Rural-urban differences in physical activity, physical fitness, and overweight prevalence of children

J Rural Health. 2008 Winter;24(1):49-54. doi: 10.1111/j.1748-0361.2008.00136.x.


Context: The increasing prevalence of overweight in youth has been well chronicled, but less is known about the unique patterns and risks that may exist in rural and urban environments. A better understanding of possible rural-urban differences in physical activity profiles may facilitate the development of more targeted physical activity interventions.

Methods: Participants (1,687 boys; 1,729 girls) were recruited from fourth, fifth, and sixth grade classes in schools from urban areas, small cities, and rural areas. Multilevel modeling analysis was used to examine rural-urban differences in physical activity and prevalence of overweight. Physical activity was assessed by self-report and body mass index was calculated from measured height and weight.

Findings: Prevalence of overweight was higher among rural children (25%; P<.001) than children from urban areas (19%) and small cities (17%). Urban children were the least active overall (Cohens' d=-0.4), particularly around lunchtime while at school (d=-0.9 to -1.1). Children from small cities reported the highest levels of physical activity.

Conclusions: The results of this study suggest there are rural-urban differences in children's prevalence of overweight and physical activity even within a fairly homogenous Midwestern state.

MeSH terms

  • Body Mass Index
  • Child
  • Exercise*
  • Female
  • Humans
  • Male
  • Midwestern United States / epidemiology
  • Overweight / epidemiology*
  • Physical Fitness / physiology*
  • Rural Population*
  • Surveys and Questionnaires
  • Urban Population*