Distribution of Obesity-related Health Outcomes Across the Urban-Rural Commuting Area in Mississippi, Alabama, Louisiana, and Georgia

Obesity-related chronic diseases are still major public health concerns in the United States, particularly in the south. The purpose of this study is to examine the association between obesity-related chronic diseases and rurality/urbanicity in the four Deep South states-Mississippi, Alabama, Louisiana and Georgia. We used publicly available Zip Code level approximations of USDA-developed RUCA Code for rurality designation and Zip Code level PLACES data developed by CDC for selected obesity-related health outcomes-Asthma, Obesity, Chronic Obstructive Pulmonary Disease, Coronary Heart Disease, Diabetes, High Cholesterol, Stroke and High Blood Pressure. This study employed the random forest method, partial least squares discriminant analysis and multinomial logistic regression to investigate the association between selected health outcomes and degrees of rurality. There are significant differences in the prevalence of Asthma, Obesity, COPD and Stroke between Metropolitan and small towns or complete rural areas. On the other hand, while considering Micropolitan and small towns or complete rural areas, Asthma, Obesity, COPD, Diabetes, High Cholesterol and Stroke show significant differences in prevalence. This study revealed disparities in health outcomes per RUCA Codes, which can be useful to target specific geographic areas for appropriate interventions.