Saturday, March 26, 2011

The Diabetes Belt Is the Bible Belt

Diabetes may be considered a national problem in the United States, but most of the cases occur in a small part of the country, which some researchers are referring to as the “diabetes belt.” In an earlier post I showed county-level maps that show where obesity and physical inactivity are concentrated, and diabetes is found in most of the same places. The use of the word "belt” is no accident, as it doesn’t take much digging to realize that the diabetes belt is essentially identical to the more famous “Bible belt.”

This geographical connection between the culture of aggressive Christianity and a dissolute lifestyle is not a recent insight. Analysts have been writing about it for years. Five years ago, long before I had touched on the subject, Blue is the New Green convincingly made the case that the 2004 “Blue States” are the more economically vital parts of the United States. Among other things, “Blue States” pay more in income taxes and effectively subsidize the “Red States.” The “Red States,” of course, are mostly the Bible belt states. Crime, obesity, infant mortality, and divorce are just some of the socioeconomic measures in which you can see a split between the Bible belt states and the rest of the United States.

Conservative writers have been writing about this too, mostly in an effort to dodge responsibility for the awful-looking state-level statistics. I believe this is the origin of the idea that obesity was especially concentrated in southern cities. I came across various analyses by politically conservative thinkers around 2003–2004 using maps to try to show that the various lifestyle problems of the Bible belt were caused by black people. This explanation might look credible when you only have state-level data, but when you get county-level data on the maps, the “blame the blacks” argument falls apart. The urban counties where black people are most easily found are doing better than the almost-all-white areas just two counties away, not just on the obesity map, but in many of the socioeconomic measures of success. This is not to say that black people are more prosperous than white people in the Bible belt — far from it — but the counties where black people live and work are more prosperous, and logically this must be in part due to the work that black people do.

What is the connection between the Bible and diabetes? So far, the connections are only speculation, but the simplest explanation I have seen has to do with emotions, specifically the outward-directed emotions of blame and anger. These are the emotions that figure prominently in the fire-and-brimstone religion of the Bible belt. The hormones associated with blame and anger are known to contribute to weight gain and interfere with sugar metabolism, two key factors in diabetes.

Blame and anger also get in the way of individual responsibility. You can‘t easily take charge of your own life while you’re busy pointing fingers. A dearth of individual responsibility may account for many of the troubling characteristics of the Bible belt. It would not be too surprising if obesity, sexually transmitted diseases, crime, low incomes, alcoholism, and energy inefficiency — to name some of the more obvious problems associated with the Bible belt — would occur more frequently in individuals who do not quite believe they are responsible for their own lives.

You won’t find much mention of the diabetes belt or its connection to the Bible belt in the mass media. It’s a difficult subject to discuss because it touches on some of the most bitter cultural divisions in the United States. It wouldn’t be responsible to critique a system of religious beliefs based on this kind of speculation; that is a matter more suited to individual introspection than public conversation. But the link between religion and lifestyle is a subject for further study. Just by going from state-level to county-level data, we have a much clearer view of the connections than we had five years ago. In another five years, with more discoveries and more detailed data, we may know enough to be able to guess specifically where things are going wrong.