Evaluating the physical and nutritional environments of rural communities in Illinois

Abstract

Background
Rural communities often have higher rates of physical inactivity and obesity than their urban counterparts. Numerous studies have shown that physical environments and access to unhealthy food are linked to poor health outcomes.
Objective
The objective of this descriptive study was to measure the physical activity and nutrition environments of three rural counties in Northern Illinois, where the prevalence of obesity is high.
Methods
The physical activity and nutrition environments of nine rural towns in three Illinois counties were assessed between December 2022 and June 2023 using adapted versions of the Rural Active Living Assessment (RALA) and Nutritional Environment Measurement Survey (NEMS). This study aimed to assess the physical and nutritional environments of rural towns so that a coalition of community stakeholders could make data-informed policy and intervention decisions.
Results
The RALA Program and Policy (PPA) and Town Wide (TWA) assessments were conducted in all nine towns and were scored from (0-100). The PPA scores ranged from 13 to 76, and the TWA scores ranged from 49 to 96. The NEMS with a possible score range of 0-45 was conducted in 51 stores in nine towns, and the score ranged from 11.3-21.5. NEMS availability scores for each type of store (convenience, grocery, and other) were significantly different from each other (p<0.0001). Differences across counties for the same type of store were not statistically significant.
Conclusions
Each town had different facilitators and barriers to being physically active and eating healthy. Most towns had a variety of amenities but lacked policies and programs that supported physical activity. There was no consistent pattern between amenities for physical activity and healthy eating. The results also suggest that access to healthy food and physical activity amenities are not the only determinants of whether a town is a healthy place to live.