Explaining obesity disparities by urbanicity, 2006 to 2016: A decomposition analysis

A large and potentially growing disparity in obesity prevalence exists between large central metros and less urban United States counties. This study examines its key predictors. At baseline, demographic predictors explain more than half the obesity gap, and socioeconomic and behavioural predictors explain the other half. Behavioural and socioeconomic predictors explain more than half the growing gap over time, whereas controlling for environmental and demographic predictors decreases the obesity gap by urbanicity over time. Results suggest policymakers should prioritize interventions targeting residents' health behaviours in non‐large central metros to slow the growth of the obesity gap between large central metros and other counties. However, to fundamentally eliminate the obesity gap, in addition to improving health behaviours, policies addressing socioeconomic inequalities are needed.