community vulnerability play an equally critical role in shaping health outcomes. The correlation plot above sheds light on how these systemic factors intersect with diabetes prevalence and other chronic health risks.

Key Socioeconomic Insights

1. Housing Burden and Diabetes
   Housing burden, which reflects the percentage of income spent on housing, shows a notable relationship with diabetes prevalence. High housing costs can force individuals to make difficult trade-offs, often leaving less money for healthy food, healthcare, and other necessities. This financial strain can lead to greater vulnerability to chronic illnesses like diabetes.
   
   

2. Access to Physicians and Life Expectancy
   There is a positive correlation between physician density and life expectancy. Areas with more doctors tend to have better health outcomes, including more effective diabetes prevention and management. Conversely, in regions with fewer healthcare providers, people face delays in diagnosis and limited access to treatment, contributing to worse diabetes outcomes.
   
   

3. Social Vulnerability Index (SVI) and Diabetes
   The Social Vulnerability Index (SVI), which combines measures such as poverty, income inequality, and housing instability, strongly correlates with diabetes prevalence. Communities with higher SVI scores often face compounded challenges, such as reduced access to healthcare and healthy food options, which increase the risk of diabetes and other chronic diseases.
   
   

4. Life Expectancy and Diabetes Prevalence
   There is an inverse relationship between life expectancy and diabetes prevalence in certain areas. Communities with higher diabetes rates tend to experience lower life expectancy, likely due to complications from poorly managed diabetes and limited access to preventative care. Addressing diabetes in these communities can lead to broader improvements in overall health and longevity.
   
   

Implications for Diabetes Prevention and Management

The relationships between diabetes and socioeconomic factors like housing burden, healthcare access, and social vulnerability highlight the need for a comprehensive approach to addressing this chronic condition. Policymakers and community leaders should consider the following:

• Reduce Housing Burden: Develop affordable housing policies to alleviate financial stress and free up resources for health-related spending.

• Increase Access to Healthcare: Invest in healthcare infrastructure in underserved areas to ensure timely access to diabetes prevention and treatment services.

• Address Social Vulnerabilities: Target interventions in high-SVI communities to address poverty, improve food access, and enhance transportation options for healthcare.

• Promote Long-Term Health: By improving social determinants of health, we can help increase life expectancy and reduce the overall burden of diabetes.

Why This Matters

Understanding these correlations is crucial for addressing the underlying social determinants of health that drive diabetes risk and outcomes. By focusing on factors like food insecurity, income inequality, and healthcare access, we can work toward strategies that reduce diabetes prevalence and improve health equity across Colorado.