Adults Living in Rural Counties More Likely to be Obese than Adults Living in Urban Counties

What is CDC Doing to Help?

People living in nonmetropolitan counties are less likely to meet physical activity recommendations or have access to healthier food retailers.

Learn how CDC is working with states and communities to improve nutrition and physical activity and reduce obesity.

Adults living in non-metropolitan (rural) counties are still more likely to be obese than adults in metro (urban) counties, according to a recent MMWR article.

CDC researchers analyzed data from the 2016 Behavioral Risk Factor Surveillance Survey. 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.

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.
Adult Obesity Prevalence, 2016 
Adult Obesity Prevalence, 2016
Metropolitan Counties Nonmetropolitan Counties
28.7% 34.2%

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.

There are many obesity-prevention strategies that can be used in rural areas:

Nutrition Strategies

  • Strengthen networks between food producers, distributors, and retail food outlets.
  • Reduce the distance customers need to travel to farmers’ markets.
  • Work with schools and worksites to develop nutrition-related policies.

Physical Activity Strategies

  • Improve community access to public buildings (e.g., school facilities) after hours for physical activity purposes.
  • Include bicycle paths, paved sidewalks, and outdoor public recreation facilities in community planning.
  • Enhance physical education in schools.
  • Implement worksite policies to promote physical activity.

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. Grantees use proven public health strategies in targeted areas to help people improve physical activity and nutrition, reduce obesity, and prevent or control diabetes, heart disease, and stroke.

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