The Influence of Socioeconomic and Environmental Factors on Health and Obesity in Rural Appalachia (original) (raw)
Related papers
International Journal of Environmental Research and Public Health, 2009
A recursive system of ordered self assessed health (SAH) and a binary indicator of obesity were used to investigate the impact of socioeconomic and environmental factors on health and obesity in the predominantly rural Appalachian state of West Virginia. Behavioral Risk Factor Surveillance System (BRFSS) data together with county specific socioeconomic and built environment indicators were used in estimation. Results indicate that an individual's risk of being obese increases at a decreasing rate with per capita income and age. Marginal impacts show that as the level of education attainment increases, the probability of being obese decreases by 3%. Physical inactivity increases the risk of being obese by 9%, while smoking reduces the risk of being obese by 14%. Fruit and vegetable consumption lowers the probability of being obese by 2%, while each hour increase in commuting time raises the probability of being obese by 2.4%. In addition, individuals living in economically distressed counties are less likely to have good health. Intervention measures which stimulate human capital development and better land use planning are essential policy elements to improving health and reducing the incidence of obesity in rural Appalachia.
An Analysis of Adult Obesity and Hypertension in Appalachia
Global Journal of Health Science, 2013
Obesity is a major health problem in the United States, and the burden associated is high. Hypertension seems to be the most common obesity-related health problem. Studies show that hypertension is approximately twice as prevalent among the obese as in the non-obese population. This study has two main objectives. First, to examine the association between obesity and hypertension within the context of economic growth in Appalachia, and second to estimate the cost of hypertension linked to obesity in Appalachia. The study uses simultaneous equations and Logit analysis for estimations. Data are from Behavior Risk Factor Surveillance Systems (BRFSS) surveys of 2001 and 2009. Results for simultaneous analysis show that hypertension decreases with decreasing obesity, increasing employment growth, and increasing income. Logit analysis highlights the importance of controlling obesity, income growth, employment growth, education, and exercises in mitigating hypertension in Appalachia. Ageing indicates a high potential of getting hypertension. Total economic cost of hypertension linked to obesity is $9.35 billion, significantly a high cost to Appalachia. Overall, results reveal the impacts of obesity on hypertension and some possible ways of mitigation. Thus, results suggest a comprehensive set of policies to Appalachia which sufficiently improve employment opportunities, educational facilities, and healthcare facilities with adequately addressed to obesity and hypertension.
A National Study of Obesity Prevalence and Trends by Type of Rural County
The Journal of Rural Health, 2005
Context: Obesity is epidemic in the United States, but information on this trend by type of rural locale is limited. Purpose: To estimate the prevalence of and recent trends in obesity among US adults residing in rural locations. Methods: Analysis of data from the Behavioral Risk Factor Surveillance System (BRFSS) for the years 1994-1996 (n ¼ 342,055) and 2000-2001 (n ¼ 385,384). The main outcome measure was obesity (body mass index [BMI] 30), as determined by calculating BMI from respondents' self-reported height and weight. Results: In 2000-2001, the prevalence of obesity was 23.0% (95% confidence interval [CI] 22.6%-23.4%) for rural adults and 20.5% (95% CI 20.2%-20.7%) for their urban counterparts, representing increases of 4.8% (95% CI 4.2%-5.3%) and 5.5% (95% CI 5.1%-5.9%), respectively, since 1994-1996. The highest obesity prevalence occurred in rural counties in Louisiana, Mississippi, and Texas; obesity prevalence increased for rural residents in all states but Florida over the study period. African Americans had the highest obesity prevalence of any group, up to 31.4% (95% CI 29.1%-33.6) in rural counties adjacent to urban counties. The largest difference in obesity prevalence between those with a college education compared with those without a high school diploma occurred in urban areas (18.4% [95% CI 17.9%-18.9%] vs 23.5% [95% CI 22.5%-24.5%], respectively); the smallest difference occurred in small, remote rural counties (20.3% [95% CI 18.7%-21.9%] versus 22.3% [95% CI 20.7%-24.0%], respectively). Conclusions: The prevalence of obesity is higher in rural counties than in urban counties; obesity affects some residents of rural counties disproportionately.
