title: A national study of obesity prevalence and trends by type of rural county.
abstract: BACKGROUND
  Obesity is epidemic in the United States, but information on this trend by type of rural locale is limited.
  
  
  OBJECTIVE
  To estimate the prevalence of and recent trends in obesity among US adults residing in rural locations.
  
  
  METHODS
  Analysis of data from the Behavioral Risk Factor Surveillance System (BRFSS) for the years 1994-1996 (n = 342,055) and 2000-2001 (n = 385,384). The main outcome measure was obesity (body mass index [BMI] > or = 30), as determined by calculating BMI from respondents' self-reported height and weight.
  
  
  RESULTS
  In 2000-2001, the prevalence of obesity was 23.0% (95% confidence interval [CI] 22.6%-23.4%) for rural adults and 20.5% (95% CI 20.2%-20.7%) for their urban counterparts, representing increases of 4.8% (95% CI 4.2%-5.3%) and 5.5% (95% CI 5.1%-5.9%), respectively, since 1994-1996. The highest obesity prevalence occurred in rural counties in Louisiana, Mississippi, and Texas; obesity prevalence increased for rural residents in all states but Florida over the study period. African Americans had the highest obesity prevalence of any group, up to 31.4% (95% CI 29.1%-33.6) in rural counties adjacent to urban counties. The largest difference in obesity prevalence between those with a college education compared with those without a high school diploma occurred in urban areas (18.4% [95% CI 17.9%-18.9%] vs 23.5% [95% CI 22.5%-24.5%], respectively); the smallest difference occurred in small, remote rural counties (20.3% [95% CI 18.7%-21.9%] versus 22.3% [95% CI 20.7%-24.0%], respectively).
  
  
  CONCLUSIONS
  The prevalence of obesity is higher in rural counties than in urban counties; obesity affects some residents of rural counties disproportionately.
authors.affiliation: Department of Family Medicine, University of Washington School of Medicine, Seattle, Wash. 98195-4696, USA. bjackson@u.washington.edu
authors.forename: J Elizabeth
authors.initials: JE
authors.lastname: Jackson
authors.forename: Mark P
authors.initials: MP
authors.lastname: Doescher
authors.forename: Anthony F
authors.initials: AF
authors.lastname: Jerant
authors.forename: L Gary
authors.initials: LG
authors.lastname: Hart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D003710:Demography; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D012423:Rural Health / Q000639:trends*; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000639:trends*