DIABETES
in Western North Carolina

Why is diabetes a key health issue in western North Carolina?

The percentage of adults in WNC diagnosed with diabetes in WNC has risen from 13% in 2012 to 14% in 2018.

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Click on the counties listed in "Change Filter" on top of the chart to select which counties you want to view.

What do the numbers say about diabetes?

Western North Carolina (WNC) Data:

In 2018, 7.5% of adults in WNC have been diagnosed with Borderline or Pre-Diabetes. 

(WNCHN - WNC Healthy Impact Community Health Survey, 2018)

Approximately 22% of adults in WNC have been diagnosed with diabetes or pre-diabetes/ borderline diabetes. The following adult populations were significantly more likely to have been diagnosed with diabetes or pre-diabetes/ borderline diabetes in 2018: 

- Men (24.9%)

- Adults aged 40-64 (28.9%) and 65+ (29.2%)

- Low income (24.1%) 

- Those identifying as Black (28.1%) or Hispanic (26.5%)

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/ or discrimination. See our data story on the social determinants of health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families. 

Obesity has been associated with increased risk for diabetes. 

Approximately two thirds (67%) of adults in WNC were considered overweight or obese in 2018.

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

Forty-five percent of adults in WNC report being insufficiently active or inactive and 58% of adults in WNC report not performing any strengthening activity during the week.

Only about 1 in 5 adults in WNC were meeting current physical activity recommendations in 2018.

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)

"Meeting physical activity recommendations” includes adequate levels of both aerobic and strengthening activities: Aerobic activity is one of the following: at least 150 minutes per week of light to moderate activity, 75 minutes per week of vigorous activity, or an equivalent combination of both.

Strengthening activity is at least 2 sessions per week of exercise designed to strengthen muscles.

Participation in Physical Activities

(Western North Carolina, 2018)

(WNCHN – WNC Health Impact Community Health Survey, 2018)

The percent of adults in WNC consuming 5+ fruits and vegetables per day has decreased from 8% in 2012 and 2015 to 6.5% in 2018. 

(WNCHN – WNC Healthy Impact Community Health Survey, 2018)



State & National Findings:

Approximately 1,075,855 people in North Carolina, or 13.1% of the adult population, have diabetes.

(CDC, 2014)

More than 100 million Americans are living with diabetes or prediabetes. 

(CDC, 2017)

In 2013-2017 the age-adjusted rate per 100,000 population for diabetes mortality in North Carolina was 19.1 for White, non-Hispanic, 43.7 for African American, non-Hispanic, 41.6 for AI/AN, non-Hispanic and 12.1 for Hispanic. 

(N.C. State Center for Health Statistics, 2019)

Differences in health outcomes across social groups, economic status, and racial/ethnic identity are closely linked with disparities in social determinants of health, which disproportionately burden individuals and communities who experience systemic disadvantage and/ or discrimination. See our data story on the social determinants of health to learn more about how the conditions in which people are born, live, work, play, learn, worship, and age can influence their ability to achieve good health for themselves and their families. 

Diabetes and prediabetes cost an estimated $10.9 billion in North Carolina each year. 

(Dall et al., 2019)

What did the region say is the story behind the diabetes numbers?

Source: WNCHN - Online Key Informant Survey, 2018

 The items below are paraphrased themes that emerged from a 2018 regional survey of key informants. These responses do not necessarily:

    •Reflect accurate or scientifically validated information about health determinants, outcomes, and/or strategies for change, 
    •Represent an exhaustive list of factors that can help or hurt efforts to address this key regional health issue.
The information in this section should be interpreted and used with care. It should be used only to help local health departments and agencies begin to understand community perceptions about local health issues. Communities are strongly encouraged to collect their own, local-level data to inform local planning and evaluation activities.

“Awareness of the genetic and heritage factors associated with this disease. Access to quality medical care.” 

“Education being done in preschools and the schools around healthy eating and healthy weight.”


“A number of factors, including: cost of processed, unhealthy foods vs healthier fresh foods; proliferation of fast food restaurants; and the fact that many people live in areas with no sidewalks/unsafe conditions to just get out and walk.” 

“Non-compliance by patients; don't see the need to do anything different than before.” 

How is the region prioritizing this issue?

The western North Carolina region includes 17 communities: 16 counties and Eastern Band of Cherokee Indians (EBCI)

In the 2018 CHA cycle:

1 community chose diabetes as a priority. 

10 communities selected priorities related to obesity, healthy eating, & active living.

6 communities selected chronic disease.

Learn more about how counties in western North Carolina work to determine their local community health priorities by watching the video (right). 

What is already happening regionally?

The list below represents a sample of what is happening in the region around this key health issue. Visit www.nc211.org for more resources. 

Diabetes Free NC (find a CDC-recognized diabetes prevention program in North Carolina. 

Diabetes Prevention Program (multiple program providers throughout the region including YMCA of WNC, MountainWise, Mission Health)

Diabetes Self-Management Education (DSME)

Diabetes Advisory Council in NC (find accredited AADE and ADA diabetes self-management programs )

Healthy Aging NC Living Healthy with Diabetes Self Management Programs

My Healthy Life Chronic Condition Clinic (Mission Health)

ACT Now! Diabetes Awareness and Prevention Program (Mission Health)

Minority Diabetes Prevention Grant (for Region 2, in partnership with YMCA of WNC and Buncombe County)

Worksite Wellness grant (MountainWise)


The regional dataset (WNC Healthy Impact Community Health Survey and Online Key Informant Survey) is available thanks to contributions from hospitals in the 16-county region of western North Carolina. Thank you!