biostudies-literatureSmith BJNIDA NIH HHSNIDDK NIH HHSNHLBI NIH HHSNCI NIH HHSNational Institutes of HealthNIH HHSNational Science Foundation939-952https://www.ebi.ac.uk/biostudies/studies/S-EPMC12354331biostudies-literatureUnknown32(6)<h4>Background</h4>Examine the role of income, perceived healthy foods availability, and consumption as mediators of rural-urban health disparities.<h4>Method</h4>Pre-registered simple mediation models with post hoc multi-mediator models were tested using national- and state-level survey data. Oregon data was collected in an online Qualtrics survey between October 8 and November 9, 2021 using CloudResearch; Health Information National Trends Survey (HINTS) 5, a nationally representative dataset, was collected over 4 cycles from 2017 to 2020. Oregon residents (n = 771; rural = 313, urban = 458) self-reported online: income, perceived fruits and vegetable (FV) availability, FV consumption, and BMI measures (height, weight). HINTS respondents (rural n = 1235; urban n = 13,912) self-reported the same variables of interest without FV availability, and with an additional self-rated health variable detailed below.  RESULTS: The effect of rurality on BMI (b = 0.012, SE = 0.005, p = 0.01) and self-rated health (b = 0.003, SE = 0.001, p = 0.008) when combining datasets was mediated by a series of income, perceived FV availability, and FV consumption.<h4>Conclusion</h4>To address rural-urban health disparities, individual (cognition, behavior), social (household income), and community (healthy food availability) factors should be targeted together.International journal of behavioral medicineIncome, Healthy Food Availability, and Consumption Mediate Rural-Urban Health Disparities.PMC12354331R01 DK128575R01 CA240452P50 DA048756BCS2220295DA048756R01 HL158555R01HL158555CA240452R01 CA211224R01DK128575CA211224Tomiyama AJMantell BBerkman ETJohn DHSmith BJfalseIncome, Healthy Food Availability, and Consumption Mediate Rural-Urban Health Disparities.<h4>Background</h4>Examine the role of income, perceived healthy foods availability, and consumption as mediators of rural-urban health disparities.<h4>Method</h4>Pre-registered simple mediation models with post hoc multi-mediator models were tested using national- and state-level survey data. Oregon data was collected in an online Qualtrics survey between October 8 and November 9, 2021 using CloudResearch; Health Information National Trends Survey (HINTS) 5, a nationally representative dataset, was collected over 4 cycles from 2017 to 2020. Oregon residents (n = 771; rural = 313, urban = 458) self-reported online: income, perceived fruits and vegetable (FV) availability, FV consumption, and BMI measures (height, weight). HINTS respondents (rural n = 1235; urban n = 13,912) self-reported the same variables of interest without FV availability, and with an additional self-rated health variable detailed below.  RESULTS: The effect of rurality on BMI (b = 0.012, SE = 0.005, p = 0.01) and self-rated health (b = 0.003, SE = 0.001, p = 0.008) when combining datasets was mediated by a series of income, perceived FV availability, and FV consumption.<h4>Conclusion</h4>To address rural-urban health disparities, individual (cognition, behavior), social (household income), and community (healthy food availability) factors should be targeted together.2025-01-01T00:00:00Z2025 Dec2026-06-15T06:11:55.161Z2026-06-15T03:08:31.638ZS-EPMC123543314029546410.1007/s12529-025-10362-1