Diabetes Coalition of South Dakota Homepage

State Demographics

South Dakota traverses over 75,000 square miles and is one of the nation’s most rural and frontier geographic areas. The prevalence of health disparities is high, particularly related to chronic diseases and their associated risk factors. There are 814,180 persons living in South Dakota (SD) and an average population density of 10.7 people per square mile (2010 U.S. Census). Of SD’s 66 counties, 30 are rural and 34 are frontier (less than 6 people per sq. mile).


The state's racial/ethnic distribution is 85.9% White, 8.8% American Indian, and 5.3% other races. The majority of the population speaks English only, however, 6.7% speak a language other than English in their home and 11.7% of persons have a physical, social or emotional disability (2011 American Community Survey). The 2011 ACS 5-year estimates indicate 13.8% of South Dakotans live below 100% of the Federal Poverty Level (FPL), however, poverty levels for counties in or near American Indian reservations are significantly higher. The 10 poorest counties are either part of or adjacent to one of nine American Indian reservations, with poverty levels from 24.5-49.9%.

South Dakota’s rural geography greatly impacts access to health care services. There are 1,034 active primary care physicians licensed to practice in South Dakota and 902 primary care midlevel providers (Physician Assistants, Nurse Practitioners, and Nurse Midwives), ranking SD 41st in the nation for physician to population ratios (CDC, 2010). Two-thirds of the state is designated by the federal government as a Health Professional Shortage Area. Eighty percent of SD hospitals are critical access hospitals (CAHs).

Prevalence of Diabetes

According to the Centers for Disease Control and Prevention (CDC), 8.3% of the population in the United States (over 25.1 million people) has diabetes. The 2008 Behavioral Risk Factor Surveillance System (BRFSS) shows that 6.6%, or 39,967 of South Dakotans 18 and older, have been diagnosed with diabetes.


Diabetes prevalence rates in South Dakota, as in the United States, have increased gradually since the late 1980’s. In 2011, the prevalence in South Dakota was 9.5% - the same as the overall United States. The BRFSS process has modified its collection metrics in measuring people with diabetes. Therefore we will use 2011 as our baseline and measure.

In 2009, the CDC released estimates of diagnosed diabetes for all counties in the United States. Derived from BRFSS and census data, the estimates provide a clearer picture of areas within the state that have higher diabetes rates.

South Dakota Statistics

  • Approximately 9.5%, 58,200, of South Dakota adults have been diagnosed with diabetes.
  •  A significant racial disparity exists as the prevalence of diagnosed diabetes in Native Americans is 24% compared to 7.8% of whites in South Dakota.
  • South Dakotans aged 65 years or older are almost twice as likely to have been diagnosed with diabetes as persons aged 45 to 64 years.
  • Analysis by the Centers for Disease Prevention and Control shows 35% of adults aged 20 years or older have prediabetes.
  • Of the estimated 35% of South Dakota adults with prediabetes, 4.8% have been told of their prediabetes status.

Cost Factors

  • In 2011, 10.5% of South Dakota adults with diabetes had no health insurance.
  • The per capita annual cost of health care for people with diabetes is calculated at $13,700 a year, of which $7,900 is attributed to diabetes.


  • There were 267 deaths directly attributed to diabetes in 2011 compared to 246 in 2007. A total of 1,170 deaths amongst South Dakota residents were attributed to diabetes from 2007-2011.
  • In 2011 diabetes was the 4th leading cause of death among American Indians and the 7th leading cause among whites
  • Native Americans have a greater number of years of potential life lost before the age of 75 than whites due to diabetes, 1,180 years and 154 years, respectively.
  • Native Americans have a lower median age at death due to diabetes than whites, 65 years versus 81 years.