title: Ecologic correlates of obesity in rural obese adults.
abstract: OBJECTIVE
  We examined relationships of individual and environmental factors with obesity and trying to lose weight in rural residents.
  
  
  METHODS
  The joint contributions of individual and environmental factors on obesity status (obese vs. morbidly obese) and trying to lose weight (yes vs. no) were evaluated using generalized estimating equations. Patients at 29 clinics in rural areas (N = 414, M age 55.0 years (SD = 15.4), 66.3% female) completed anthropometric assessments of weight and height along with survey assessments of individual sociodemographics and trying to lose weight. Rural environments were assessed on aggregated physician access, and sociodemographic context.
  
  
  RESULTS
  Most participants (70%, M BMI = 38.3) were obese and 30% morbidly obese. A majority (73%, n = 302) of the sample was trying to lose weight. Compared to obese, morbidly obese participants were more likely to be younger, disproportionately female, not have private insurance, have more comorbid conditions, and rate themselves in worse health in comparison to their obese peers. Compared to not trying to lose weight, trying to lose weight participants were more likely to be younger, disproportionately female, have fewer comorbid conditions, and have attempted to lose weight more times through exercise. Few relationships were seen between environmental variables and obesity or trying to lose weight.
  
  
  CONCLUSIONS
  There was no consistent pattern of relationships between environment factors and obesity or trying to lose weight was seen. Unique aspects of rural living may not be captured by traditionally available neighborhood measures.
authors.affiliation: Department of Health and Human Performance, University of Houston, Giarrison Gymnasium 104 E, 3855 Holman Rd., Houston, TX 77004, USA. releephd@yahoo.com
authors.forename: Rebecca E
authors.initials: RE
authors.lastname: Lee
authors.forename: K Allen
authors.initials: KA
authors.lastname: Greiner
authors.forename: Sandra
authors.initials: S
authors.lastname: Hall
authors.forename: Wendi
authors.initials: W
authors.lastname: Born
authors.forename: Kim S
authors.initials: KS
authors.lastname: Kimminau
authors.forename: Andrew
authors.initials: A
authors.lastname: Allison
authors.forename: Jasjit S
authors.initials: JS
authors.lastname: Ahluwalia
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D015992:Body Mass Index; D015897:Comorbidity; D004038:Diet, Reducing / Q000523:psychology; D004777:Environment; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D009767:Obesity, Morbid / Q000453:epidemiology / Q000523:psychology; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors; D015431:Weight Loss