Chronic Disease Prevalence in the US: Sociodemographic and Geographic Variations by Zip Code Tabulation Area
ORIGINAL RESEARCH — Volume 21 — February 14, 2024
PEER REVIEWED
The 5 categories are 1) economic stability, which includes income, social welfare, employment, and uninsurance; 2) education access and quality, measured by college degree; 3) health care access and quality, which includes access to hospital services, access to primary care services, and access to pharmacies; 4) neighborhood and built environment, including access to a vehicle, long commuting time, internet access, and home value; and 5) social and community context, measured by population age and by racial and ethnic makeup.
Figure 1.
Categories of variables included, based on Healthy People 2030 Social Determinants of Health framework (22), in study of sociodemographic and geographic variations of chronic disease prevalence in the US by Zip Code Tabulation Area.
Zip code tabulation areas in the lowest quartile of chronic disease prevalence are dispersed throughout the US with large, concentrated pockets in Colorado, Wyoming, and California’s coastal region. Zip code tabulation areas in the highest quartile of chronic disease prevalence are prominent in the southeastern region of the US, especially in Alabama, Arkansas, West Virginia, and Kentucky.
Figure 2.
Choropleth map of the US showing the geographic distribution of chronic disease prevalence scores by quartile across Zip Code Tabulation Areas (ZCTAs). Chronic disease prevalence scores ranged from 0 to 20 with a score of 0 meaning the ZCTA was in the 25th percentile and a score of 20 meaning the ZCTA was in the 75th percentile of prevalence for each chronic disease examined.
Significant spatial clusters of high chronic disease prevalence scores are concentrated in the southeastern region of the US ranging from the eastern region of Texas to the southern region of Ohio. Additional hot spot clusters are apparent in the Great Lakes region of Michigan. Clusters of cold spots are dispersed throughout the US and concentrated in the states of Vermont, New Hampshire, Massachusetts, Rhode Island, and Connecticut as well as large metropolitan regions of states such as the Dallas–Fort Worth Area of Texas, the Atlanta area of Georgia, and the Los Angeles and Bay Area regions of California.
Figure 3.
Hot Spot analysis of chronic disease prevalence scores throughout the US calculated in ArcGIS Pro (Esri) showing significant spatial clusters of high chronic disease prevalence scores (red clusters = hot spots) and low chronic disease prevalence scores (blue clusters = cold spots).
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