RT Journal Article SR Electronic T1 Regional differences in the impact of diabetes on population health in the USA JF Journal of Epidemiology and Community Health JO J Epidemiol Community Health FD BMJ Publishing Group Ltd SP 56 OP 61 DO 10.1136/jech-2020-214267 VO 75 IS 1 A1 Zang, Emma A1 Lynch, Scott M A1 West, Jessica YR 2021 UL http://jech.bmj.com/content/75/1/56.abstract AB Background To evaluate regional disparities in the influence of diabetes on population health, we examine life expectancies at age 50 between population with diabetes and healthy population and life quality among the population with diabetes among native-born Americans by birth region and current residence.Methods Using data on a cohort of 17 686 native-born individuals from the Health and Retirement Survey (1998–2014), we applied a Bayesian multistate life table method to estimate life expectancies at age 50 between population with diabetes and healthy population by each birth/current region combination. We further estimate the proportion of life remaining without either chronic conditions or disabilities as a quality of life measure and the probabilities that one region is worse than the other in terms of different health outcomes.Results At age 50, persons with diabetes (PWD) were expected to live on average 5.8–10.8 years less than their healthy equivalents across regions. Diabetes had the greatest influence on life expectancy (LE) for older adults who lived in the South at the time of interviews. PWD born in the South were more likely to have developed chronic conditions or disabilities and spent greater proportions of life with these two issues compared to other regions.Conclusion Diabetes is a significant threat to LE and healthy LE in the USA, particularly for people born or living in the South.