Chronic Disease Burden

Pulse Atlas combines CDC PLACES 2024 (BRFSS-based small-area estimates) for diabetes, hypertension, obesity, and coronary heart disease into a single chronic disease burden composite. The 100 counties below carry the highest chronic disease burden in the U.S. — concentrated in the rural South and Appalachia, where four-decade life-expectancy gaps remain the country's largest.

Top 100 counties by diabetes prevalence

  1. East Carroll Parish, LA — 21.3%
  2. Oglala Lakota County, SD — 23.8%
  3. Bullock County, AL — 21.3%
  4. Greene County, AL — 21.1%
  5. Humphreys County, MS — 20.6%
  6. Perry County, AL — 20.5%
  7. Todd County, SD — 22.9%
  8. Holmes County, MS — 21.0%
  9. Jefferson County, MS — 19.8%
  10. Tunica County, MS — 19.9%
  11. Sharkey County, MS — 19.6%
  12. Madison Parish, LA — 19.6%
  13. Quitman County, MS — 19.5%
  14. Wilcox County, AL — 19.1%
  15. Lowndes County, AL — 19.4%
  16. Claiborne County, MS — 19.6%
  17. Sioux County, ND — 20.1%
  18. Claiborne Parish, LA — 18.8%
  19. Coahoma County, MS — 19.5%
  20. Yazoo County, MS — 17.9%
  21. Sunflower County, MS — 18.3%
  22. Tensas Parish, LA — 18.1%
  23. Lake County, TN — 17.8%
  24. Sumter County, AL — 18.2%
  25. Dimmit County, TX — 21.5%
  26. Issaquena County, MS — 17.8%
  27. Zavala County, TX — 21.4%
  28. Phillips County, AR — 17.2%
  29. Randolph County, GA — 18.9%
  30. Kusilvak Census Area, AK — 18.0%
  31. Lee County, AR — 17.1%
  32. Leflore County, MS — 19.0%
  33. Wilkinson County, MS — 17.6%
  34. Dallas County, AL — 18.1%
  35. Bolivar County, MS — 17.9%
  36. McDowell County, WV — 17.4%
  37. Macon County, AL — 17.7%
  38. Bienville Parish, LA — 17.5%
  39. Noxubee County, MS — 18.0%
  40. Desha County, AR — 17.1%
  41. Buffalo County, SD — 18.7%
  42. Hancock County, GA — 18.3%
  43. St. Francis County, AR — 16.6%
  44. Mellette County, SD — 18.3%
  45. Macon County, GA — 18.5%
  46. Washington County, MS — 17.6%
  47. Ziebach County, SD — 18.1%
  48. Conecuh County, AL — 16.8%
  49. Morehouse Parish, LA — 16.8%
  50. Tallahatchie County, MS — 17.0%
  51. Concordia Parish, LA — 16.8%
  52. Jim Hogg County, TX — 20.2%
  53. Allendale County, SC — 17.9%
  54. Robeson County, NC — 16.4%
  55. Chicot County, AR — 16.1%
  56. Starr County, TX — 20.5%
  57. Barbour County, AL — 16.5%
  58. Jefferson Davis County, MS — 16.8%
  59. Corson County, SD — 18.3%
  60. Hale County, AL — 16.3%
  61. Pike County, MS — 16.3%
  62. Clay County, MS — 16.0%
  63. Zapata County, TX — 20.1%
  64. Stewart County, GA — 18.4%
  65. Telfair County, GA — 17.6%
  66. Dillon County, SC — 17.3%
  67. Haywood County, TN — 16.5%
  68. Marion County, SC — 17.7%
  69. Rolette County, ND — 16.5%
  70. Terrell County, GA — 17.3%
  71. Lafayette County, AR — 15.3%
  72. Calhoun County, GA — 17.1%
  73. Dewey County, SD — 18.0%
  74. Jefferson County, AR — 15.1%
  75. Kemper County, MS — 15.8%
  76. Panola County, MS — 15.6%
  77. Mingo County, WV — 15.8%
  78. Lawrence County, MS — 15.2%
  79. Hancock County, TN — 15.6%
  80. Pickens County, AL — 15.2%
  81. Red River Parish, LA — 16.1%
  82. Adams County, MS — 16.8%
  83. Webster Parish, LA — 15.7%
  84. Petersburg city, VA — 17.0%
  85. Marlboro County, SC — 17.4%
  86. Baker County, GA — 16.9%
  87. Escambia County, AL — 15.6%
  88. Adair County, OK — 15.2%
  89. Willacy County, TX — 19.0%
  90. Lee County, SC — 16.9%
  91. Crittenden County, AR — 14.8%
  92. Jackson County, SD — 17.1%
  93. Okfuskee County, OK — 14.7%
  94. Marengo County, AL — 16.1%
  95. Avoyelles Parish, LA — 15.2%
  96. St. Helena Parish, LA — 16.2%
  97. McKinley County, NM — 17.9%
  98. Atkinson County, GA — 16.5%
  99. Scotland County, NC — 15.2%
  100. Bennett County, SD — 17.3%

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