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Reidun Heggem, Alexander Zahl-Thanem and Maggi Brigham

Topic: Potential causes of overweight and obesity in rural areas


The increasing prevalence of overweight and obesity is recognized as a major public health challenge nationally and internationally. There is emerging evidence of geographical inequalities in overweight and obesity in Norway, as well as in many other high-income countries. Both national and international research shows that rural residency increases the risk of overweight and obesity. For instance, results from The Nord-Trøndelag Health Study (HUNT) show that the prevalence of obesity among young people seems to be higher in municipalities defined as less central.

Related to this, studies have investigated the effects of demographic and socioeconomic factors on overweight and obesity, and studies point to the fact that people living in rural areas often have lower income and educational level than people in urban areas. Even though level of income and education are negatively correlated with unhealthy lifestyle, studies show that rural residency in itself is an independent risk factor for being overweight or obese as well.

We use an explorative method, qualitative interviews, with relevant actors as public health nurses and teachers in three rural communities and one urban community, to reveal possible reasons for the uneven distribution of overweight and obesity between rural and urban areas. The analyses shows several potential causes for the rural-urban inequality in weight status. In the study, they point out challenges for rural areas, connected to both contextual and compositional factors. For instance, i) maintaining diet habits established by previous generations, often based on tradition, in combination with changed activity patterns, ii) rural parents’ perception of children’s’ ideal weight, and iii) scattered settlement and longer distances which requiring usage of passive transportations (e.g. car and bus). A basic underlying perception the study revealed was a feeling that overweight is a theme that is defined, handled and communicated from an urban perspective and through urban glasses. This might create a foundation for a general, cultural resistance in rural areas, against health authorities and official expert knowledge.

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