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 9.7% of adults in the Philadelphia-Camden-Wilmington metro area have diabetes, more than the national share of 9.3% and the third smallest share in Pennsylvania.

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 Philadelphia, some 23.1% of adults do not exercise outside of work, roughly similar to 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 Philadelphia, 27.0% of residents are obese, the same as the national rate of 27.0% and the third lowest of any Pennsylvania metro area.

Residents of Philadelphia, however, are more likely to engage in other unhealthy behaviors. For example, the city’s 17.8% smoking rate and 19.0% 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 Philadelphia metro area, the typical household earns $65,123 annually, roughly $9,300 more than the national median household income of $55,775. An estimated 36.0% of adults in Philadelphia have a bachelor’s degree, a larger share than the national college attainment rate of 30.6% and the second highest of any city in Pennsylvania.

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 Philadelphia metro area, there are 370 deaths per 100,000 metro area residents, more than the national mortality rate and the fourth highest of any city in Pennsylvania.