Urban/rural differences in stunting and obesity: Trends for low-income and middle-income countries

We use cross-section and pooled cross-section/time series data from a large number of low- and middle-income countries to examine how stunting and obesity evolve both with country income and over time, and similarly how the urban-rural gaps in both stunting and obesity also evolve. As is well known, stunting is shown to decrease both with income and with time, while obesity increases. Interestingly, while the urban-rural gap in stunting narrows both with time and increased income, the urban-rural gap in obesity widens (although there are signs that rural areas subsequently start to catch up). There are strong regional differences, controlling for income and time. South Asia is an outlier with particularly high levels of stunting in both urban and rural areas (the “Asian enigma†), and there are strong regional effects on obesity. Factors such as food habits, quality of sanitation, and cultural differences in physical activity are likely implicated.