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Journal of the American College of Nutrition, Vol. 26, No. 5, 424-433 (2007)
Published by the American College of Nutrition

Ecologic Correlates of Obesity in Rural Obese Adults

Rebecca E. Lee, PhD, K. Allen Greiner, MD, MPH, Sandra Hall, PhD, Wendi Born, PhD, Kim S. Kimminau, PhD, Andrew Allison, PhD and Jasjit S. Ahluwalia, MD, MPH, MS

Department of Health and Human Performance, University of Houston, Houston, Texas (R.E.L.)
Departments of Family Medicine and Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas (K.A.G.)
Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, Kansas (S.H.)
Department of Psychology, Baker University, Baldwin City, Kansas (W.B.)
Department of Family Medicine, University of Kansas Medical Center, Kansas City, Kansas (K.S.K.)
Kansas Health Policy Authority, Topeka, Kansas (A.A.)
Office of Clinical Research, University of Minnesota Academic Health Center, Minneapolis, Minnesota (J.S.A.)

Address reprint requests to: Rebecca E. Lee, Ph.D., Department of Health and Human Performance, University of Houston, Giarrison Gymnasium 104 E, 3855 Holman Rd., Houston, TX 77004. E-mail: releephd{at}yahoo.com

Objective: We examined relationships of individual and environmental factors with obesity and trying to lose weight in rural residents.

Methods: The joint contributions of individual and environmental factors on obesity status (obese vs. morbidly obese) and trying to lose weight (yes vs. no) were evaluated using generalized estimating equations. Patients at 29 clinics in rural areas (N = 414, M age 55.0 years (SD = 15.4), 66.3% female) completed anthropometric assessments of weight and height along with survey assessments of individual sociodemographics and trying to lose weight. Rural environments were assessed on aggregated physician access, and sociodemographic context.

Results: Most participants (70%, M BMI = 38.3) were obese and 30% morbidly obese. A majority (73%, n = 302) of the sample was trying to lose weight. Compared to obese, morbidly obese participants were more likely to be younger, disproportionately female, not have private insurance, have more comorbid conditions, and rate themselves in worse health in comparison to their obese peers. Compared to not trying to lose weight, trying to lose weight participants were more likely to be younger, disproportionately female, have fewer comorbid conditions, and have attempted to lose weight more times through exercise. Few relationships were seen between environmental variables and obesity or trying to lose weight.

Conclusions: There was no consistent pattern of relationships between environment factors and obesity or trying to lose weight was seen. Unique aspects of rural living may not be captured by traditionally available neighborhood measures.

Key words: rural health, obesity, environment, diet therapy, physical activity






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Copyright © 2007 by the American College of Nutrition.