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Yesterday we reported that while smoking rates have declined according to the U.S. Centers for Disease Control and Prevention, they remain higher outside of metropolitan regions.

Today we focus on non-urban obesity. And the news is not good.

This information can be highly useful for well-run workplace wellness programs, particularly those that serve businesses and members who may reside outside metropolitan locations.

A new JAMA study is titled “Differences in Obesity Prevalence by Demographic Characteristics and Urbanization Level Among Adults in the United States, 2013-2016.” The study asks a simple question: ” During 2013-2016, were there differences in the prevalence of obesity and severe obesity by demographics and urbanization level among US adults?”

The authors write: “Differences in obesity by sex, age group, race and Hispanic origin among US adults have been reported, but differences by urbanization level have been less studied. To provide estimates of obesity by demographic characteristics and urbanization level and to examine trends in obesity prevalence by urbanization level.”

The results? As MedPage Today reports: “Smalltown America Seeing More Severe Obesity: Report adds to sense of growing rural health crisis.” It states:

“During 2013-2016, 42.4% of men who resided in small to medium metropolitan statistical areas (MSAs) — those with populations less than 1 million — had obesity compared to 31.8% of men living in large MSAs.”

“There were also similar patterns among women as well, marked by a significantly higher age-adjusted prevalence for obesity among those living in small or medium MSAs versus large MSAs.”

“However, women residing in non-MSAs — non-metropolitan areas — saw the highest numbers out of all the areas, with an obesity prevalence of 47.2%.”

“As for severe obesity, both men and women in non-MSAs saw significantly higher prevalence compared to those living in large metropolitan areas.”

Said the authors, according to MedPage: “Urban-rural health disparities also have been reported for various health conditions such as diabetes and cardiovascular disease, arthritis, mental health disorders, and prescription medication use. [C]ompared with adults living in urban areas, those living in rural areas have higher mortality from certain chronic diseases, suicide, and all causes. Life expectancy in rural areas in 2005-2009 was 2 years shorter than in metropolitan areas.”

As the study concludes: ” In this nationally representative survey of adults in the United States, the age-adjusted prevalence of obesity and severe obesity in 2013-2016 varied by level of urbanization, with significantly greater prevalence of obesity and severe obesity among adults living in nonmetropolitan statistical areas compared with adults living in large metropolitan statistical areas.”