Environmental factors associated with physical activity in rural US counties

Authors: ABILDSO, CHRISTIAAN - West Virginia University; DAILY, SHAY - West Virginia University; UMSTATTD MEYER, M. RENÉE - Baylor University; EDWARDS, MICHAEL - Texas A&M Agrilife; JACOBS, LAUREN - North Carolina State University; MCCLENDON, MEGAN - University Of Maine; PERRY, CYNTHIA - Oregon Health & Science University; Roemmich, James

Submitted to: International Journal of Environmental Research and Public Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 7/15/2021
Publication Date: 7/20/2021
Citation: Abildso, C.G., Daily, S.M., Umstattd Meyer, M., Edwards, M.B., Jacobs, L., Mcclendon, M., Perry, C.K., Roemmich, J.N. 2021. Environmental factors associated with physical activity in rural US counties. International Journal of Environmental Research and Public Health. https://doi.org/10.3390/ijerph18147688.
DOI: https://doi.org/10.3390/ijerph18147688

Interpretive Summary: US adults living in rural settings engage in less leisure time physical activity than adults living in urban areas. However, most data on the natural, social, recreation, and transportation environment factors associated with physical activity have been collected on urban populations to increase physical activity of people living in urban communities. The current study sought to understand differences in environmental influences of physical activity of adults’ living in rural and urban counties. We created a five-category rurality variable based on the percentage of a county population living in a rural area. We found that the natural environment was associated with physical activity in all but the urban counties, whereas the recreation environment was associated with physical activity in the urban counties and the two most rural categories of counties. This work highlights that environmental factors associated with leisure time physical activity differ across the rural-urban continuum and that more research is needed to understand how to help adults living in rural places.

Technical Abstract: Background: Rural US adults’ prevalence of meeting physical activity (PA) guidelines is lower than urban adults, yet rural-urban differences in environmental influences of adults’ PA are largely unknown. The objective was to determine urban-rural differences in environmental factors associated with the prevalence of adults meeting PA guidelines. Methods: County-level data for non-Frontier counties (n=2,697) were utilized for analyses. A five-category rurality variable was created using the percentage of county population living in a rural area. From Factor Analyses (FA) weighted factor scores were obtained and used in Multiple Linear Regression (MLR) analyses, stratified by rurality, to identify associations between environmental factors and prevalence of males and females meeting PA guidelines. Results: A 13-variable, four-factor structure of natural, social, recreation, and transportation environment factors emerged from FA. MLR revealed that natural, social, and recreation environment factors were associated with PA for men and women, with variation by gender for social factors. The natural environment was associated with PA in all but the Urban counties, whereas the recreation environment was associated with PA in the Urban counties and the two most rural categories of counties. Conclusions: Variations across the rural-urban continuum in factors associated with adults’ PA highlight the need for improved surveillance and more in-depth understanding of what works in creating active rural places.