The Influence of Socioeconomic and Environmental Factors on Health and Obesity in Rural Appalachia

A recursive system of ordered self assessed health (SAH) and a binary indicator of obesity were used to investigate the impact of socioeconomic and environmental factors on health and obesity in the predominantly rural Appalachian state of West Virginia. Behavioral Risk Factor Surveillance System (BRFSS) data together with county specific socioeconomic and built environment indicators were used in estimation. Results indicate that an individual’s risk of being obese increases at a decreasing rate with per capita income and age. Marginal impacts show that as the level of education attainment increases, the probability of being obese decreases by 3%. Physical inactivity increases the risk of being obese by 9%, while smoking reduces the risk of being obese by 14%. Fruit and vegetable consumption lowers the probability of being obese by 2%, while each hour increase in commuting time raises the probability of being obese by 2.4%. In addition, individuals living in economically distressed counties are less likely to have good health. Intervention measures which stimulate human capital development and better land use planning are essential policy elements to improving health and reducing the incidence of obesity in rural Appalachia.