Online-only: Rural residents more likely to be obese, study finds
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* Donya Currie

Underscoring the importance of community-based interventions that target people where they live, a recent study found rural residents are more likely to be obese than city dwellers.

Based on an analysis of data from the National Center for Health Statistics, the study used measured heights and weights rather than self-reported data. Researchers found nearly 40 percent of rural residents were obese, compared to about 33 percent of urban residents.

Study author Christie Befort, PhD, assistant professor of preventive medicine and public health at the University of Kansas Medical Center, said cultural diet and physical isolation are two likely factors contributing to more rural residents being obese.

“There is a definite cultural diet in rural America, full of rich, homemade foods, including lots of meat and dessert,” Befort said.

The study also found rural Americans typically eat a diet higher in fat than their rural counterparts.

Accessing health care and finding opportunities for regular exercise via walking and cycling trails and gyms also can be tougher for rural residents, she said.

“Access is often about travel time in a rural area, but it can also be that there’s no place to go — literal physical isolation,” Befort said. “It’s tough to go to a gym if you live outside of a town without one.”

Among the interesting study findings, said Alan Morgan, MPA, CEO of the National Rural Health Association, were a higher percentage of married couples in rural areas. He said that can translate into high-fat comfort foods eaten at home. Also, in households where both parents work, meals are often fast food.

“People assume and link rural America to a healthier lifestyle because they’re where they’re producing the food,” Morgan told *The Nation’s Health*. “But the fact of the matter is, in rural areas you have lower average incomes for a lot of the populations and they’re looking for inexpensive food sources — easy, convenient and inexpensive food sources. And those are not always the healthy choices.”

The study, which was published in the Fall 2012 Journal of Rural Health, found rural residents had lower levels of physical activity, were less likely to have a college degree and ate more fat than urban residents.

“So you have an inappropriate diet, let’s say that,” Morgan said. “But in urban areas you have those opportunities — running paths, biking paths, gyms — to get exercise. You just don’t have that in rural areas. Let’s be honest. In rural areas you have fast food that’s easy to have. You have two spouses working and limited time. The quality of food that you’re taking in, and the lack of exercise that you’re having, there just has to be a larger public health focus on this going forward.”

The study found the largest rural/urban disparity in obesity prevalence among adults ages 20–39. In that age group, about 38 percent of rural residents were obese, compared to about 28 percent of urban residents. The gap also was larger among blacks, with nearly 56 percent of those rural residents obese compared to about 43 percent of urban residents.

“From a national standpoint, I think we all realize we’re not going to be able to reduce health care costs unless we address these front end, preventive health issues,” Morgan said. “Diabetes, heart problems, so many of these are tied back to diet and the obesity issue.”

The study is online at [http://onlinelibrary.wiley.com/doi/10.1111/j.1748-0361.2012.00411.x/full](http://onlinelibrary.wiley.com/doi/10.1111/j.1748-0361.2012.00411.x/full).

*   Copyright The Nation’s Health, American Public Health Association