Evidence for a continuing gap in rural/urban adult obesity in the Samoan archipelago.

Significant differences in adult obesity prevalence exist between rural and urban settings throughout the world. Here, we estimate and evaluate the prevalence of adult obesity in rural Independent Samoa, rural American Samoa, and urban American Samoa in 2009. Volunteers over the age of 40 years were weighed and measured by convenience sampling in rural Independent Samoa (N = 85), rural American Samoa (N = 124), and urban American Samoa (N = 95) Mean BMI increased from rural Independent Samoa (32.2 males; 33.3 females) to rural American Samoa (33.5 males; 34.9 females) to urban American Samoa (36.9 males; 39.7 females). Differences among groups were statistically significant (P = 0.004, ANOVA). In all locations, women were substantially more obese than men. While obesity is a major health problem in the Samoan archipelago, significant differences exist between rural and urban settings. A substantial rural/urban gap in adult obesity has been in existence since at least the 1970s. However, results of our study, combined with those of previous studies, indicate that the prevalence of obesity in both rural and urban environments has been on the rise since the 1970s.