California's Central Valley battles diabetes epidemic

FRESNO, Calif. _ Every week in the San Joaquin Valley, at least 19 people die of diabetes, and the death toll is rising.

The disease has reached epidemic proportions nationwide, but few places are as stricken as the Valley's eight counties, from San Joaquin to Kern. Nowhere in California are people more likely to die of diabetes than here.

The complex web of reasons include obesity and poverty.

The Valley's fast-food, car-centered culture is partly to blame, health experts say, because it packs pounds on waistlines. The agriculture-based minimum-wage job market keeps people poor and unable to afford healthier foods, they say. And a doctor shortage has stalled efforts to bring the epidemic under control.

Now the disease touches nearly one out of every 10 people who live in the Valley _ compared to 1 in 13 statewide. It steals eyesight, burns nerves, disables organs. It kills. An analysis of state death records and other statistics by The Bee and the Center for California Health Care Journalism at the University of Southern California paints a vivid picture of the disproportionate toll diabetes takes here:

Minorities are up to two times as likely as whites to die from diabetes and its complications.

Less educated residents are more at risk. Almost half of those who die lack high school diplomas.

The poor _ regardless of ethnic background _ are more likely to get the disease than other Valley residents.

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