Assessing how alcohol use patterns relate to obesity among American adolescents from rural and urban areas: Five years of pooled data

Abstract

Background Obesity is associated with locality and alcohol use; however, less is known about how the interaction of these two factors may compound the risk of obesity among adolescents. Objectives This study examines the relationship between alcohol use and obesity among adolescents from rural and urban areas in the United States. Methods Data came from a sample of American adolescents aged 12–17 years from the National Survey on Drug Use and Health (2015–2019; n = 39,489). Obesity was regressed on age, sex, race/ethnicity, income, cigarette smoking, locality, and alcohol use, with an interaction term to examine locality x alcohol use. Predicted probabilities were plotted to assess the interaction. Results Compared to adolescents from urban areas, those from rural areas had 1.35 times higher odds of being obese (95% CI 1.25, 1.47). Predicted probabilities indicated that the probability of being obese was higher for rural adolescents at lower levels of drinking, up to about 40 drinks in the past 12 months. Conclusions Findings suggest rural-urban differences at the intersection of alcohol use and obesity could depend on the frequency of use, but overall adolescents from rural areas may be more at risk.