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Obesity and Weight Control Frequently Asked Questions


How do rural areas compare to urban areas regarding obesity rates?

Rural residents experience higher rates of obesity and overweight than people living in urban areas. Rural demographics may play some role in this difference. Rural residents tend to be older, less educated and have lower income than urban residents and all of these factors are related to higher obesity levels.

In addition, expertise in obesity prevention and treatment may be limited in rural communities and access to such services may require long travel distances in areas where public transportation is not available.

Source: 2005 Report to the Secretary: Rural Health and Human Service Issues


Are rural children at greater risk of obesity and overweight?

According to the 2010 publication Diet, Physical Activity, and Sedentary Behaviors as Risk Factors for Childhood Obesity: An Urban and Rural Comparison (Fact Sheet):

  • Prevalence of overweight and obesity is higher among rural children than urban children.
  • Nearly a third (30%) of US children were overweight and 15.9% obese. Rural children were more likely to be overweight or obese.
  • Overweight and obesity were more common among minority children. Rural black children had the highest prevalence of overweight and obesity.

Diet and physical activity do not fully explain rural disparities:

  • Among young children, obesity and overweight remained more prevalent in rural children even when differences in diet and exercise were taken into consideration.
  • Among adolescents, rural disparities were no longer present after differences in diet and physical activity were held statistically equal. Specifically, low consumption of dietary fiber and high screen time (more than 2 hours of TV or computer time) were more common in rural adolescents and contributed strongly to obesity.

What are some factors contributing to rural obesity?

Unhealthy diet is one culprit in the rural obesity problem. Rural residents in some areas eat a higher fat and calorie diet that the average American. People in rural areas are often faced with limited selection and higher cost for fresh fruit and vegetables than consumers in more urban areas. Due to distance and limited transportation options, shopping for healthy food can prove difficult for those living in areas not served by a major grocery chain. People in rural areas may also lack nutrition information that would help them to choose a healthier diet. Nutritionists tend to be less available in rural areas, and fewer school and community nutrition education opportunities exist, compared with what may be available in larger communities.

A lack of exercise also contributes to rural obesity. The popular image of active rural lifestyle is no longer accurate. Rural residents tend to be less physically active than urban residents. Some possible causes include less access to exercise facilities and fewer school physical education classes. Rural areas may also face challenges in terms of the "built environment," which consists of buildings, sidewalks, parks and other physical aspects of a community. People who live in rural areas without sidewalks and public transport may find exercise as a part of daily activity and outdoor exercise to go places much more difficult.

Source: 2005 Report to the Secretary: Rural Health and Human Service Issues


How does obesity impact health?

According to A Healthier America 2013, the obesity-related health care costs in 2012 was $147 billion for the nation and the health care costs will continue to rise.

Obesity increases the risk of serious diseases such as diabetes, heart disease, stroke, and some types of cancer. Overweight and obesity are associated with high cholesterol, pregnancy complications, and other negative health consequences. The higher rate of rural obesity may be a driving force behind the higher rural rates of chronic diseases that have been found in some studies.


What can rural health care providers do to address obesity and overweight?

Rural clinics and hospitals can offer classes that encourage healthy diet and exercise, such as sessions on nutrition, how to prevent heart disease, controlling diabetes, and similar topics. Hospitals that have exercise equipment for rehabilitation may want to make their workout areas available to the entire community.

Primary health care providers can be a good resource for providing information on healthy diet and physical activity to their patients. Because rural areas often have limited access to nutritionists or dietitians, health care providers may benefit from additional training in nutrition. Primary care providers can also benefit from more training in behavioral and preventive sciences concepts and strategies to increase their skills and confidence in motivating patients to change unhealthy behaviors.


How can local public health agencies help prevent obesity?

Local public health agencies are most suited to developing community partnerships with schools, health care providers and community groups to ensure that exercise and healthy eating classes are being offered, schools and restaurants are offering low-fat and healthy choices, and to ensure the development of walking trails and bike paths for the entire community.

Many local public health agencies have also become involved through policy development. The National Association of County and City Health Officials provides examples of some of these activities.


What role can schools play in encouraging healthy weight?

Schools can support healthy eating habits in children by offering nutritious, low-fat snacks and lunches and by teaching proper nutrition. Physical education programs are also important to ensure that children develop an active lifestyle.

The most effective school programs are comprehensive ones that address food service, physical education, classroom education in the importance of healthy lifestyles and health decision making, and include community/parent involvement. The CATCH Program (Coordinated Approach to Child Health) is an example of a comprehensive obesity prevention program. For more information about coordinated school health programs, see Making Health Academic.

School and community-based gardens are another good approach to encourage healthy eating. Students can benefit from growing their own fruits and vegetables and then consuming them in school and community-supported lunch programs.


What can rural communities do to help reduce obesity?

The Community Guide provides some examples of successful obesity prevention activities in community settings. Walking clubs, support groups for weight management, healthy cooking and exercise classes are a few possibilities for supporting healthy weight throughout the community.

Rural communities may want to develop a wellness center, bike trails, or walking paths to encourage healthy lifestyles. Facilities may already exist in some rural communities that could become community resources. For example, a local college might open its pool to community swimming and exercise classes or a school gymnasium might be open after-hours for community use.

The Rural Obesity Prevention Toolkit helps communities assess factors contributing to obesity, identify community stakeholders, and learn about successful program models and evidence-based community interventions.

Last Reviewed: 7/10/2013

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Funding for this project was supported by Grant Number U56RH05539 from the Office of Rural Health Policy, Health Resources and Services Administration, U.S. Department of Health and Human Services. The contents of this website are solely the responsibility of the authors and do not necessarily represent the official views of the funder.