Prevalence of obesity among adults from rural and urban areas of the United States: findings from NHANES (2005-2008).
OBJECTIVE
Rural residents have higher rates of chronic diseases compared to their urban counterparts, and obesity may be a major contributor to this disparity. This study is the first analysis of obesity prevalence in rural and urban adults using body mass index classification with measured height and weight. In addition, demographic, diet, and physical activity correlates of obesity across rural and urban residence are examined.


METHODS
Analysis of body mass index (BMI), diet, and physical activity from 7,325 urban and 1,490 rural adults in the 2005-2008 National Health and Nutrition Examination Survey (NHANES).


RESULTS
The obesity prevalence was 39.6% (SE = 1.5) among rural adults compared to 33.4% (SE = 1.1) among urban adults (P = .006). Prevalence of obesity remained significantly higher among rural compared to urban adults controlling for demographic, diet, and physical activity variables (odds ratio = 1.18, P = .03). Race/ethnicity and percent kcal from fat were significant correlates of obesity among both rural and urban adults. Being married was associated with obesity only among rural residents, whereas older age, less education, and being inactive was associated with obesity only among urban residents.


CONCLUSIONS
Obesity is markedly higher among adults from rural versus urban areas of the United States, with estimates that are much higher than the rates suggested by studies with self-reported data. Obesity deserves greater attention in rural America.
University of Kansas Medical Center, Department of Preventive Medicine and Public Health, Kansas City, Kansas 66160, USA. cbefort@kumc.edu
Christie A
CA
Befort
Niaman
N
Nazir
Michael G
MG
Perri
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D004034:Diet Surveys; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult