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By MIKE O'BRIEN, a staff writer for Human Resource Executive ®, the sister publication of Risk & Insurance® where this article first appeared

While the news may not surprise anyone who's been watching the nation's waistline expand over the years, a new report from the Centers for Disease Control and Prevention in Atlanta has identified 644 counties in 15 U.S. states as the "Diabetes Belt."

Nearly 12 percent of people living in that "belt" have diabetes -- which is characterized by the abnormal production of blood sugar -- compared to 8.5 percent of individuals in the rest of the nation, according to the report.

The report--compiled by comparing demographics and risk factors of residents across the country, such as gender, age, education, lifestyle, obesity and race/ethnicity--was published in the April issue of the American Journal of Preventive Medicine and was written by lead investigator Dr. Lawrence E. Barker, along with co-authors Karen A. Kirtland, Edward W. Gregg, Linda S. Geiss and Theodore J. Thompson.

"Identifying a diabetes belt by counties allows community leaders to identify regions most in need of efforts to prevent type-2 diabetes and to manage existing cases of the disease," said Barker.

"Although many risk factors for type-2 diabetes can't be changed, others can," he said. "Community design that promotes physical activity, along with improved access to healthy food, can encourage the healthy lifestyle changes that reduce the risk of developing type-2 diabetes."

Currently, about 26 million Americans have diabetes, according to the Alexandria, Va.-based American Diabetes Association, and treatment costs for employers and patients total $100 billion annually. Sufferers are at risk for other medical conditions, including heart disease, kidney damage and some kinds of cancer.

EMPLOYERS WOULD BE WISE

Barker said organizations would be wise to focus their wellness efforts on diabetes prevention and maintenance even if their organizations are not located within the belt.

"Many costs are associated with diabetes, including increased absenteeism and more expensive medical care," he said. "Programs that encourage physical activity and weight loss can help reduce or avoid these costs.

"Addressing diabetes at work can be something as simple as giving employees a place to be physically active during lunch hour, or offering healthy alternatives in the cafeteria or vending machines," he said.

Dr. Carolyn Dean, medical director of the Orange, Calif.-based nonprofit Nutritional Magnesium Association, said climate may play a role in the prevalence of the disease in the south.

"The southeastern U.S. tends to be a more humid and hot environment," she said, "where people lose vital minerals, including magnesium, through perspiration--minerals which help with blood-sugar control, pancreatic function and insulin sensitivity."

Diet is clearly another factor, she added.

"Consumption of high-carbohydrate foods and drinks would make this study result make sense," she said.

Meanwhile, Dr. Sue Kirkman, senior vice president for medical affairs and community information at the American Diabetes Association, said it is a "mixture" of factors that is causing the diabetes epidemic.

"Just like with everything else, there are cultural, financial as well as genetic" reasons for the belt, she said.

"Noncaucasians are more likely to be obese and to develop type-2 diabetes, and that part of the country has a lot of African-Americans and other minorities," she said. "And obesity (in the United States) is more a disease of poverty than wealth, and income is lower and socio-economic status is also lower (within the belt)."

ROI

Kirkman said organizations that make concerted efforts to control diabetes within their workforce often see a return on their investment within just a few short years, compared with other wellness initiatives.

"(Such efforts) reduce healthcare costs over a fairly short amount of time if people get their diabetes under control," she said. "People are more likely to be productive at work if they have this under control."

While including more healthful food offerings in an organization's cafeteria is important, she said, price must be taken into consideration as well.

"If the salad is six bucks but the burger is only one dollar, that's obviously going to sway people one way or the other," she said.

With her organization located within the belt, Kirkman said, the 300 employees working at headquarters are offered, among other incentives, a subsidy for gym memberships in an effort to get them moving toward healthier lifestyles.

"It's all about keeping employees healthy and productive, and that's really the reason to do it," she said.

April 5, 2011

Copyright 2011© LRP Publications