Defeat Diabetes

Disparities and Opportunities in Missouri's Commercially Insured Population

New MHI Report Shares Disease Prevalence, Social Demographic Factors, Cost and Other Findings for Every Missouri County and Zip Code

Researchers using medical claims have calculated rates of type 2 diabetes, sometimes referred to as “adult onset diabetes,” in every Missouri county and zip code. The report shows the overall prevalence of diabetes among commercially insured adults 18 to 64 years old to be 5.2 percent.

Because one or more household members in this population is healthy enough to work full-time, has an income and health care coverage, this population is thought to fare better when it comes to a chronic illness like diabetes. Despite faring better overall, the study’s statistical models show that social factors as well as age were associated with disease prevalence, adherence to recommended screening tests and emergency department visits. Employers have opportunities to address the consequences of social factors through health plan benefit design and education.

Commercially insured Missourians with type 2 diabetes are nearly 4 times more likely than non-diabetes patients to receive emergency room care, and 2.69 times more likely to be hospitalized. MHI data shows an average 2019 statewide cost of $14,791 for adults with diabetes, as compared to $5,568 for those without diabetes, or 2.6 times less.

Only 70% of commercially insured people with Type 2 diabetes received all three of the major diagnostic tests recommended by CDC and American Diabetes Association to support effective medical management. Medication adherence is also an area for improvement. Of people with Type 2 diabetes 32% did not consistently refill their blood pressure medications, 40% did not consistently refill their cholesterol medications, and 26% percent did not consistently refill their prescription for anti-diabetes medications.

Using a blended index of interrelated socioeconomic factors based on the American Community Survey’s findings such as income, race, educational attainment, and transportation access at the zip code level, the report shows that higher social deprivation factors are associated with higher diabetes prevalence. 

Employment and health insurance coverage do not protect Missourians from type 2 diabetes or assure high quality care. The same underlying socioeconomic factors that predict higher prevalence in other populations also apply to those with commercial insurance. Policymakers and healthcare leaders would be well served to consider diabetes prevalence and health outcomes in relation to socioeconomic factors within communities. 

MHI produced county and zip code level findings to activate regional resources and creative interventions to improve health outcomes for people with or at risk of diabetes. Small changes, community by community, can add up to big improvements in health outcomes across the state. To request findings by zip code in exchange for a small contribution, please click here.

Click here for the full report