Skip to main content

Adult Obesity in Rural America

Man and woman walking on a wooded path, smiling
An analysis of obesity prevalence, sociodemographic factors, and access to care in rural and urban counties
  • Client
    Novo Nordisk
  • Dates
    June 2023 - October 2023


Obesity is substantially more prevalent among adult rural populations than urban ones.

Obesity is a complex and chronic disease that is a growing public health problem in the United States, with an estimated 100 million adults in the U.S. living with obesity. Research has shown that obesity is substantially more prevalent among adult rural populations than urban ones. A 2022 NORC analysis led to the creation of an Obesity & Comorbidity Prevalence Map which shows that 48 percent of adults in non-metro areas are living with obesity, compared to 41 percent in metro areas.

Research also shows that obesity prevalence varies by sex, age, race, ethnicity, and education.  Sociodemographic factors may also interact with urbanicity, such as increased racial disparities in obesity prevalence in rural vs. urban areas. But there is less research on how health system factors relate to a higher obesity burden or may contribute to challenges in accessing obesity-related treatment in rural areas.


NORC analyzed the impact of socioeconomic and health access factors on obesity.

NORC assembled multiple datasets to develop a fuller picture of obesity and related factors in rural areas. Our analysis builds on existing research by investigating the relationships between the prevalence of obesity, diverse socioeconomic factors, and various health access measures in rural areas compared to non-rural ones. We sought to detect if there are differences in how socioeconomic and health access measures interact with obesity prevalence in rural versus non-rural areas.


We published a white paper summarizing how socioeconomic and health access factors interact with obesity prevalence.

Our analysis led to multiple findings, including:

  • Social and economic factors contribute to the higher burden of obesity in rural areas. Lower income, lower educational attainment, reduced access to food, and fewer options for exercise contribute to higher obesity prevalence especially in rural areas. 
  • Race and ethnicity play a role in obesity prevalence. Demographics interact with and influence obesity prevalence. Additional research at the individual level is needed to understand how race and ethnicity interact with obesity.
  • Limited health care access in rural areas makes it more challenging to treat obesity. Reduced access to primary care providers and specialists, more uninsured residents, longer distances to clinics, and less internet access make it more challenging to effectively prevent and treat obesity in rural areas.

Related Tags

Project Leads

Data & Findings

Explore NORC Health Projects

Enhancing Maine’s All-Payer Claims Database

New and improved processes for collecting and using Maine’s health care claims data


Human Services Research Institute (HSRI)

Understanding California’s Middle-Income Older Adult Population

California’s middle-income seniors projected to grow to 1.6M by 2033


The SCAN Foundation, West Health