The online journal, BioMed Central, has recently published a nationwide survey on diabetes in the United States that includes a detailed state-by-state breakdown. The results are not surprising and confirm more or less what researchers have known for quite some time: Diabetes continues to be on the rise everywhere in America, and the situation is the worst in the southern parts of the country. Especially in the Southeast, diabetes, obesity, heart disease and hypertension are more widespread than ever before. In Mississippi, one in ten adults over 30 years of age and more than a quarter of those over 60 have been diagnosed as diabetic. Florida, Tennessee, Alabama and Texas are not much better off. By contrast, Vermont has the lowest rates, followed by Colorado, Minnesota and Montana.

Numbers like these should frighten us all. But what do they actually mean? As reported in the New York Times, the study lacks vital information about possible causes for an epidemic that is evidently out of control. Regrettably, so the Times writes, “researchers were unable to include family history, alcohol use and specific dietary risk factors in their research.” (New York Times 10/13/2009)

It is hard to comprehend why such an elaborate research effort would be made without concern for the most important issues in question.

Especially type 2 diabetes has been steadily on the rise for more than three decades. Type 2 diabetes, a.k.a. adult-onset or non-insulin dependent diabetes, is the most common form of diabetes. People who are overweight or obese and have a mostly sedentary lifestyle are prime candidates for becoming diabetic. More and more children are being diagnosed with Type 2 diabetes due to weight problems at a young age.

On most cases, type 2 diabetes is perfectly preventable. Studies have shown time and again that even moderate weight loss and regular physical activity can reduce the risks considerably. Small but lasting lifestyle changes could make a real difference in many people’s lives. But even such modest goals may turn out to be a daunting task.

Precisely the issues that were not addressed in the diabetes survey mentioned above are the ones that need to be better understood and taken into account. For instance, the consideration of “environment” and “family history” is key for any meaningful analysis of the diabetes epidemic.

Take for example the culinary culture of the Deep South, which is well known for its heavy-handed cooking techniques. Way back in the days when most folks engaged in hard physical labor on farms and in factories, having a healthy appetite was perfectly natural and necessary to survive. Those times are long gone, but eating habits haven’t changed that much. On the contrary. Today, food is cheaper and more accessible than ever and consumption keeps going up. At the same time, very limited physical activity is needed for work or for getting around.

Restaurants and fast food places offer “added value” and “supersized” portions of caloric and fatty foods. Most meals are eaten in the car or in front of the TV and the computer. Many poorer communities don’t have health-promoting infrastructures available to them that would allow for physical exercise, such as sidewalks, playgrounds, parks, bicycles paths and the likes. There is also a notorious lack of access to high quality food outlets. Affordable alternatives to high-end grocery stores, such as farmers markets, are also amiss where they are needed the most.

I am all for monitoring our public health, and I am sure that statistics and surveys are necessary to address these ever more pressing issues, especially when they are put to use to prevent unnecessary diseases. But we must not be shy to look at the problems as they are and name their causes and, if necessary, point out the culprits. If we can’t do even that, how are we ever going to take action?

Timi Gustafson R.D. is a clinical dietitian and author of the book “The Healthy Diner – How to Eat Right and Still Have Fun®”, available in bookstores, at http://www.timigustafson.com and at Amazon.com. You can also follow Timi on Twitter at http://www.twitter.com/TimiGustafsonRD