Prevalence of and Risk Factors for Diabetes in Western Tidewater: A Community-Based Screening Study
Abstract
Introduction: Diabetes is a growing public health concern particularly in rural, lower income areas. A screening study was conducted in the Western Tidewater area of Virginia, a rural community, to assess the prevalence of diabetes, prediabetes, and their associated risk factors.
Methods: 298 Western Tidewater residents were screened for diabetes between April 2022 and May 2024 using point-of-care hemoglobin A1c (HbA1c) and completed blood pressure testing along with surveys assessing demographics, medical history, and social determinants of health. The data were analyzed using generalized linear models, chi-square tests, and descriptive statistics.
Results: 18.71% of those screened were found to have diabetes and 28.91% were found to have pre-diabetes compared to the national averages of 11.6% and 38% (National Health Interview Survey, 2022) and Virginia state averages of 9.6% and 33.3% (Dall et. al. 2020). Despite only 6.5% of individuals reporting not having a primary care provider (PCP), 31.05% were unaware if they were prediabetic or diabetic. Of those who did not know their diabetes status, 31.2% were diabetic or prediabetic. Most of the participants who were unaware of their diabetes status were from Suffolk and Franklin zip codes. The mean HbA1c was 5.6% and mean BMI was 32.67 kg/m2. There were significant associations found between diabetes and insurance status (p=.002), education (p=.003), household income (p=.020), poverty status (p=.029), and age (p=.048). Ability to pay utilities (p=.001), food insecurity (p=.001) and sex (p=.046) also significantly affected HbA1c levels according to the generalized linear model.
Conclusion: This study finds a high prevalence of diabetes and prediabetes in a screened population in Western Tidewater Virginia with significant associations with multiple social determinants of health including insurance status, education level, and food security. It also emphasizes the need for greater patient health status education even among those with PCPs. Furthermore, it shows the possible benefits of screening programs targeted towards lower-income, uninsured, undereducated, or food insecure individuals. Future research should investigate the best way to target these screenings toward those most likely to benefit.