La NPR (National Public Radio) parla di come negli Stati Uniti ci sia una forte correlazione fra debiti e diabete nell’area che viene denominata “Diabetes Belt”.
ADWDiabetes traccia i confini di questa zona e cerca di spiegare le ragioni di questa elevata incidenza della malattia:

• The CDC (Centro per il controllo e la prevenzione delle malattie) determined the highest rates of diabetes in the United States are in a diabetes belt. The diabetes belt is similar to the “stroke belt” found in earlier studies. The diabetes belt is in 15 mostly Southern states. The diabetes belt includes 644 counties in parts of Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Ohio, Pennsylvania, Tennessee, Texas, Virginia and West Virginia. About 12 percent of the people in these areas have type 2 diabetes compared with 8.5 percent in the rest of the nation.
• About a third of the difference in diabetes prevalence between these areas and the rest of the United States is associated with obesity and sedentary lifestyles. The CDC identified regions that most need efforts to prevent diabetes type 2 and help people who have it manage the disease. Communities are encouraged to promote physical activity and access to healthy food to help people initiate positive lifestyle changes to reduce the risk of type 2 diabetes.

L’indagine della NPR ha valutato la sovrapposizione delle contee della “Diabetes Belt” con quelle ad alto debito medico, fondendo il database del debito medico dell’Urban Institute, un’organizzazione no-profit di politica sociale, con l’elenco delle contee della “Diabetes Belt” del CDC .
Oltre ai risultati di NPR, una ricerca dell’American Diabetes Association afferma che le persone con la malattia hanno più del doppio delle spese mediche annuali rispetto a quelle senza la malattia. E’ opinione dell’Urban Institute che espandere Medicaid (il programma federale sanitario degli Stati Uniti che provvede a fornire aiuti agli individui e alle famiglie con basso reddito) potrebbe migliorare la situazione.

…the Urban Institute and others say a simple policy change could prevent others from getting to such a difficult stage in their disease and finances: Expand Medicaid. “Seventy-nine out of the 100 counties with the highest levels of medical debt are in states that have not expanded Medicaid under the ACA,” the Urban Institute’s Braga says.

L’ACA è l’Affordable Care Act, noto anche come Obamacare, che offriva agli stati la possibilità di espandere i loro programmi di assicurazione sanitaria per i poveri.

A Boston University researcher looked at health centers just like CareSouth — more than 900 of them serving nearly 20 million patients. The centers in states that did expand Medicaid reported better diabetes control than those in states that didn’t expand the program, and the effect was quick — within three years of the expansion. Those improvements happened consistently among Black and Hispanic patients, who have higher rates of diabetes. A study in Louisiana found that people who gained Medicaid coverage after an expansion there had reduced medical debt.

L’articolo è parte di una lunga serie di pubblicazioni uscite su NPR e dedicate alla relazione tra salute e problemi economici.