In 2021, Newport, Arkansas, in Jackson County earned a title many others would prefer not to have: Most Diabetic Place in America. When I first read this title, I thought it may have been clickbait. I can believe that an entire state would be the most diabetic place in America, but a single county within a state just didn’t seem true.
But it is.
I dug through data from the Centers for Disease Control and Prevention (CDC) and found that diabetes affects nearly 1 in 10 individuals in America. That seems like a lot already. In Newport, however, that number is 1 in 3.
This staggering difference is due, in large part, to the corresponding rise in obesity throughout the nation. Over the past 60 years, the percentage of Americans 20 and older battling obesity has tripled from 14% to 42%. Other factors, such as smoking, binge drinking, lack of physical activity, and poor diet, also affect a person’s risk of Type 2 diabetes. In Newport, the main factor for Type 2 Diabetes is poor diet, which has a lot to do with the socio-economic status of the county.
Jackson County is in the Mississippi River Delta, home to the most rural areas in the U.S. While the Delta has numerous lush farming landscapes, it is also ridden by poverty. Some of the nation’s most impoverished communities live in the Delta. While the national poverty rate for 2020 was 11.4%, according to the U.S. Census Bureau, Jackson County’s rate was 23.1%, over double the national rate.
On top of the high poverty rate, Jackson County is also considered a food desert. While most convenience stores are closer, they also have lower-quality food, including processed foods, which are high in calories. High calories lead to higher weight gain, which leads to obesity. The higher price of healthy foods in most food deserts also compounds the problem. According to the Harvard University Public School of Health, healthy foods, such as fresh fruits and vegetables, cost $1.50 more than unhealthy foods per day.
While these costs are trivial to middle- and upper-class families, to lower-class families like those in Jackson County, this $1.50 is a big difference. Since convenience stores and restaurants offer cheaper prices than grocery stores with fresh produce, families tend to utilize the more affordable option just so they can save money on other expenses. The convenience of unhealthy choices in rural areas promotes unhealthy eating habits, which leads to higher numbers of obese and diabetic patients in these areas.
In Arkansas’ more rural counties, the proximity of grocery stores to the community increases obesity risk. Seniors in rural communities are less likely to drive to grocery stores to purchase food if the grocery store is farther away than a convenience store with more frozen, processed foods. Additionally, restaurants near high schools and colleges in rural counties create an increased risk of obesity. Families in rural communities also may not have reliable access to transportation that would allow them to travel longer distances for their food. In the midst of the proximity issue, however, there are opportunities for health care organizations in Arkansas to take action.
Populating Food Deserts
Farmers’ markets and mobile food markets can bring healthy food into rural areas like Jackson County. Smaller grocery stores can be incentivized to build locations in rural areas. Renovations and enhancements from these incentives can also allow them to sell a wider variety of foods. Local community groups and schools can start up gardens which can help to educate children and community members and promote healthier eating habits. Policymakers can create interventions that reduce the number of food deserts throughout the state. Politicians can work with grocery stores and supermarkets like Walmart, Whole Foods, and Fresh Market to determine where new sites are needed for underserved areas. Even providing incentives to expand farmers’ markets in the area would create a huge shift in the focus toward healthy foods.
Successful hunger relief interventions have already been established in parts of the state that aim to tackle food insecurity. Federal programs, such as the Supplemental Nutrition Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), offer grant funding to organizations that are willing to work toward eliminating food deserts. The point is there are ways to increase rural communities’ access to healthy foods.
Diabetes Prevention and Treatment Initiatives
To promote diabetes prevention and treatment, health care professionals should bring national prevention programs into their organizations. Organizations across the state can establish a Diabetes Prevention Recognized Program by contacting the Arkansas Department of Health, Chronic Disease Prevention and Control Branch at 501-661-2942. National Diabetes Prevention Recognized Programs are cost-effective and successfully delay or prevent type 2 diabetes in people with prediabetes.
Providers can also encourage patients with prediabetes to participate in diabetes self-management education and support. There are many Diabetes Self-Management Education and Support (DSMES) programs throughout the state that would be worth discovering. In fact, there are around 30 DSMES programs in Arkansas. Patients with prediabetes can find an education program here. Two organizations, the Association of Diabetes Care & Education Specialists and the American Diabetes Association, accredit diabetes education programs.
Providers should also download the CDC’s On Your Way to Preventing Type 2 Diabetes guide, which offers a prediabetes risk test, ways to join a lifestyle change program, and plans and activities patients can take on their journey to prevent type 2 diabetes. There are also helpful resources and articles providers should download at the end of this post.
Arkansans have an obligation to one another to prevent type 2 diabetes. From health care professionals to patients with prediabetes, there are resources out there designed to help prevent and treat type 2 diabetes. Politicians and funders should also consider incentivizing farmers’ markets and supermarkets to establish sites in rural counties to increase their access to healthier foods. Regardless of the intervention, Newport and other Arkansas Rural towns suffer from a preventable disease. The articles below should help educate providers, health care professionals, and patients.