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Obesity and diabetes are more prevalent among Black individuals in both urban and rural settings. 

Obesity has been a persistent epidemic in the United States and obese individuals have been known to have a decreased life expectancy compared to the national average. This is even more pronounced in those of African descent, with obese Black individuals having a life expectancy four years lower than that of obese White individuals. The decrease in life expectancy has been attributed to racial disparities in all aspects of health. This study aims to elucidate the racial disparities in obese individuals with the inclusion of geographic factors (urban or rural).

The study utilized data from the 2012 Behavioral Risk Factor Surveillance System which is the largest system of health-related telephone surveys administered by the CDC, 2012 being the last year wherein the respondents’ county of residence was listed. The outcomes that were examined in this study were obesity, defined as a BMI equal to or more than 30 kg/m2; diabetes mellitus, which was only self-reported; and physical activity, which was defined as activity performed in the last 30 days outside of activities of daily living. Predictors of behavior were race and rural or urban status of residence.

The study found that most respondents from urban counties were more than twice as likely to be Black, whereas respondents who were from rural counties tended to be younger. It was also determined that cases of obesity and diabetes were higher among the respondents of rural areas than among respondents who lived in urban areas. Black respondents were also found to be more likely than White respondents to have obesity and diabetes regardless of the place of residence. Prevalence of obesity among Blacks was 45.8% while the prevalence for Whites was 27%.

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The overall conclusion that could be derived from this study was that the prevalence of obesity, diabetes, and a lack of physical activity was significantly higher among Black respondents irrespective of urban/rural status. However irrespective of race, rural areas had a higher prevalence of obesity than those of urban areas. Taken together the prevalence of obesity was higher among Blacks. This prevalence was more significant in rural areas compared to urban areas.

Further studies are warranted in order to elucidate sociocultural factors that may play a role in the discrepancy in obesity rates between Whites and Blacks so that these factors can be addressed in order to reduce the obesity rates in the United States.


Cohen, S. A., Nash, C. C., Byrne, E. N., Mitchell, L. E., & Greaney, M. L. (2022). Black/White Disparities in Obesity Widen with Increasing Rurality: Evidence from a National Survey. Health Equity, 6(1), 178-188. doi:10.1089/heq.2021.0149