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Rural Health Information Hub

Factors Contributing to Obesity

Certain features of rural communities make it more challenging for people to eat a healthy diet and to be physically active. These features differ between communities, but include environmental characteristics, access barriers, and population characteristics.

Environmental Characteristics

Environmental characteristics refer to the natural and physical (built) surroundings in which people live their lives. The design and condition of the environment can contribute to rural obesity – for example, by making it more difficult to obtain healthy foods or to be physically active.

Built Environment

The built environment includes homes, schools, workplaces, parks, farms, and roads. Barriers to healthy eating and physical activity in the built environment include:

  • Limited access to public parks
  • Few sidewalks
  • Lack of public transportation
  • Lack of street lighting

Natural Environment

The natural environment includes climate, resources, water, air, and geography. Barriers to physical activity and access to healthy foods in nature include:

  • Harsh weather (e.g., snow, heat)
  • Rough or hilly terrain
  • Remote location, creating long traveling distances

Access Barriers

Access barriers refer to the availability of resources to support a healthy weight and lifestyle. For example, transportation is a key part of “access to opportunity,” such as the chance to obtain healthy foods, physical activity, and health care, or to travel to jobs or educational institutions. Nearly 40 percent of rural counties have no form of public transportation. Common rural access issues include:

Healthy Foods

  • Higher rates of food insecurity
  • Limited access to grocery stores carrying fresh fruits and vegetables
  • Higher cost of fresh fruits and vegetables

Physical Activity

  • Limited areas and equipment for structured physical activity
  • Lack of funding for public facilities and/or programs

Transportation Options

  • Long travel distances
  • Lack of transportation infrastructure
  • Dependence on driving


  • Fewer healthcare providers
  • Higher rates of uninsured
  • Fewer disease management programs
  • Limited nutrition education

Public Health Resources

  • Sparsely populated areas receive less public health funding
  • Health programs may not be designed to address rural health issues

Population Characteristics

Population characteristics refer to the demographic and socioeconomic qualities of the community. Rural populations tend to be older, poorer, and at greater risk of becoming obese and overweight than their urban counterparts. To learn more, visit the At-Risk Populations section of this module.