KANSAS CITY, Kan. — Those living in rural America are more likely to be obese than city dwellers, according to a new study led by researchers at the University of Kansas.

The study — published in the Journal of Rural Health's fall issue — is the first in more than 30 years to draw on measured heights and weights rather than on self-reported measurements, which tend to underestimate the prevalence of obesity.

KU researcher Christie Befort led the study and said two main reasons may lead to rural residents being more likely to be overweight: cultural diet and physical isolation.

"There is a definite cultural diet in rural America, full of rich, homemade foods including lots of meat and dessert," said Befort. The study, which also examined demographic and lifestyle factors, found that rural Americans typically consume a diet higher in fat.

Rural residents also face challenges to accessing health care, prevention and lifestyle activities.

"Access is often about travel time in a rural area, but it can also be that there's no place to go — literal physical isolation," said Befort. "It's tough to get to a gym if you live outside of a town without one."

The research demonstrated that the rural-urban obesity disparity existed in younger Americans, ages 20 to 39, but not in older age groups. This can be partially attributed to increased mechanization of previously labor-intensive jobs, said Befort.

"Physical activity is now needed to compensate for diet and technology," she said. "That requires cultural change because rural areas typically don't have a culture of physical activity as leisure time."

The study examined several factors which are thought to affect obesity, including diet, physical activity, age, race, gender and education. The researchers found that even when other contributing factors are held constant, rural residents were more likely to be obese.

"Living in a rural area isn't always recognized as a category for obesity-related health disparities but — according to our study — it should be," said Befort.

Alan Morgan, chief executive of the National Rural Health Association, said the link between poverty and obesity is having a disproportionate impact on rural America.

"If we truly want to decrease health care costs and improve the nation's health status, we are going to have to start viewing obesity as a top-tier public health concern for rural Americans," Morgan said.

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