Does Rural Residence Cause Weight Gain?: Longitudinal Evidence of BMI Change in a Nationally Representative Cohort

Mark Lee , University of Minnesota

A disproportionate number of residents in rural America carry excess body weight. This public health issue adds stress to overburdened rural healthcare systems. Previous studies have established that compositional differences between rural and urban areas alone do not explain this disparity. However, these cross-sectional associations cannot distinguish between causal contextual effects and selection bias since they do not track people over time. In the current study, I aim to reduce the threat of selection bias by estimating the effect of rural residence on two-year BMI change using panel data from a nationally representative sample. Results suggest a greater increase in BMI for rural residents than urban residents over a two-year observation period after controlling for socio-demographic confounders. This is the first longitudinal evidence supporting a causal relationship between rural residential environments and weight gain. Further research should investigate the mechanisms that produce this effect.

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 Presented in Session 5. Health & Mortality 1