County-level association of diabetes and obesity with premature mortality

Objective The association between the prevalence of diabetes and obesity and premature mortality at the county-level has not been well characterized. This study aims to elucidate the relationship between county-level prevalence of diabetes and obesity and premature mortality . Methods We utilized the data from the 2022 County Health Rankings which obtained the data from Behavioral Risk Factor Surveillance System in 2019, and National Center for Health Statistics Mortality Files 2018–2020. The county prevalence of diabetes and obesity was determined, and univariable and multivariable associations with premature mortality were identified. Results Among 3082 counties, the percentage of individuals with diabetes ranged from 5.5 to 21.0 % and the percentage of individuals with obesity ranged from 16.4 to 51.0 %. Our analysis revealed a stepwise increase in premature age-adjusted death rates (AADR) with rising deciles of county-level diabetes ( P < 0.001) and obesity (P < 0.001) in both univariable and multivariable models. Conclusions These findings underscore the significance of addressing diabetes and obesity at the county-level to reduce premature mortality and improve population health outcomes across varied communities in the United States.