West Virginia is often celebrated for its picturesque Appalachian scenery, but the state is grappling with notable public health issues. The life expectancy in West Virginia is below the national average, and it also reports the highest prevalence of both diabetes and depression.
As per the U.S. Centers for Disease Control and Prevention (CDC), in 2020, 18.4% of U.S. adults were suffering from depression. However, when the statistics were analyzed state-wise, West Virginia emerged with the highest depression rate of 27.5%, which surpasses the national average and is more than double Hawaii’s lowest rate of 12.7%. Additionally, when the CDC examined diabetes-related mortality rates, West Virginia was again at the top with 41.1 deaths per 100,000 people.
These statistics reveal a concerning trend: regions with high depression rates are found in the Appalachian and Mississippi Valley areas, as well as states like Missouri, Oklahoma, and Washington. For diabetes mortality rates, following West Virginia, the states of Arkansas, Mississippi, and Oklahoma also rank high. This pattern suggests that there are shared factors contributing to both physical and mental health challenges across these regions.
Factors driving West Virginia’s diabetes and depression
While West Virginia isn’t the lowest-income state in the U.S., it ranks among the top five poorest states (via Friends Committee on National Legislation). The state also ranks lowest in education among the 50 states. “Despite a high percentage of adults having completed high school, West Virginia lags in higher education, with few adults possessing bachelor’s and advanced degrees,” said WalletHub analyst Cassandra Happe in an interview with Newsweek. The World Population Review awarded West Virginia a score of 1 out of 50 in 2025 based on education quality and accessibility. These socioeconomic barriers are closely linked to adverse health outcomes, both physical and mental.
West Virginia also has the highest smoking rate in the U.S., at 21%, according to the American Lung Association. Furthermore, 41.2% of its residents are obese, which is another critical issue (per CDC). Obesity is among the leading causes of diabetes, as noted by the Mayo Clinic, and smokers face a 30% to 40% increased risk of developing diabetes, according to the CDC.
The high depression rates in West Virginia may be exacerbated by economic obstacles to accessing care, a shortage of healthcare providers, and ongoing mental health stigma linked to educational gaps. “One major issue is the lack of healthcare providers,” said psychiatrist Dr. Suzanne Holroyd in an interview with U.S. News & World Report, explaining that some patients experience months-long wait times. “This is true for both adults and children. For example, there has been a rise in suicide attempts among children and adolescents, and even for these patients, outpatient psychiatric care is hard to access.”
Improving diabetes and depression outcomes in West Virginia
Initiating healthy changes can be daunting, especially when there is limited access to healthcare, nutritious food, or even reliable information. However, small, manageable actions can still lead to significant improvements. Reducing smoking, adopting a balanced diet (your ultimate guide to grocery shopping), and engaging in 20 to 30 minutes of physical activity each day can all help decrease the risk of diabetes and enhance mental health.
Limited access to mental health services poses a significant challenge in West Virginia, with long wait times not being the fault of those seeking assistance. Fortunately, options like mental health apps and text-based therapy are becoming increasingly accessible and affordable. If you’ve been raised to believe in enduring hardships silently, remember that many share this sentiment — as of 2019, 280 million people worldwide were diagnosed with depression, according to the World Health Organization. Reaching out for help is not a sign of weakness; it’s a brave step towards healing, and no one should have to face it alone.
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