Urban vs Rural: Varying US Obesity Rates Across Regions

Understanding US Adult Obesity Rates Across Different Regions

The prevalence of adult obesity differs significantly across various geographic regions and rural/urban areas in the United States, indicating that exposure to obesity-related diseases can vary location-wise. The National Institutes of Health suggests that obesity in adults can lead to the development of heart disease, type II diabetes, certain types of cancer, and other long-term health conditions. These diseases not only reduce the quality of life and life expectancy but also increase medical costs and reduce productivity, negatively impacting economic growth potential for communities.

Trends in US Adult Obesity Rates

In the years preceding the COVID-19 pandemic, US adult obesity rates showed a general upward trend, with an average year-on-year increase of 0.6 percentage points from 2011 to 2019, as per findings of Economic Research Service (ERS) researchers at USDA. By 2024, though, the national trend had reversed, with the average adult obesity rate dropping to 43.1 percent, down by 0.2 percentage points from the preceding year. However, a closer look at obesity trends by location revealed that adults in rural areas consistently had higher obesity rates than those in urban areas from 2016 through 2024, despite the overall decline in urban and US adult obesity rates.

Divergence in Rural and Urban Obesity Rates

According to the CDC, an adult with a body mass index (BMI) of 30 or higher is classified as obese. The COVID-19 pandemic saw changes in obesity rates among urban, rural, and overall populations. Before the pandemic struck, rural obesity rates were growing faster than urban rates. In the first year of the pandemic, the obesity rate among rural adults increased by 0.4 percentage points whereas the urban obesity rate rose about 3.5 times faster. As of March 2024, the urban adult obesity rate had declined to 42.1 percent while rural obesity rate rose to 48.3 percent. Due to the majority (over 80 percent) of the US adult population living in urban areas, as per the 2020 Census, the overall adult obesity rate often mirrors the urban rate more closely than the rural rate.

Rural-urban Disparities in Healthcare and Wellness Infrastructure

Rural communities often face more challenges in maintaining a healthy weight due to variations in healthcare, food retail, and physical wellness infrastructure. Rural adults are less likely to have access to healthcare professionals and facilities. The availability of affordable healthy foods can differ across urban and rural communities due to variations in the distances between homes and grocery stores. Rural residents, particularly those with low income, have less frequent access to grocery stores than their urban counterparts. Furthermore, physical wellness activities may be limited in some rural communities due to the lack of fitness infrastructure. Such inconsistent access to healthcare, healthy food, and physical wellness spaces may compound the challenges rural adults face in maintaining a healthy weight.

Variations in Obesity Prevalence Across US Regions

ERS researchers also studied the shifts in obesity rates across the four US Census regions, namely the West, Midwest, South, and Northeast. At the onset of the COVID-19 pandemic, the West had the lowest adult obesity rate (36.0 percent), while the South had the highest (42.5 percent). The West saw the greatest increase in adult obesity rates during the first year of the pandemic, with a 2.8-percentage-point increase. In contrast, the Northeast witnessed a decrease in adult obesity rates during the same period. By March 2024, obesity rates had fallen in all regions except the Midwest.

Geographical Differences in National Obesity Trends

After decades of steady increase, the changes in US adult obesity rates have become less predictable in recent years. These trends also display geographical variations, the reasons for which are not well understood. Responses to unexpected societal shocks like the COVID-19 pandemic can vary by location. Factors such as access to healthcare, grocery stores, and fitness facilities may differ for adults residing in rural versus urban areas, or in different regions of the country. These differences could be potential areas for future research. The shifts in US adult obesity rates may continue to vary across geographical areas, potentially leading to greater disparities in disease and healthcare needs between the areas.