What leads to obesity in rural communities?

New Saint Louis University public health study is first to examine link between obesity and characteristics of small towns

ST. LOUIS -- Residents of rural communities who feel isolated from recreational facilities, stores, churches and schools are more likely to be obese than those who believe they are closer to facilities, new Saint Louis University research finds.

The study is thought to be the first to examine the link between obesity and the environmental factors within rural communities. It builds upon previous Saint Louis University School of Public Health research that examines the environmental features of a community that encourage physical activity, which is critical in the fight against obesity.

"What we found is similar to what we've known. Certain characteristics of a neighborhood may put residents at greater risk of being obese," said Tegan Boehmer, Ph.D., principal investigator and a researcher from Saint Louis University School of Public Health.

"This is the first time it's been confirmed in people who live in rural settings. Altering the neighborhood environment to be more activity friendly may result in higher levels of physical activity and the reduced prevalence of obesity on a population level."

Researchers conducted telephone interviews with about 2,500 residents of 13 rural communities in Missouri, Tennessee and Arkansas. Participants were asked their weight and height so researchers could determine their body mass index, which shows whether a person is obese, overweight or normal weight.

Those surveyed also answered questions about access to recreation facilities and other localities, transportation and safety, aesthetics and food choices in their community.

The study quantified how residents perceive their environment.

Personal behaviors, such as eating a high-fat diet or spending leisure time watching television, and being middle-aged were strongly related to obesity. However environmental factors, such as distance from recreational facilities and other destinations, feeling unsafe from crime and traffic and poor aesthetics of the neighborhood, also were moderately linked to obesity. Those who were both obese and inactive were more likely to be influenced by these community characteristics than those who were simply obese, the study found.

"Further distance to the closest recreational facility increased the likelihood of being obese," Boehmer says. "In particular, obese persons were more likely to perceive no walking or biking trail within a 10-minute walk from home when compared with other types of recreational facilities."

Nearly half of the participants reported lack of sidewalks on most streets and stated they felt unsafe from traffic while walking or biking.

Those who expressed concerns about traffic safety also were more likely to be obese, the study found.

"Promoting and enhancing existing trails or adding nearby trails could be a useful intervention in rural communities," Boehmer says. "They may be a more economical alternative than sidewalks in making it safer for rural residents to be physically active, particularly in areas with winding or narrow roads."

The research validates the importance of community leaders, researchers and practitioners from the fields of public health, urban planning and transportation collaborating to design communities that encourage a healthy lifestyle, she adds.

About a quarter of the population in the South and Midwest live in rural towns. Obesity and a more sedentary lifestyle are more common in rural communities than in large metropolitan areas and suburban areas, previous research has found.

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The research, funded by the National Institutes of Health, National Institutes of Diabetes and Digestive and Kidney Diseases (NDDK) was published in the July/August issue of the American Journal of Health Promotion.

Saint Louis University School of Public Health is one of only 37 fully accredited schools of public health in the United States and the nation's only School of Public Health sponsored by a Jesuit university. It offers masters degrees (MPH, MHA and MS) and doctoral programs (Ph.D.) in six public health disciplines and joint degrees with the Doisy College of Health Sciences and Schools of Arts and Sciences, Business, Law, Medicine and Social Service. It is home to seven nationally recognized research centers and laboratories with funding sources that include the National Institutes of Health, the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the American Cancer Society, the Robert Wood Johnson Foundation and the World Health Organization.


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