Multiple sclerosis (MS) is a chronic autoimmune disorder that affects the central nervous system. It damages the myelin sheath that surrounds and protects nerve fibers, slowing down or blocking messages between the brain and body. MS is a disabling disease that can cause vision loss, pain, fatigue, cognitive changes, and impaired mobility. According to the National Multiple Sclerosis Society, nearly 1 million people are living with MS in the United States. However, MS does not impact all states equally. Read on to discover which US state has the highest rates of multiple sclerosis.
What Is Multiple Sclerosis?
Multiple sclerosis is considered an immune-mediated disorder, meaning the body’s immune system attacks its own healthy cells. In the case of MS, the immune system mistakenly targets myelin, the fatty substance that coats nerve fibers and ensures signals can travel quickly and efficiently along neurons. When myelin becomes damaged, communication between the brain and other parts of the body is disrupted. This myelin damage is called demyelination and leads to the symptoms of MS.
MS causes a wide range of symptoms depending on where in the central nervous system the demyelination occurs. Common signs and symptoms include:
- Fatigue
- Numbness and tingling
- Weakness
- Vision problems
- Mobility and balance issues
- Bladder dysfunction
- Bowel dysfunction
- Pain
- Cognitive changes
- Emotional changes
MS symptoms can range from mild to disabling. They may come and go or worsen over time. MS is an incurable condition, but various treatments exist to manage symptoms and modify the course of the disease.
MS Prevalence Across the United States
MS impacts over 2.8 million people worldwide. In the United States, nearly 1 million people between the ages of 18-65 are living with MS. This equals about 1 in 750 people. However, MS does not strike all states equally. The National Multiple Sclerosis Society estimates MS prevalence in each state based on insurance claims data and other statistics. The states with the highest rates of MS are concentrated in the Northeast, upper Midwest, and Pacific Northwest regions.
Here are the top 10 states with the highest rates of MS per 100,000 people:
- Alaska – 218.5
- Vermont – 218
- South Dakota – 179
- Minnesota – 171
- Montana – 142
- Nebraska – 139
- Washington – 136
- Wisconsin – 131
- Oregon – 127
- Iowa – 122
This data shows Alaska has the highest rate of MS in the country at nearly 219 cases per 100,000 residents. South Dakota, Minnesota, Montana, Nebraska, and Washington also rank in the top 10 states with elevated rates of MS.
Reasons for Geographic Differences in MS Prevalence
Researchers do not fully understand why some parts of the United States have higher concentrations of MS cases. Susceptibility to MS likely involves a combination of genetic and environmental factors. Some possible explanations for the geographical patterns include:
- Genetics: Scientists have identified over 200 genes associated with increased MS risk. Certain genetic traits that increase risk may be more predominant in populations living in areas of higher MS prevalence.
- Vitamin D: Research indicates vitamin D deficiency could be one environmental risk factor for MS. Populations living farther from the equator may have lower vitamin D levels due to decreased sun exposure.
- Infections: Viral infections are another proposed environmental link to MS. Respiratory infections such as the Epstein-Barr virus are more common in cold climates.
- Smoking: Smoking may interact with genetic factors to increase MS risk. States with higher smoking rates tend to have more MS cases.
- Migration patterns: Moving from an area of low MS risk to high risk before age 15 may increase a person’s MS risk. Clustering in high-risk areas raises prevalence.
In addition to increased genetic susceptibility and environmental exposures, higher rates of MS diagnosis and reporting in certain states could contribute to elevated prevalence. Regardless of the reasons, statistics clearly show states like Alaska, South Dakota, and Minnesota have disproportionately high MS rates compared to other parts of the country.
Demographics of MS in the United States
Beyond geography, MS also impacts some groups more than others within the United States:
- Age – Most people receive an MS diagnosis between the ages of 20 and 50.
- Sex – MS is over 3 times more common in women than men.
- Ethnicity – MS rates are highest among Caucasians/Whites and lowest among Asians, Hispanics/Latinos, and Indigenous people.
