Diabetes rates have been on the rise for the last two decades, and show no sign of abating. According to the Centers for Disease Control and Prevention, roughly 11.3% of the U.S. population suffers from diabetes—though many of those affected do not know they have the chronic illness.
Diabetes was the 8th leading cause of death in 2020, but the disease does not impact all Americans equally. Instead, variables like poverty level, geographic region, and race all influence diabetes rates, meaning some Americans are disproportionately impacted by the disease.
The Southeastern portion of the U.S. has a particularly high concentration of counties with elevated diabetes rates, with parts of Alabama, Mississippi, Tennessee, Pennsylvania, Texas, and nearly all of Louisiana, along with other states, facing some of the highest rates. Studies have shown that lack of access to healthy, affordable foods and health care services, exposure to environmental toxins, and other health hazards associated with poverty and systemic racism contribute to the increased likelihood of developing diabetes. These same conditions also mean that poor, non-white Americans are more likely to endure complications and have higher mortality rates from diabetes than wealthier white Americans with the disease.
The proportion of young people with diabetes is projected to increase over the next several decades, with racial, geographic, and socioeconomic disparities only growing larger if trends continue. Using 2022 County Health Rankings & Roadmaps from the University of Wisconsin Population Health Institute, Stacker identified the counties in North Carolina with the highest percentage of adults with diabetes. Ties were broken by the broader Quality of Life rank provided by the analysis, which includes other poor physical and mental health indicators. The age-adjusted diabetes rate was obtained through the Behavioral Risk Factor Surveillance System.
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1 / 25#25. Nash County
- Estimated percentage of adults with diabetes: 13% (2 points higher than state percentage)
- Health outcomes statewide rank: #64
--- Quality of life rank: #62
--- Length of life rank: #66
- Estimated county population: 94,859
Indy beetle // Wikimedia Commons
2 / 25#24. Wayne County
- Estimated percentage of adults with diabetes: 13% (2 points higher than state percentage)
- Health outcomes statewide rank: #74
--- Quality of life rank: #64
--- Length of life rank: #77
- Estimated county population: 123,967
HarmonyReignPope // Wikimedia Commons
3 / 25#23. Tyrrell County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #16
--- Quality of life rank: #30
--- Length of life rank: #8
- Estimated county population: 3,774
CZmarlin — Christopher Ziemnowicz // Wikimedia Commons
4 / 25#22. Hoke County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #57
--- Quality of life rank: #63
--- Length of life rank: #54
- Estimated county population: 55,830
Tradewinds // Wikimedia Commons
5 / 25#21. Jones County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #70
--- Quality of life rank: #67
--- Length of life rank: #65
- Estimated county population: 9,250
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6 / 25#20. Sampson County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #62
--- Quality of life rank: #75
--- Length of life rank: #48
- Estimated county population: 63,382
Indy beetle // Wikimedia Commons
7 / 25#19. Duplin County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #75
--- Quality of life rank: #82
--- Length of life rank: #56
- Estimated county population: 58,794
Indy beetle // Wikimedia Commons
8 / 25#18. Greene County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #59
--- Quality of life rank: #84
--- Length of life rank: #28
- Estimated county population: 20,928
Ammodramus // Wikimedia Commons
9 / 25#17. Wilson County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #82
--- Quality of life rank: #85
--- Length of life rank: #58
- Estimated county population: 81,979
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10 / 25#16. Bladen County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #85
--- Quality of life rank: #86
--- Length of life rank: #88
- Estimated county population: 32,911
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11 / 25#15. Martin County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #88
--- Quality of life rank: #87
--- Length of life rank: #89
- Estimated county population: 22,178
Indy beetle // Wikimedia Commons
12 / 25#14. Lenoir County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #90
--- Quality of life rank: #88
--- Length of life rank: #91
- Estimated county population: 55,720
gerrydincher // Wikimedia Commons
13 / 25#13. Columbus County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #91
--- Quality of life rank: #90
--- Length of life rank: #92
- Estimated county population: 54,754
Ymblanter // Wikimedia Commons
14 / 25#12. Washington County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #87
--- Quality of life rank: #91
--- Length of life rank: #86
- Estimated county population: 11,485
Upstateherd // Wikimedia Commons
15 / 25#11. Anson County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #94
--- Quality of life rank: #94
--- Length of life rank: #95
- Estimated county population: 24,097
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16 / 25#10. Richmond County
- Estimated percentage of adults with diabetes: 14% (3 points higher than state percentage)
- Health outcomes statewide rank: #93
--- Quality of life rank: #95
--- Length of life rank: #90
- Estimated county population: 44,332
Boston Public Library // Wikimedia Commons
17 / 25#9. Hertford County
- Estimated percentage of adults with diabetes: 15% (4 points higher than state percentage)
- Health outcomes statewide rank: #84
--- Quality of life rank: #83
--- Length of life rank: #79
- Estimated county population: 23,108
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18 / 25#8. Warren County
- Estimated percentage of adults with diabetes: 15% (4 points higher than state percentage)
- Health outcomes statewide rank: #92
--- Quality of life rank: #89
--- Length of life rank: #93
- Estimated county population: 19,522
Indy beetle // Wikimedia Commons
19 / 25#7. Northampton County
- Estimated percentage of adults with diabetes: 15% (4 points higher than state percentage)
- Health outcomes statewide rank: #86
--- Quality of life rank: #92
--- Length of life rank: #81
- Estimated county population: 19,088
KimWrenn // Wikimedia Commons
20 / 25#6. Vance County
- Estimated percentage of adults with diabetes: 15% (4 points higher than state percentage)
- Health outcomes statewide rank: #95
--- Quality of life rank: #93
--- Length of life rank: #97
- Estimated county population: 44,718
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21 / 25#5. Bertie County
- Estimated percentage of adults with diabetes: 15% (4 points higher than state percentage)
- Health outcomes statewide rank: #89
--- Quality of life rank: #96
--- Length of life rank: #83
- Estimated county population: 18,712
State Archives of North Carolina // Wikimedia Commons
22 / 25#4. Edgecombe County
- Estimated percentage of adults with diabetes: 15% (4 points higher than state percentage)
- Health outcomes statewide rank: #99
--- Quality of life rank: #97
--- Length of life rank: #98
- Estimated county population: 50,829
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23 / 25#3. Scotland County
- Estimated percentage of adults with diabetes: 15% (4 points higher than state percentage)
- Health outcomes statewide rank: #98
--- Quality of life rank: #99
--- Length of life rank: #94
- Estimated county population: 34,637
Cecouchman // Wikimedia Commons
24 / 25#2. Halifax County
- Estimated percentage of adults with diabetes: 16% (5 points higher than state percentage)
- Health outcomes statewide rank: #97
--- Quality of life rank: #98
--- Length of life rank: #96
- Estimated county population: 49,479
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25 / 25#1. Robeson County
- Estimated percentage of adults with diabetes: 17% (6 points higher than state percentage)
- Health outcomes statewide rank: #100
--- Quality of life rank: #100
--- Length of life rank: #99
- Estimated county population: 129,999
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