The Centers for Disease Control and Prevention estimates that 29.1 million Americans today have diabetes. While diabetes is the seventh leading cause of death in the U.S., most cases of type 2 diabetes are preventable. Diabetes can be prevented by healthy eating, weight management, and an active lifestyle — factors which vary heavily by geography. An estimated 10.6% of adults in the Detroit-Warren-Dearborn metro area have diabetes, more than the national share of 9.3% and the sixth smallest share in Michigan.

According to the CDC, more than one in three Americans is prediabetic. A person with prediabetes has blood sugar levels higher than normal, and is 15% to 30% more likely to develop diabetes within five years. Prediabetes is mostly caused by lifestyle factors such as diet and exercise, as well as risk factors such as age and family history. In Detroit, some 23.0% of adults do not exercise outside of work, the same as the national share of 23.0% inactive Americans.

In inactive lifestyle can affect the likelihood of developing excess body fat, one of the primary causes of diabetes. In Detroit, however, 30.8% of residents are obese, higher than the national rate of 27.0% and the fourth lowest of any Michigan metro area.

Residents of Detroit are also more likely to engage in other unhealthy behaviors. For example, the city’s 18.3% smoking rate and 19.6% excessive drinking rate are both higher than than the corresponding national rates of 17.0% and 18.0%.

Diabetes is often more prevalent in low-income areas where residents tend to have lower education levels. Individuals living in impoverished neighborhoods are less likely to have adequate access to healthy food, opportunities for exercise, or preventative health care. According to one study, residents of poor neighborhoods are up to twice as likely to have diabetes than those in wealthy neighborhoods.

In the Detroit metro area, the typical household earns $53,628 annually, roughly $2,100 less than the national median household income of $55,775. An estimated 29.5% of adults in Detroit have a bachelor’s degree, a share roughly equivalent to the national college attainment rate of 30.6% and the sixth highest of any city in Michigan.

Diabetes increases the risk of blindness, kidney failure, heart disease, and stroke. Ultimately, the risk of death is 50% higher for adults with diabetes than those without. Diabetes causes 76,600 deaths in the U.S. annually, or roughly 24 per 100,000 Americans. Overall, an estimated 474 in 100,000 Americans die prematurely before the age of 75 each year. In the Detroit metro area, there are 396 deaths per 100,000 metro area residents, more than the national mortality rate and the third highest of any city in Michigan.