An urban versus rural comparison of obesity between youth with and without autism spectrum disorder.

To examine obesity prevalence in youth with autism spectrum disorder (ASD) and neurotypical (NT) youth living in rural and urban areas. Data is from the 2019 National Survey of Children's Health, a national dataset that collected information on child health and well-being. Overweight/obesity status was based on parent/caregiver report of child height and weight. Urban and rural status was determined by whether children lived in/near a city. Chi-square tests were conducted to examine differences in obesity prevalence in youth with ASD and NT youth living in rural and urban areas. Overall, 43.9% of youth with ASD were overweight/obese compared to 30.6% of NT youth (p < 0.001). There was a significantly higher proportion of NT youth living in rural areas (36.44%) who were overweight/obese compared to urban NT youth (30.35%, p = 0.002). There were no significant differences in the proportion of overweight/obese youth with ASD living in rural areas (44.02%) compared to urban areas (44.44%, p = 0.96). Urban residence reduced the odds of overweight/obese compared to rural residence among NT youth (aOR = 0.77, 95%CI = 0.66-0.90) but urban/rural residence was not a significant factor in models for ASD youth (aOR = 1.25, 95%CI = 0.63-2.48). In contrast to NT youth, there were no differences in levels of overweight/obesity in youth with ASD living in rural areas compared to urban areas. Further research on how sociodemographic factors and geographic location affect obesity in youth with ASD is warranted.