Diabetes  rates  continue  to  grow  in  the  United  States. Effectively addressing the epidemic requires better under-standing of the distribution of disease and the geographic clustering  of  factors  that  influence  it.  Variations  in  the prevalence  of  diabetes  at  the  local  level  are  largely  unre-ported,  making  understanding  the  disparities  associated with the disease more difficult. Diabetes death rates during the past 15 years in Duval County, Florida, have been dis-proportionately high compared with the rest of the state.

We analyzed multiple sources of secondary data related to  diabetes  illness  and  death  in  Duval  County,  includ-ing  data  on  hospital  discharge,  emergency  department (ED)  use,  and  vital  statistics.  We  accessed  diabetes  and diabetes-related  ED  use  and  hospitalization  and  death data by using codes from the International Classification of Diseases versions 9 and 10. We analyzed data from the Behavioral  Risk  Factor  Surveillance  System  survey  for Duval  County  and  adapted  Centers  for  Disease  Control and  Prevention  weighting  formulas  for  subcounty  analy-sis.  We  used  relative  risk-type  disease  ratios  and  geo-graphic information systems mapping to analyze data.

The  urban,  mostly  minority,  low-socioeconomic  area  of Duval County had twice the rate of diabetes-related illness and death as other areas of the county, and the inner-city, poor area of the county had almost 3 times the rate of hos-pitalization and ED use for diabetes and diabetes-related conditions compared with the other areas of the county.

Our  analyses  show  that  diabetes-related  disparities affect  not  only  people  and  their  families  but  also  the community  that  absorbs  the  costs  associated  with  the disproportionate  health  care  use  that  results  from  these disparities.  Analyzing  data  at  the  subcounty  level  has implications  for  health  care  planning  and  public  health policy development at the local level.