"There is some perception that rural areas have better access to fresh vegetables because of farming," said Dr. Joseph A. Skelton of Wake Forest Baptist Health -- Brenner's Children's Hospital in Winston-Salem, N.C., who was not involved in the study. "Many farms practice mono-agriculture, such as corn, and may not get access to a wide variety of vegetables."
There are many studies to show that rural Americans have worse shopping access to healthy food choices, added Popkin.
In addition to the lack of access to healthy food, rural dwellers face barriers to healthy living because of their physical isolation.
"It's tough to get to a gym if you live outside of a town without one," said Befort, "Physical activity is now needed to compensate for diet and technology. That requires cultural change because rural areas typically don't have a culture of physical activity as leisure time."
Nearly 70 million or one-quarter of Americans call rural areas home, according to the study. Rural residents face greater challenges to living healthy lives. As rural communities continue to dwindle in size, rural health issues are often overlooked. This study reminds us that obesity is another challenge that rural Americans face.
"Rural America is fatter than urban America," said Popkin, "We've ignored rural America in public thinking. We do know this is a population with major needs."