Wide open waistlines
Obesity a bigger problem for rural dwellers
By Jill Pease
The occurrence of obesity in rural areas of the U.S. is significantly higher than in urban areas, a new study from UF researchers and colleagues has found. Forty percent of rural residents are obese, compared with 33 percent of urban residents.
The study is the first to use body mass index, or BMI, classification based on researcher-measured height and weight to compare rates of obesity in rural and urban adults. Previous studies relied on participants’ self-reports of height and weight, which led to too-low estimates of obesity, the researchers say.
“I was surprised by the magnitude of the rural-urban difference — it was larger than expected and much larger than previously estimated,” said senior author Michael G. Perri, Ph.D., a professor and dean of the UF College of Public Health and Health Professions.
The findings appear in the fall issue of the Journal of Rural Health, published by the National Rural Health Association.
Nearly 60 million people, or 19 percent of the population, live in rural areas, according to the 2010 U.S. Census.
Perri and fellow investigators Christie Befort, Ph.D., and Niaman Nazir, M.D., both of the University of Kansas Medical Center, analyzed data from the 2005-2008 National Health and Nutrition Examination Survey conducted by the National Center for Health Statistics. Survey participants included 7,325 urban and 1,490 rural residents between the ages of 20 and 75.
Almost 40 percent of rural adults were obese — having a BMI of 30 or greater — compared with just over 33 percent of urban adults.
Among rural participants, several factors were associated with higher rates of obesity, including being married, being African-American, or consuming a higher daily calorie intake or a higher percentage of calories from fat. Urban dwellers were more likely to be obese if they were older, African-American, had less education, were inactive and consumed a higher percentage of calories from fat. There was no difference in physical activity between the rural and urban participants, but rural participants consumed a much higher percentage of their daily calories from fat. That finding is in keeping with reports from previous rural health studies that show heavy meals and limited access to healthy foods are common in rural areas.
When age was taken into account, the rural-urban disparity was seen in participants ages 20 to 39, but not among older adults. The researchers theorize that a combination of heavier meals and increased mechanization of traditional rural occupations, such as farming and logging, might account for the increased obesity rates among young rural workers.
“Rural areas have fewer resources to assist residents with lifestyle changes related to weight management,” said Perri, a professor of clinical and health psychology.
One solution may be to tap the expertise of the U.S. Department of Agriculture’s Cooperative Extension Service, an educational network with offices in nearly every U.S. county, said Perri, who has led several behavioral weight management studies for rural residents in collaboration with that service.
“The infrastructure offers an ideal opportunity for providing weight management services to residents of rural counties,” he said. “We have demonstrated the real benefits of offering such programs in this way to children as well as adults.”