About 10% of MS cases are diagnosed in childhood. After age 50, the number of MS diagnoses declines. Researchers do not fully understand why more women than men develop MS. Genetics, hormones, and environmental exposures may play a role.
MS Prevalence by Sex
| Sex | Prevalence per 100,000 People |
|---|---|
| Female | 248.5 |
| Male | 78.8 |
This table illustrates how MS rates among women are over three times higher than among men. Sex hormones, genetics, and autoimmune responses may underlie this discrepancy.
MS Prevalence by Race/Ethnicity
| Race/Ethnicity | Prevalence per 100,000 People |
|---|---|
| Caucasian/White | 149 |
| African American/Black | 64 |
| Hispanic/Latino | 46 |
| Asian American | 25 |
| American Indian/Alaska Native | 50 |
Caucasians/Whites have significantly higher rates of MS than other racial groups. Researchers think genetics likely play a major role in these disparities.
MS Prevalence in Alaska
Now that we’ve reviewed MS rates across the entire US, let’s take a closer look at the state with the highest rate of all – Alaska. With 218 cases per 100,000 people, Alaska’s MS rate is nearly double the national average. Within Alaska, MS prevalence is even higher among certain groups:
- Women: 370 cases per 100,000
- Men: 90 cases per 100,000
- Caucasians: 360 cases per 100,000
- Alaska Natives: 135 cases per 100,000
Just as nationally, Caucasian women have significantly higher rates of MS than other groups in Alaska. Researchers have floated some theories about why MS is so prevalent in Alaska specifically:
- Genetics: The state was populated by migrations from Scandinavian countries and Russia, where MS rates are also elevated.
- Sunlight: Much of Alaska gets very little sunlight in the winter, leading to vitamin D deficiency.
- Infections: Alaska has higher rates of certain viral infections linked to MS.
- Environmental factors: Cold climates, smoking, and other exposures may interact with genes to increase MS risk.
More research is needed on the unusually high MS rates in Alaska. Prevalence is rising across the United States, for reasons not fully understood. Alaska provides a dramatic example of just how much MS can vary between different geographic regions.
MS Diagnosis and Treatment
With MS impacting nearly 1 million Americans, being able to recognize the signs and symptoms is important for prompt diagnosis and treatment. Some common red flags for MS include:
- Numbness, tingling, weakness in the extremities
- Electric shock sensations with neck movement
- Vision problems or eye pain
- Dizziness or vertigo
- Fatigue, especially as the day wears on
- Bladder urgency or incontinence
- Sexual dysfunction
- Memory, concentration, or judgment problems
- Gait, balance, or coordination difficulties
Since many of these symptoms occur with other conditions, a neurologist will run tests to confirm an MS diagnosis. These may include:
- MRI – Detects areas of myelin damage in the central nervous system
- Spinal fluid analysis – Checks for antibodies/proteins linked to MS immune response
- Evoked potential tests – Measures electrical signals in the central nervous system
- Neurological exam – Assesses function of cranial nerves, reflexes, and other areas
Once diagnosed, the neurologist will recommend a customized treatment plan which may involve:
- Disease-modifying therapies – Immunotherapy drugs to modify the course of MS
- Steroids – Reduce inflammation and shorten MS attacks
- Pain medication – Relieve neuropathic and muscle pain
- Physical therapy – Improve mobility, balance, and coordination
- A multidisciplinary approach – Managing MS requires a team of medical professionals
While MS has no cure, advances in treatment have greatly improved quality of life for people living with this condition. The National MS Society provides invaluable resources and support services as well.
Conclusion
In summary, Alaska has the highest rate of multiple sclerosis in the United States at 218 cases per 100,000 people. Several states in the Northeast, Midwest, and Northwest also rank among those with the highest MS prevalence. Rates are significantly elevated in women and Caucasians. The reasons for geographical clustering remain under investigation but likely involve genetic, environmental, and behavioral factors. With MS impacting nearly 1 million Americans, ongoing research and improved access to treatment can help those living with this progressive disease lead full, active lives.