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June 7, 2026Diabetes

Rural residents had a higher diabetes (10-18%) and obesity (16-20%) prevalence than urban residents (PR: 1.10-1.18; 1.16-1.20).

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Why the study?

Does rural residence affect the prevalence of diabetes and obesity in U.S. adults compared to urban residence?

Population

2,971,000 U.S. adults from the Behavioral Risk Factor Surveillance System (2018-2024)

Comparison

Rural residence vs Urban residence

Design

Cross-sectional

Authors

MEMegan O. EzeudeMHMaryam HashemianGHGretell Henríquez-Santos

Discussion

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Overview

Rural residents in the U.S. experience a persistently higher burden of diabetes and obesity compared to urban residents, particularly among non-Hispanic Black and White adults.

Key Points

  • This research aims to examine how rurality affects the prevalence of diabetes and obesity across different racial and ethnic groups in the U.S.
  • Analyzed cross-sectional data from the Behavioral Risk Factor Surveillance System (2018-2024)
  • Estimated age-adjusted prevalence and prevalence ratios (PRs) using survey-weighted Poisson regression
  • Included 2,971,000 participants with 14% residing in rural areas.
  • Rural residents had a higher diabetes prevalence of 10-18% compared to urban residents (PR: 1.10-1.18)
  • Obesity prevalence in rural areas was 16-20% versus urban areas (PR: 1.16-1.20)
  • Significant differences were particularly noted among non-Hispanic Black and White adults, with the highest rates in non-Hispanic Black adults.

Structured PICO

Does rural residence affect the prevalence of diabetes and obesity in U.S. adults compared to urban residence?

P
Population
2,971,000 U.S. adults from the Behavioral Risk Factor Surveillance System (2018-2024)
I
Intervention
Rural residence
C
Comparator
Urban residence
O
Outcome
Prevalence of diabetes and obesity

Rural residents in the U.S. experience a persistently higher burden of diabetes and obesity compared to urban residents, particularly among non-Hispanic Black and White adults.

Cite This Study

Ezeude et al. (2026) studied this question.

synapsesocial.com/papers/6a250ae37def13d035e1ae9fhttps://doi.org/10.2337/db26-2361-p
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Geographic and Sociodemographic Patterns in Prevalence of Diagnosed Diabetes, US, 2021–20242026
  2. 2Behavioral and Sociodemographic Predictors of Diabetes Among Non-Hispanic Multiracial Adults in the United States: Using the 2023 Behavioral Risk Factor Surveillance System2025
  3. 3A Retrospective Study of Disparities in Mortality Due to Diabetes Mellitus Over a 22-Year Period in the United States2025
  4. 4Rural‐urban disparities in the prevalence of chronic pain in adults: Associations with demographic and socioeconomic characteristics2025
  5. 5Heterogeneous associations of socioeconomic status with metabolic disease in racial and ethnic subgroups in the United States: A cross-sectional cohort study in NHANES and All Of Us2026