People who live in rural areas of the United States are far more likely than city dwellers to smoke, be overweight, and face a host of related health concerns, researchers said Tuesday.
Many chronic diseases are linked to obesity, including type 2 diabetes, heart disease, some cancers and arthritis, and researchers say understanding local trends can help them design better intervention strategies.
The study in the Journal of the American Medical Association relied on survey data about nearly 7,000 children and almost 11,000 adults in the United States.
It found that among children and adolescents, "rates of severe obesity were higher in rural areas than large urban areas."
Severe obesity is defined as a body mass index of 40 or above.
"Rates of obesity showed similar patterns, but weren't statistically significant," added the report.
Among youths, obesity was more likely among those whose parents had less education, and more common among African-Americans and Hispanics than whites.
When it came to adults, severe obesity was "higher in rural areas than large urban areas, and rates for obesity (defined as BMI at or above 30) showed similar patterns," said the report.
A separate report last week by the US Centers for Disease Control and Prevention found obesity prevalence was "significantly higher" among adults in rural counties (34.2 percent) compared to those in metropolitan counties (28.7 percent).
About 46 million people, or 14 percent of the US population, live outside metropolitan areas.
Smoking is down to its lowest point in America—with just 13.9 percent of the population identifying as cigarette smokers—but is still twice as common in rural areas than cities, said the CDC.
Just 11 percent of adults in a metro area of one million people or more smoke, compared to nearly 22 percent in rural areas.
People living outside city centers also "had the highest rates of being obese, having experienced serious psychological distress during the past 30 days, or having diagnosed diabetes," said the federal health agency.
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