Is Rural Residency a Risk Factor for Overweight and Obesity for U.S. Children?

Abstract

Objective: Despite studies suggesting that there is a higher prevalence of overweight or obese children in rural areas in the U.S., there are no national studies comparing the prevalence levels of overweight or obese rural to metropolitan children. The objective of this research was to examine the hypothesis that living in a rural area is a risk factor for children being overweight or obese. Research Methods and Procedures:Using the National Survey of Children's Heath, the prevalence of overweight and/or obese rural children was compared with that of children in metropolitan settings. Multivariate analyses were performed on the data to detect if differences varied by health services use factors or demographic factors, such as household income, gender, and race. Results: Multivariate analysis revealed that overweight or obese children Ն5 years of age were more likely to live in rural rather than metropolitan areas (odds ratio ϭ 1.252; 95% confidence interval, 1.248, 1.256). Rural overweight U.S. children Ն5 years of age of age were more likely than their metropolitan counterparts to: be white, live in households Յ200% of the federal poverty level, have no health insurance, have not received preventive health care in the past 12 months, be female, use a computer for non-school work Ͼ3 hours a day, and watch television for Ͼ3 hours a day. In addition, they were more likely to have comorbidities. Discussion: Living in rural areas is a risk factor for children being overweight or obese.

Continued development of the Rural Active Living Perceived Environmental Support Scale (RALPESS): preliminary evidence for validity among American Indians

“…Some researchers suggest that merely living in a certain geographic location is not, in itself, a risk factor, but factors that differ between urban/rural residence contribute to the observed differences in CVD risk factors 14 . Others argue that there remains a strong link between rurality and obesity that cannot be explained by demographic factors alone 15 …”

Preliminary assessment of a school-based healthy lifestyle program among rural children.

“…Subjects in this study were recruited from a rural district, and about 69% of the children were eligible for free lunch or reduced-price lunch (National Center for Educational Statistics, 2012). In addition, evidence has supported that rural residency is a risk factor for children being overweight or obese and participating in unhealthy behaviors -sedentary activity and sugar/fat consumption (Liu et al, 2008;Lutfiyya et al, 2007). The low percentages of rural children meeting physical activity and nutrition recommendations suggest that further healthy lifestyle programs need to tailor rural children for improving healthy behaviors and finally preventing or controlling childhood obesity.…”

“…Only 22% of overweighed or obese rural children live in a household with annual family income >200% of the federal poverty level compared to 32% of metropolitan children (Lutfiyya, Lipsky, Wisdom-Behounek, & Inpanbutr-Martinkus, 2007). Evidence supports that overweight or obese school age children are more likely to live in a rural area rather than a metropolitan area (Liu et al, 2008;Lutfiyya et al, 2007). Consistently, rural children are more likely to be overweight or obese compared to urban children after controlling the socio-demographic characteristics, health and obesity-related behavioral factors.…”

“…Compared to urban children, the majority of rural children is white, poor, and has less-educated parents. Only 22% of overweighed or obese rural children live in a household with annual family income >200% of the federal poverty level compared to 32% of metropolitan children (Lutfiyya, Lipsky, Wisdom-Behounek, & Inpanbutr-Martinkus, 2007). Evidence supports that overweight or obese school age children are more likely to live in a rural area rather than a metropolitan area (Liu et al, 2008;Lutfiyya et al, 2007).…”

“…Overweight or obese rural children are reported to watch TV for more than 3 hours a day and use a computer for non-school work more often than overweight or obese urban children. Moreover, about 41% of rural children do not participate in any after school activities (Lutfiyya et al, 2007). The difference in prevalence of overweight and obesity might be attributed to the higher prevalence of unhealthy behaviors among rural children.…”