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January 21, 2015 - Kim Moore [see other posts]

Farm Labor

One Area of Growth in Rural Areas

Those of us who grew up in rural areas--even though that was decades ago in my case--retain a mind picture of a hard-working population living a large part of its life outdoors. Rightly or wrongly, we remember a generally healthy group of people. Policymakers likely have similar views and may believe the rural population is healthier than the general American population. The truth for 2015 is that rural populations frequently have similar characteristics in terms of health with urban populations and the suburban population is the healthiest demographic group. A recent report from the Nemours Foundation, Childhood Obesity Prevention Strategies for Rural Communities [pdf] explains the rural obesity challenge:

"Rural residents tend to eat diets higher in fat and calories, exercise less, and watch more television...Rural communities face barriers to addressing obesity, such as higher poverty levels, less access to opportunities for physical activity and healthy eating, and limited resources to provide nutritious foods and physical education in school."

It is counter-intuitive to believe that the places which produce food for America can lack access to nutritious foods. It boggles the mind that places with wide-open, uncrowded spaces lack opportunities for physical exercise. None of that squares at all with the lingering perceptions of rural life which many of us have. But it is the reality! We recently dealt with a grant program in far western Kansas which could not get access to the fruits and vegetables utilized in a child care curriculum on healthy eating. We know the rural grocery store movement in Kansas has had to work hard to retain local food access in many communities through community-owned or cooperative stores. Many of us need to check our mythic ideas about rural living with those actually living there and with the data.

At a meeting last week conducted by ChangeLab Solutions, in cooperation with the Association of State Public Health Nutritionists, twenty-five of us from twenty states considered the problem of rural obesity and discussed promising practices for addressing the obesity epidemic as it really exists in rural life. It was good to be reminded of variances in rural living from densely settled rural to frontier areas. My own rural living (yes, Hutchinson--population 45,000--would be rural to most Americans) occurs in an environment very different from the rural living of Health Ministry Fund directors in Colby, Hays, Hillsboro, Hugoton, and Ulysses.

Some of the quick and dirty learnings I wrote down include:

  • Rural work is not done well by just downsizing urban models.
  • We already have enough pavement (in some areas); we just need to draw new lines (bicycling, walking, etc.) on the existing pavement.
  • Young Americans (employees) want to live in walkable communities.
  • You need to win healthy drink vending battles for everyone, including vendors.
  • Not all health disparities are inequities. Inequities occur (and there are many between rural and urban/suburban populations) when those differences are unnecessary, avoidable, unfair, or unjust.
  • We live in environments where food insecurity stands next door to food overconsumption.
  • Rural environments are particularly interested in interventions which involve neighbor helping neighbor.

There are many scientifically validated interventions to address the obesity problem and many are very applicable to rural areas. Check out Our work at the Health Ministry Fund aims at increased breastfeeding rates as one of the answers to childhood obesity in rural areas (and that is scientifically validated). I will share additional rural obesity prevention ideas when the report from the ChangeLab Solutions meeting is available. We can all understand more about the health of rural Kansans and the environments they and we live in by reviewing county health rankings provided by the University of Wisconsin Population Health Institute:

Kansas County Health Rankings Overview

That data will change some of our perceptions and prepare us to address the growing obesity problem facing rural Kansans.