Location may play a bigger role in your health than you think—especially in this region. But experts say there are ways to address it.
Where we live can sometimes unknowingly influence certain health outcomes, such as having an increased risk of heart failure. And if you call a certain region of the U.S. home, your heart and metabolism might be working harder than you realize. In this part of the country, rates of high blood pressure and diabetes outpace much of the nation.
According to the U.S. Centers for Disease Control and Prevention (CDC), those who live in the Southeastern United States are at the highest risk of hypertension (a term for high blood pressure) when compared with other parts of the nation. A county-level map, which uses data from 2021, shows that the concentrations of hypertension prevalence are found in Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, West Virginia, and Virginia. Smaller clusters also appear in parts of Alaska, Maryland, Missouri, Ohio, North Dakota, and South Dakota. (Florida provided insufficient evidence, and could not be included.)
However, the CDC cautions that this might not paint the fullest picture: “…this map likely underreports the true effect of hypertension in each state, because about 1 in 5 adults with high blood pressure is unaware of it and would not report having it.”
These patterns echo what public health researchers have sometimes referred to as the “Stroke Belt” and “Diabetes Belt,” distinct but overlapping swaths of primarily southern states where people experience disproportionately high rates of these conditions and their risk factors. According to 2020 research published in the journal Stroke, the “Stroke Belt” refers to “a region of higher stroke mortality in the Southeastern United States that has persisted since at least 1940.” Meanwhile, a 2021 review published by the American Diabetes Association found that the “Diabetes Belt” consisted of “consists of 644 counties in the Appalachian region and southeastern part of US” with diabetes prevalence more than 11% in 2008 versus approximately 8.5% in the rest of the country.
A 2017 American Heart Association study exploring geographic differences in hypertension and diabetes found three major factors appear to be at play. First, lifestyle and health factors including diet, physical activity, and smoking vary widely from region to region. Second, differences in treatment access and medication use can affect how often these conditions are reported or controlled. Finally, self-report bias—people not accurately reporting their medication use or health status—can further skew data.
Socioeconomic conditions play a role as well, influencing access to nutritious food, healthcare, and safe spaces for exercise. However, socioeconomic status alone explains less than 16% of the excess stroke mortality seen in the Stroke Belt, the AHA study notes. That means other social, cultural, and environmental factors are also at work.
Mayo Clinic experts also point out that the divisions are not just regional, but also racial: “41% of African Americans can have high blood pressure compared to 27% of their white counterparts,” says Ivan Porter, II, MD, a nephrologist with the Mayo Clinic. The AHA adds that lack of access to health care, lower rates of taking blood pressure medications, and historical factors play a “major role” in these numbers.
The Mayo Clinic advises that if you live in the Southeastern U.S., assessing your diet is a good place to start—especially if you tend to eat “traditionally Southern” foods, which can include fried foods, processed meats, sugar-sweetened beverages, and more. Their experts recommend cutting one high-risk food at a time, taking aim at highly processed products, sugar-sweetened beverages, and any food with high amounts of added salt, sugar, and saturated fat.
For daily wellness updates, subscribe to The Healthy by Reader’s Digest newsletter and follow The Healthy on Facebook and Instagram. Keep reading:
- Here’s How Much Alcohol Increases Your Heart Risk, Says New Study
- New Study: This Group Has Increased Risk of Kidney Disease and High Blood Pressure
- Odd Symptoms of Type 2 Diabetes You Didn’t Know About, According to Expert Dietitians
- Does Daylight Saving Time Cause Heart Attacks? Not So Fast, Says New Study
