Residency and Racial/Ethnic Differences in Weight Status and Lifestyle Behaviors Among US Youth

Purpose Elevated risk for obesity is found in rural environments and in some minority populations. It is unclear whether living in rural or nonmetropolitan areas and being a minority compound the risk of obesity beyond that of either factor acting alone. Our purpose was to examine adolescent obesity in light of the potential concomitant influences of race/ethnicity, residency, and obesity-related lifestyle behaviors. Methods We assessed obesity prevalence, physical activity, consumption of fatty snack foods, and screen time in 8,363 US adolescents based on variation in race/ethnicity and residency. Descriptive, bivariate, and multivariate statistics were used to: (1) calculate race- and residency-based rates of obesity and obesity-related lifestyle behaviors and (2) generate race- and residency-based obesity odds ratios as a function of those same behaviors. Findings The results indicated that nonmetropolitan black youth had the highest risk of obesity (26%), rate of consuming fatty snack foods on more than 2 days/week (86%), and rate of spending more than 2 hours/day in screen time (91%) compared to white metropolitan youth. Compared to their metropolitan counterparts, black nonmetropolitan youth had greater odds of being obese if they exercised less than daily (1.71 times), ate fatty snack foods on more than 2 days/week (1.65 times), or spent more than 2 hours/day in screen time (1.64 times). Conclusions Race/ethnicity and residency may have a compounding effect on the risk of obesity. Prevention and intervention must be viewed in a socioecological framework that recognizes the importance of culture and community on obesity-related behaviors.