Urban-rural disparities in childhood obesogenic environments in the United States: Application of differing rural definitions

Marilyn E Wende; M Renée Umstattd Meyer; Christiaan G Abildso; Kara Davis; Andrew T Kaczynski

doi:10.1111/jrh.12677

Urban-rural disparities in childhood obesogenic environments in the United States: Application of differing rural definitions

J Rural Health. 2023 Jan;39(1):121-135. doi: 10.1111/jrh.12677. Epub 2022 May 30.

Authors

Marilyn E Wende¹, M Renée Umstattd Meyer¹, Christiaan G Abildso², Kara Davis³, Andrew T Kaczynski^{3

4}

Affiliations

¹ Deparment of Public Health, Robbins School of Health and Human Sciences, Baylor University, Waco, Texas, USA.
² Department of Social and Behavioral Health Sciences, School of Public Health, West Virginia University, Morgantown, West Virginia, USA.
³ Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
⁴ Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.

Abstract

Background: Research is needed that identifies environmental resource disparities and applies multiple rural definitions. Therefore, this study aims to examine urban-rural differences in food and physical activity (PA) environment resource availability by applying several commonly used rural definitions. We also examine differences in resource availability within urban-rural categories that are typically aggregated.

Methods: Six food environment variables (access to grocery/superstores, farmers' markets, fast food, full-service restaurants, convenience stores, and breastfeeding-friendly facilities) and 4 PA environment variables (access to exercise opportunities and schools, walkability, and violent crimes) were included in the childhood obesogenic environment index (COEI). Total COEI, PA environment, and food environment index scores were generated by calculating the average percentile for related variables. US Department of Agriculture Urban Influence Codes, Office of Management and Budget codes, Rural-Urban Continuum Codes, Census Bureau Population Estimates for percent rural, and Rural Urban Commuting Area Codes were used. One-way ANOVA was used to detect urban-rural differences.

Results: The greatest urban-rural disparities in COEI (F=310.2, P<.0001) and PA environment (F=562.5, P<.0001) were seen using RUCC codes. For food environments, the greatest urban-rural disparities were seen using Census Bureau percent rural categories (food: F=24.9, P<.0001). Comparing remote rural categories, differences were seen for food environments (F=3.1, P=.0270) and PA environments (F=10.2, P<.0001). Comparing metro-adjacent rural categories, differences were seen for PA environment (F=4.7, P=.0090).

Conclusion: Findings inform future research on urban and rural environments by outlining major differences between urban-rural classifications in identifying disparities in access to health-promoting resources.

Keywords: childhood obesity; environment; measurement; rural; urban.

Publication types

Research Support, U.S. Gov't, P.H.S.

MeSH terms

Censuses
Environment
Exercise*
Humans
Rural Population*
Social Environment
United States
Urban Population