CDC: More obesity in U.S. rural counties than in urban counties

Media Statement

Embargoed Until: Thursday, June 14, 2018
Contact: Media Relations,
(404) 639-3286

Adults living in non-metropolitan (rural) counties are still more likely to be obese than adults in metro (urban) counties, according to a Centers for Disease Control and Prevention (CDC) report in today’s MMWR.

The findings, based on 2016 Behavioral Risk Factor Surveillance Survey (BRFSS) data, are consistent with previous findings published in 2012 using 2005-2008 National Health and Nutrition Examination Survey (NHANES) data.

Key findings

  • Obesity prevalence was significantly higher among adults living in rural counties (34.2 percent) than among those living in metropolitan counties (28.7 percent).
  • The greatest differences in prevalence were in the South and Northeast regions.
  • The findings held true for adults in most sociodemographic categories, including age, sex, and household income.

The analysis compared obesity based on self-reported weight and height among adults living in metropolitan (e.g., urban) and nonmetropolitan (e.g., rural) counties in the United States in 2016.

The report identifies differences in obesity prevalence by metropolitan status within states, census regions and divisions, and sociodemographic characteristics (e.g., age, sex, race/ethnicity, and education).

What can be done to address this issue?

Obesity is a risk factor for many chronic diseases including type 2 diabetes, coronary heart disease, some cancers and arthritis. Understanding regional variation in obesity prevalence by metropolitan residence status can help inform interventions and targeting of obesity prevention resources.

Numerous obesity-prevention strategies can be used in rural areas. These include increasing the availability of healthy food by working with schools, worksites, and the Cooperative Extension Service; opening public buildings (e.g., school facilities) after hours for physical activity purposes; and including bicycle paths, paved sidewalks, and outdoor public recreation facilities in community planning.

One way CDC addresses obesity is through its High Obesity Program (HOP). HOP funds land grant colleges and universities in states with counties that have more than 40 percent prevalence of adult obesity. Residents of these communities — mostly in rural areas — may have less access to healthy foods and fewer opportunities to be physically active. Grantees work with existing county cooperative extension and outreach services in targeted areas. They use proven public health strategies to help people improve physical activity and nutrition, reduce obesity, and prevent or control diabetes, heart disease, and stroke. More about the HOP program can be found here:


Page last reviewed: June 14, 2018