Mass urbanisation, reduced activity and poor diets are accelerating the rise of obesity.
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Planners have reviewed content to ensure there is no bias. CDC does not accept commercial support. National estimates from a decade ago found a higher prevalence of obesity among adults living in nonmetropolitan counties than among those living in metropolitan counties.
What is added by this report? Analysis of Behavioral Risk Factor Surveillance System data found a higher obesity prevalence among adults in nonmetropolitan counties than among those in metropolitan counties.
The greatest differences in obesity prevalence between nonmetropolitan and metropolitan residents were in the South 5. What are the implications for public health practice?
Both nonmetropolitan and metropolitan counties can address obesity through a variety of policy and environmental strategies to increase access to healthier foods and opportunities for physical activity.
However, this difference has not been examined by state. Obesity prevalence was significantly higher among nonmetropolitan county residents than among metropolitan county residents in all U.
Census regions, with the largest absolute difference in the South 5. In 24 of 47 states, obesity prevalence was significantly higher among persons in nonmetropolitan counties than among those in metropolitan counties; only in Wyoming was obesity prevalence higher among metropolitan county residents than among nonmetropolitan county residents.
Both metropolitan and nonmetropolitan counties can address obesity through a variety of policy and environmental strategies to increase access to healthier foods and opportunities for physical activity 4. Inusing combined landline and cell phone data across all states, the median response rate was Census regions and nine divisions: Rhode Island, New Jersey, Delaware, and DC do not have nonmetropolitan counties; for these jurisdictions, obesity prevalence was calculated for adults living in metropolitan counties only.
Unadjusted obesity prevalence was stratified by metropolitan and nonmetropolitan status. All analyses accounted for complex survey design and sampling weights.
Inoverall obesity prevalence was Overall, obesity prevalence was significantly higher among adults living in nonmetropolitan counties Among Census regions, the largest difference in obesity prevalence between persons living in nonmetropolitan and metropolitan counties was in the South 5.
Obesity prevalence was also significantly higher among nonmetropolitan county residents than among metropolitan county residents for all sociodemographic categories except Hispanics and persons with less than a high school education.
Among adults living in nonmetropolitan counties, obesity prevalence ranged from Wyoming was the only state where obesity prevalence was significantly higher among metropolitan county residents Top Discussion In this study, obesity prevalence was significantly higher among adults living in nonmetropolitan counties than among those living in metropolitan counties, overall, in all Census regions, all Census divisions, and in approximately half of states with both county types.
Across regions and divisions, this disparity in obesity prevalence was highest in the South and Northeast regions and the Middle Atlantic division.
With the exception of Hispanics and persons with less than a high school education, the higher obesity prevalence among nonmetropolitan residents was observed in all sociodemographic groups.
These findings are consistent with those previously reported using — NHANES data, which documented higher overall obesity prevalence among adults living in nonmetropolitan versus metropolitan counties of the United States 3and expand the understanding of this health disparity by highlighting differences across states and regions.
Research has documented differences between adults living in nonmetropolitan and metropolitan counties in health behaviors and community factors, which could influence obesity risk 5—7.
In addition, several social determinants of health that are risk factors for obesity, such as persistent poverty and food insecurity 7are more prevalent in rural than in urban areas.
One possible contributing factor is the high rate of persistent poverty in the South, which also is affected by the largest difference in poverty rate between metropolitan and nonmetropolitan county residents.
First, data are self-reported, and self-reported weight and height data underestimate BMI values, particularly among persons with a higher BMI 8.
It is not known whether self-reporting bias is comparable across regions and between metropolitan and nonmetropolitan counties. The literature on rural obesity disparities and prevention strategies uses various methods to define rural areas, some of which might differ in population size from the nonmetropolitan designation used in this paper.
CDC recommends 24 obesity-prevention policy and environmental strategies 4.
Two systematic reviews summarized the relevance and effectiveness of these strategies in rural areas and identified how these strategies could be adapted for rural settings 9, One nutrition-related obesity prevention strategy, increasing the availability of healthier food and beverage choices, is challenging to implement in rural areas because of the long distances between food suppliers and retailers and between retailers and consumers, which can influence food cost and the availability of fresh foods.
The CDC State Indicator Report on Fruits and Vegetables also highlights approaches to increase the purchase, supply, and demand of fruits and vegetables in states and communities across the United States. Strategies to increase physical activity in rural areas should take into consideration geographic dispersion, transportation challenges, and limitations on community resources that might not be present in urban areas Strategies that have been implemented in rural settings include improving community access to public buildings e.
The data in this report can serve as a resource for states seeking to reduce obesity disparities in nonmetropolitan counties through strategies to increase physical activity and healthier eating.Food-insecure and low-income people are subject to the same often challenging influences as other Americans in trying to consume a healthful diet and maintain a healthful weight (e.g., more sedentary lifestyles, increased portion sizes).
Discussion. In this study, obesity prevalence was significantly higher among adults living in nonmetropolitan counties than among those living in metropolitan counties, overall, in all Census regions, all Census divisions, and in approximately half of states with both county types.
If Doctors, Healthcare and the Fitness industries ever wondered why African Americans are not coming in droves, this book is a Must Read! The Bottom Line: Limit TV and “Sit Time,” Increase “Fit Time” to Prevent Obesity. Overall, there is little doubt that time spent watching TV is an important risk factor for obesity-and a modifiable risk factor.
Apr 29, · I reread the Fast Food Nation excerpt in At the time, I was studying the history of obesity as a postdoctoral fellow at the National Institutes of Health, so obesity was on my mind a lot.