Key result
Older age, smoking, inactivity, and lacking vehicles linked to higher county-level diabetes mortality.
Why the study?
Despite increasing diabetes-related deaths over the last ten years, population-level predictors of diabetes-related mortality risks in Florida were poorly understood.
Observational (n=6,078)
Effect estimate: Coefficient 0.034 (95% CI 0.022-0.046)
p-value: p=<0.001
Geographic disparities in diabetes-related mortality exist in Florida, with higher risks in rural counties and areas with older, less active, and smoking populations.
County-level factors associate with higher Florida diabetes mortality; hypothesis-generating for targeted intervention trials.
Background Diabetes is an increasingly important public health problem due to its socioeconomic impact, high morbidity, and mortality. Although there is evidence of increasing diabetes-related deaths over the last ten years, little is known about the population level predictors of diabetes-related mortality risks (DRMR) in Florida. Identifying these predictors is important for guiding control programs geared at reducing the diabetes burden and improving population health. Therefore, the objective of this study was to identify geographic disparities and predictors of county-level DRMR in Florida. Methods The 2019 mortality data for the state of Florida were obtained from the Florida Department of Health. The 10th International Classification of Disease codes E10-E14 were used to identify diabetes-related deaths which were then aggregated to the county-level. County-level DRMR were computed and presented as number of deaths per 100,000 persons. Geographic distribution of DRMR were displayed in choropleth maps and ordinary least squares (OLS) regression model was used to identify county-level predictors of DRMR. Results There was a total 6,078 diabetes-related deaths in Florida during the study time period. County-level DRMR ranged from 9.6 to 75.6 per 100,000 persons. High mortality risks were observed in the northern, central, and southcentral parts of the state. Relatively higher mortality risks were identified in rural counties compared to their urban counterparts. Significantly high county-level DRMR were observed in counties with high percentages of the population that were: 65 year and older ( p < 0.001), current smokers ( p = 0.032), and insufficiently physically active ( p = 0.036). Additionally, percentage of households without vehicles ( p = 0.022) and percentage of population with diabetes ( p < 0.001) were significant predictors of DRMR. Conclusion Geographic disparities of DRMR exist in Florida, with high risks being observed in northern, central, and southcentral counties of the state. The study identified county-level predictors of these identified DRMR disparities in Florida. The findings are useful in guiding health professionals to better target intervention efforts.
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Nath et al. (2025) conducted an observational in Diabetes (n=6,078). County-level risk factors (older age, smoking, physical inactivity, lack of vehicle, diabetes prevalence) vs. Counties with lower prevalence of these risk factors was evaluated on County-level diabetes-related mortality risk (DRMR) (Coefficient 0.034, 95% CI 0.022-0.046, p=<0.001). County-level diabetes-related mortality risks in Florida were significantly higher in counties with greater percentages of residents who were aged 65 or older, current smokers, insufficiently physically active, lacked vehicles, or had diabetes.
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