Pedagarla Cyril, Pradeep Anirudh, Pradeep Ramarao
Independent Researcher, University of Iowa, Iowa City, USA.
Endocrinology, Diabetes and Metabolism, MercyOne Genesis, Bettendorf, USA.
Cureus. 2025 Jun 2;17(6):e85224. doi: 10.7759/cureus.85224. eCollection 2025 Jun.
Cardiometabolic conditions - including diabetes, hypertension, and hyperlipidemia - are leading contributors to morbidity, mortality, and health disparities across the United States. In Iowa, the burden of these diseases varies substantially by county, with notable geographic and racial/ethnic inequities. This ecological study analyzed data from all 99 Iowa counties to assess the prevalence of cardiometabolic diseases, evaluate demographic correlations, and identify underserved regions we term "cardiometabolic screening deserts." We defined screening deserts as counties that lacked at least two of the following preventive services: blood pressure (BP) screening, HbA1c testing, and lipid panel access; had high poverty or uninsured rates (>15%); and were designated Health Professional Shortage Areas (HPSAs). County-level data on disease prevalence, screening availability, race/ethnicity, poverty, and provider access were obtained from state and federal datasets and analyzed descriptively. Nineteen counties (19.2%) met all criteria to be classified as screening deserts. As shown in Centers for Disease Control and Prevention (CDC) national surveillance data, disease prevalence varied widely: diabetes (6.1%-10.9%), hypertension (28.1%-39.0%), and hyperlipidemia (25.2%-39.9%). Screening availability was limited - HbA1c testing was present in only 24 counties, and lipid testing in just 18. Counties with higher proportions of Black, Hispanic, or Native American residents disproportionately lacked screening access and had higher disease burdens. Our findings emphasize the critical need to align preventive care infrastructure with disease burden. This analysis provides a county-level framework to guide targeted interventions and improve equity in chronic disease prevention across Iowa.
心血管代谢疾病——包括糖尿病、高血压和高脂血症——是美国发病率、死亡率和健康差距的主要促成因素。在爱荷华州，这些疾病的负担因县而异，存在显著的地理和种族/族裔不平等。这项生态学研究分析了爱荷华州所有99个县的数据，以评估心血管代谢疾病的患病率，评估人口统计学相关性，并确定我们称之为“心血管代谢筛查荒漠”的服务不足地区。我们将筛查荒漠定义为至少缺乏以下两种预防服务的县：血压（BP）筛查、糖化血红蛋白（HbA1c）检测和血脂检测；贫困率或未参保率高（>15%）；并且被指定为卫生专业人员短缺地区（HPSA）。从州和联邦数据集中获取了关于疾病患病率、筛查可及性、种族/族裔、贫困和医疗服务提供者可及性的县级数据，并进行了描述性分析。19个县（19.2%）符合被归类为筛查荒漠的所有标准。如疾病控制和预防中心（CDC）的全国监测数据所示，疾病患病率差异很大：糖尿病（6.1%-10.9%）、高血压（28.1%-39.0%）和高脂血症（25.2%-39.9%）。筛查可及性有限——只有24个县提供HbA1c检测，只有18个县提供血脂检测。黑人、西班牙裔或美国原住民居民比例较高的县，筛查可及性严重不足，疾病负担也较高。我们的研究结果强调了使预防保健基础设施与疾病负担相匹配的迫切需求。该分析提供了一个县级框架，以指导有针对性的干预措施，并改善爱荷华州慢性病预防的公平性。
