Lundeen · MMWR. Morbidity and mortality weekly report 2018 · cross-sectional surveillance study · n=?

Obesity Prevalence Among Adults Living in Metropolitan and Nonmetropolitan Counties - United States, 2016.

Cited 165 times in the scientific literature.

Level 4 - case-series / case-control

Cross-sectional observational surveillance study (BRFSS)

PubMed 29902166 · doi:10.15585/mmwr.mm6723a1 · record verified 2026-08-29

What was done

The CDC analyzed state-level data from the 2016 Behavioral Risk Factor Surveillance System (BRFSS) to evaluate adult obesity prevalence (body mass index ≥30 kg/m²) across metropolitan and nonmetropolitan counties in the United States, broken down by Census regions and individual states.

What was found

Adult obesity prevalence was significantly higher in nonmetropolitan counties (34.2%) than in metropolitan counties (28.7%, p < 0.001). Nonmetropolitan prevalence was significantly higher across all US Census regions, with the largest absolute gaps in the South (5.6 percentage points) and Northeast (5.4 percentage points). Across 47 states analyzed, nonmetropolitan obesity prevalence was significantly higher in 24 states, while only Wyoming showed higher prevalence in metropolitan counties.

Why it matters

This study provides state- and regional-level resolution demonstrating that obesity is consistently more prevalent among rural and nonmetropolitan US adults. These findings identify key geographic disparities to inform targeted policy and community-level interventions.

Limits

The abstract does not report the total participant sample size, provides data for only 47 states, uses a cross-sectional design that cannot determine causation, and does not control for individual-level socioeconomic or behavioral confounders.

Cited by