Obesity and obesity-related behaviors among rural and urban adults in the USA
Rural and Remote Health, 2015
Introduction: Previous studies have reported a higher prevalence of obesity among rural Americans. However, it is not clear whether obesity-related behaviors can explain the higher level of obesity among rural adults. The purpose of this study was to examine the differences in obesity-related behaviors across rural-urban adult populations in the USA. Methods: Data were obtained from the 1999-2006 National Health and Nutrition Examination Survey, restricted to 14 039 participants aged 20 years or more. Body mass index (BMI) was calculated using measured height and weight, and individuals with BMI≥30 kg/m 2 were categorized as obese. Physical activity recommendations were used to define participants' physical activity levels: no leisure-time physical activity, less than, meeting, and exceeding the recommended levels. Sedentary behaviors were measured by hours sitting and watching TV or videos or using a computer (outside of work). Dietary intake was assessed by one-day 24 hour dietary recall. Residence was measured at the census tract level using the Rural-Urban Commuting Area Codes. Multiple logistic regression models were used to examine urban-rural differences after adjusting for sociodemographic, health, dietary, and lifestyle factors. Results: The prevalence of obesity was higher in rural than in urban residents (35.6% vs 30.4%, p<0.01), among both men (37.7% vs. 32.5%, p<0.01) and women (33.4% vs 28.2%, p<0.01). Compared to urban adults, more rural adults reported no leisure-time physical activity (38.8% vs 31.8%, p<0.01) and fewer rural adults met or exceeded physical activity recommendations (41.5% vs 47.2%, p<0.01). Rural adults had lower intake of fiber and fruits and higher intake of sweetened beverages. After adjusting for sociodemographic, health, diet, sedentary behaviors, and physical activity, the odds of being obese among rural adults were 1.19 times higher than that among urban adults (95% confidence interval: 1.06, 1.34).
Economics of adult obesity and diabetes in Appalachia
Health, 2013
Obesity and diabetes are major health problems in the United States. The primary aim of this study is to examine the association between obesity and diabetes and to estimate the cost of diabetes linked to obesity in the Appalachian region. A system of simultaneous equations approach, and a logit estimation are employed for the analyses. Behavioral Risk Factor Surveillance System (BRFSS) surveys for 2001 and 2009 are the main sources of data. Both county-level and individual-level data are used for the analyses. The simultaneous approach at county-level based on the changes of income, employment, obesity, and diabetes reveals that obesity increases diabetes, but diabetes does not have an effect on obesity. The counties with high initial levels of obesity had less obesity growth but more diabetes growth. Increasing income impacts negatively on diabetes growth. Logit analysis indicates that obesity significantly increases the risk of diabetes of adults' in Appalachia. Besides, being employed, higher income, as well as engaging in exercise reduce the prevalence of diabetes, while age increases diabetes. The economic cost of obesity-related diabetes is $1.9 billion, and can be reduced through mitigating obesity.
The Burden of Obesity in the Rural Adult Population of America
Cureus, 2021
There is an epidemic of obesity in adults in rural America. It is estimated that about 19% of the population resides in rural areas, which encompasses 97% of America's total landmass. Although rural America makes up a fraction of America's total population, it has been estimated that the prevalence of obesity is approximately 6.2 times higher than in urban America. This illustrates an apparent disparity that exists between the rural population and urban populations that needs to be examined. The prevalence of obesity, especially in rural America, is a growing concern in the medical community in recent years. Obesity has been identified as a significant risk factor for cardiovascular disease, cancer, and type 2 diabetes mellitus, which are leading causes of morbidity and mortality in the US. To better understand the disparity in the prevalence of adult obesity between rural and urban America, researchers have identified risk factors that are associated with the high incidence...
Advances in Preventive Medicine, 2014
Most Western chronic diseases are closely tied to lifestyle behaviors, and many are preventable. Despite the well-distributed knowledge of these detrimental behaviors, effective efforts in disease prevention have been lacking. Many of these chronic diseases are related to obesity and type 2 diabetes, which have doubled in incidence during the last 35 years. The Complete Health Improvement Program (CHIP) is a community-based, comprehensive lifestyle modification approach to health that has shown success in addressing this problem. This pilot study demonstrates the effectiveness of CHIP in an underserved, rural, and vulnerable Appalachian population. Two hundred fourteen participants in CHIP collectively demonstrated significant reductions in body mass index, systolic and diastolic blood pressure, and fasting blood levels of total cholesterol, low-density lipoprotein, and glucose. If these results can be repeated in other at-risk populations, CHIP has the potential to help reduce the burden of preventable and treatable chronic diseases efficiently and cost-effectively.
Obesity Among Women Living in Appalachia: A Dimensional Analysis
Online Journal of Cultural Competence in Nursing and Healthcare, 2015
Conclusions The environment in which Appalachian women live plays a significant role in how obesity is experienced and understood by these women. Implications for Practice Understanding Appalachian women's perspectives on obesity can lead to culturally tailored weight loss interventions that take a broader social view of the problem.