Many people are surprised to hear that childhood obesity is a rural phenomenon, because they assume that rural kids have more access to the outdoors and physical activity. However, studies have found that there is little open public space in rural areas, often because of a lack of a robust local government to provide and maintain such public spaces, Lifsey and Mantinan write. They also cite research showing that rural families don't use public activity areas partly due to fear of crime in public spaces, even though crime is less likely in rural areas.
Poorer food and lower levels of activity are often the result of the distance it takes to get to a physical-activity venue or a grocery store in rural areas, the authors write. The time and fuel it takes to get to and from a venue can discourage commitment to transport children or to travel to groceries with better food options, Lifsey and Mantinan write.
Many rural families who lack access to fresh and healthy foods live in "food deserts," Generally defined as those with no grocery with fresh produce within 10 miles. Studies have found poverty and childhood obesity are more likely in rural food deserts.
Rural communities are using several school-based strategies to fight obesity, Lifsey and Mantinan report. They include making sure school-bus schedules and family transportation schedules coordinate to encourage after-school activities; ensuring that schools provide gym class and recess; allowing recreational areas of school grounds to be available to the community after hours; providing alternative transportation options to students who need rides home in order to participate in after school activities; improving school meals to include more whole grains, fruits and vegetables; and improving the choices available in soda and vending machines.
Engaging programs and groups that are already in existence, such as 4-H Youth Development and telemedicine programs that focus on childhood obesity intervention, are great places to start when initiating childhood obesity programs, the authors write. Having local farmers teach gardening skills can also improve access to healthy food.
Noting that African-American children are the most likely to be obese, Lifsey and Mantinan say communities must keep minority populations in mind. They also suggest working with employers to start employee wellness programs that encourage parents to model healthy behaviors for their children.
Also, It's important for rural communities to observe, measure and decide how each of them want to attack this issue to increase the probability of success, they say.
Tools are available to help with this planning such as the Rural Active Living Assessment Tools, developed by the Robert Wood Johnson Foundation. Other resources include the Rural Assistance Center, funded by the U.S. Department of Health and Human Services Rural Initiative, which features a Rural Obesity Prevention Toolkit developed by the& Nutrition Obesity Research Center’s Walsh Center for Rural Analysis, as well as a resource guide for rural areas developed by the University of North Carolina’s Active Living by Design.