By Jennifer Peters
Many people working in health promotion have seen the astonishing slide show on the history of State Obesity Prevalence from 1985 to 2010. Developed by the Centers for Disease Control, the maps start from nearly all blue (lowest percentage of adults who are obese) and over time, get more and more red (highest percentages). The data show as well that rural states have become obese at a faster rate, and at a higher percentage. A recent analysis report from the Trust for America’s Health and the Robert Wood Johnson Foundation predict that by 2030, if obesity rates continue to climb as they are now, about two-thirds of adults in some states will be obese – and 13 states will have rates over 60%. Arizona is predicted to come in at 40th in the report, at 58.8%. Truly, this is cause for concern – it’s not just the weight, but also the chronic diseases associated with obesity that are costly in terms of dollars and people’s lives.
Addressing obesity requires us to think about health broadly. Putting all the focus on individual behaviors is too simplistic – and actually, not that simple when you think about all the issues an individual may face – genetics, activity level, socioeconomic issues, etc.! We must also think about relationships with family and friends; organizational, school, and workplace support; community assets and needs; cultural practices and beliefs; and policy change and development. Rural communities have great assets that can be leveraged to impact the rates of obesity – strong social bonds, high participation in organizations, and the capacity to organize around community resources and policies. A new Rural Obesity Prevention tool kit developed by the Rural Assistance Center addresses many of the unique characteristics of obesity in rural communities, and strengths that can be utilized to address the issue.
As public health is always pushing us to “look upstream” for solutions to problems, I also think that we must address the issue of food systems and food security in rural communities, and through the country. It is challenging to have a conversation about overeating when we know that food security – getting enough to eat – is a significant problem. It is not realistic to expect people to eat healthy when there are obstacles to accessing healthy foods, or when access to food is cyclical and there are times of bounty, and times of hunger. Also, when present, the stress of poverty, family crisis, and job insecurity are also factors in a person’s ability to practice healthy habits.
Rural communities have the ability to innovate and, perhaps, demonstrate to the country ways to return to a healthier, more sustainable, energy balance of food and physical activity. What do you think? What is your community doing to help people become healthier?
Jennifer Peters is the Associate Director, Arizona State Office of Rural Health Program and Coordinator for Community Health Promotion