Abstract
BackgroundObesity is a critical public health issue, affecting over one-third of all Americans, and is an underlying cause of numerous health issues across the lifespan. For older adults, obesity is linked to premature declines in physical and mental health and cognitive functioning. The occurrence of obesity and related health behaviors and chronic diseases are higher in rural areas than in urban areas. Furthermore, rural areas of the United States have a higher proportion of older adults than urban areas. Few studies, to date, have explored rural-urban differences in the relationships between dietary patterns and obesity among older adults. Therefore, the purpose of this study is to assess rural-urban differences in obesity rates in older adults, and the potential for the associations between obesity and physical activity and dietary patterns to vary by rural-urban status.MethodsData were abstracted from respondents aged 65 and above from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) database linked to Census-based county-level information on rural-urban status and socioeconomic status. Generalized linear models were utilized to assess rural-urban disparities in obesity, and the potential for associations between obesity and known risk factors (fruit consumption, green vegetable consumption and physical activity) to vary by rural-urban status, accounting for complex sampling and confounders.ResultsObesity rates were highest and fruit consumption was lowest in the most rural areas. However, for older adults in the most urban areas, there was a significant negative association between obesity and fruit and green vegetable consumption. This association was not observed in more rural older adults.ConclusionThese findings underscore the need to take into account place-based factors such as rural-urban status, when designing and implementing policies and interventions designed to reduce obesity through risk factor mitigation in older adults. To reduce rural-urban disparities in older adults, all policies, programs, and interventions should address the unique barriers and needs specific to rural and urban older adults.
Highlights
OPEN ACCESSCitation: Cohen SA, Greaney ML, Sabik NJ (2018) Assessment of dietary patterns, physical activity and obesity from a national survey: Rural-urban health disparities in older adults
Study findings suggest that there are important associations between rural-urban status and obesity and obesity-related factors for older adults. Results of this current study largely support results of previous research that show that for adults of all ages, obesity rates are higher in rural areas than in urban areas [35,36,37,38,39], while low fruit and vegetable consumption and rates of physical activity are lower in rural areas compared to urban areas [45]
Actual availability of grocery stores in close proximity and lack of access to transportation to grocery stores [47] may limit the availability of fruits and vegetables and other healthful foods for older adults in rural areas as they may depend on smaller convenience stores than residents in cities [48]
Summary
Obesity is a critical public health issue, affecting over one-third of all Americans, and is an underlying cause of numerous health issues across the lifespan. Obesity is linked to premature declines in physical and mental health and cognitive functioning. The occurrence of obesity and related health behaviors and chronic diseases are higher in rural areas than in urban areas. Rural areas of the United States have a higher proportion of older adults than urban areas. To date, have explored rural-urban differences in the relationships between dietary patterns and obesity among older adults. The purpose of this study is to assess rural-urban differences in obesity rates in older adults, and the potential for the associations between obesity and physical activity and dietary patterns to vary by rural-urban status
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