In this study, we aimed to analyze the demographic factors, socioeconomic factors, health behavior factors, and health education of urban and rural adolescents and their impact on obesity in rural and urban youths. We analyzed data from 60,040 students from 800 schools using the 14th Youth Health Behavior Web-based Survey data for 2018. The mean age of the participants was 15.01 ± 1.77; 30,463 (50.7%) males and 29,577 (49.3%) females. The data were analyzed using a chi-square test and multinominal logistic regression analysis. Rural adolescents had significantly lower parental income, parental education, and academic performance levels. Urban adolescents tended to have a higher rate of breakfast fasting, ate more fast-food, exercised less, had a higher rate of sleep dissatisfaction, and had significantly higher current alcohol intake. Rural adolescents reported more stress and obesity levels than their urban counterparts. Factors influencing the obesity of urban adolescents were grade level, father's education, mother's education, academic performance level, fast-food, exercise, current alcohol intake, and sleep satisfaction. Factors influencing the obesity of rural adolescents were parents' income level, academic performance level, exercise, and sleep satisfaction. To effectively prevent and manage adolescent obesity, which is an indicator of health equity among adolescents, an effort must be made to improve health education and the local environment in both urban and rural areas.
Keywords: adolescent; health equity; obesity; rural health; urban health.