Study: Adults in Rural Areas More Likely to Be Obese Than Urban Areas


A recent study concluded that adults living in rural counties in the United States are still more likely to be obese than those residing in urban counties, as they were 4 years ago.

Adults living in rural counties in the United States are still more likely to be obese than those residing in urban counties, according to a recent CDC report, as they were 4 years ago. Based on 2016 Behavioral Risk Factor Surveillance Survey (BRFSS) data, the findings are consistent with results published in 2012, using data from the 2005-2008 National Health and Nutrition Examination Survey (NHANES) data.

The recent data analysis, published in the CDC’sMorbidity and Mortality Weekly Report, compared obesity based on self-reported weight and height among adults living in the United States in 2016, and identified states, census regions, and divisions, and noted the greatest difference in prevalence occurred between the South and Northeast regions. The report researchers concluded that, in 2016, obesity prevalence was 34.2% among adults living in rural counties, compared to 28.7% of adults in metropolitan areas. Overall, obesity prevalence was 29.6% among adults in the United States.

According to the report, obesity prevalence was highest among individuals residing in the South (32.0%) and Midwest (31.4%) regions, and the East South Central (35.3%) and West South Central (33.9%) divisions. Among adults living in nonmetropolitan counties, obesity prevalence ranged from 20.8% in Colorado to 39.1% in Louisiana. Among those living in urban counties, prevalence ranged from 22.5% in Colorado to 36.9% in West Virginia.

In 24 of the 47 states with both metropolitan and nonmetropolitan counties, obesity prevalence was significantly higher among adults living in rural counties than among those living in metropolitan counties. In 22 states, no difference was observed. Wyoming was the only state where obesity prevalence was significantly higher among metropolitan county residents (32.8%) than among rural residents (25.4%).

In most sociodemographic categories identified in the report, including age, sex, race/ethnicity, and household income, the obesity prevalence findings of rural and urban locations held true. The exception was Hispanic individuals with less than a high school education, who presented as the only sociodemographic group with a higher obesity prevalence in urban areas than in nonmetropolitan counties.

According to the CDC, residents in communities with higher prevalence of obesity in adults may have less access to healthy foods, and fewer opportunities for physical activity. However, there are a number of strategies that can be deployed in these mostly rural regions to help prevent obesity. They include working with schools, job sites, and the local Cooperative Extension Service to increase access to healthy foods. In addition, CDC researchers suggest that all communities can support obesity prevention by opening public buildings after hours to provide space for physical activities, and to build or maintain bicycle paths, sidewalks, and outdoor recreation facilities.

The CDC is also helping to address obesity through its High Obesity Program (HOP), which funds land grants to colleges and universities in state with counties that have more than 40% prevalence of adult obesity. According to the agency, those receiving grants work with a county cooperative extension, and local outreach services. They also utilize proven public health strategies to help people improve their physical activity and nutrition, reduce obesity, and prevent or control diabetes, heart disease, and stroke.


  1. CDC: More obesity in US rural counties than in urban counties [news release]. Atlanta, GA: CDC; June 14, 2018. Accessed June 19, 2018.
  2. CDC. Obesity Prevalence Among Adults Living in Metropolitan and Nonmetropolitan Counties — United States, 2016. CDC website. Published June 14, 2018. Accessed June 19, 2018.
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