Severe obesity three times higher in rural populations than urban areas: Study

Federal researchers have found that where you live is as important in influencing rates of severe obesity as traditional measurements of age, race and education.

People living in rural environments have severe obesity at almost triple the rate of those who live in urbanized areas, and those numbers are increasing at a higher rate over time.

“The differences are quite striking,” said Cynthia L. Ogden, Ph.D., an epidemiologist at the Centers for Disease Control and prevention lead author on one of two studies released Tuesday.

The latest reports, published in the Journal of the American Medical Association, take data from the nationally representative National Health and Nutrition Examination Survey and looked at changing rates of obesity and severe obesity between 2001 and 2004 and 2013 and 2016.

One study looked at obesity rates among children and teens while the other focused on adults age 18 and over.

In total, rates of obesity for youth in the U.S. age two- to 19-years-old is 17.8 percent and cases of severe obesity is 5.3 percent, between 2013 and 2016.

For adults, 38.9 percent have obesity and 7.6 percent have severe obesity.

Yet to better understand a variety of risk factors, researchers focused on how three urbanization areas — large urban areas; medium and small areas; and rural — influence weight gain.

There wasn’t much difference in changes over time of obesity rates in rural verse urban areas, but rates of severe obesity were much higher and increasing at a higher rate in areas with populations less than 50,000 people compared to larger metropolitan areas with a population greater than one million.

The prevalence of severe obesity in rural areas is triple the rate in urban areas, Ms. Ogden said, comparing 10 percent to two or three percent, respectively.

Women, in particular, had rates of severe obesity twice as high in rural compared to urban environments, 13 percent compared to six percent.

Severe obesity is considered having a Body Mass Index, calculated as weight divided by height, greater than the 95th percentile. For a person with a height of five feet, nine inches, a weight of over 241 pounds is considered severely obese.

Researchers have earlier looked at how geographic areas and population centers can influence weight. A study published in January by University of Southern California researchers found that obesity can be socially influenced — communities that are either set up or promote healthy lifestyles influence residents. Likewise, environments that make it difficult to be active, eat healthily, among other health factors, have a negative effect on the health of residents.

Scientists have established certain risk factors that contribute to people having obesity or severe obesity, including living in a home where the head of the household has a lower education, being older and being African-American or Hispanic.

Yet in the latest report, federal scientists tried to understand if these factors had a greater influence than others but found that controlling for age, race and education had little influence on the overall results.

“I can’t say what does explain it,” Ms. Ogden said, “all I can say is that age, race, and education differences in urban vs rural areas didn’t explain the difference.”