It’s no secret that where people live is a major determinant of how healthfully they live. Rural community developers know this, even as they know that rural counties are home to some of the unhealthiest communities in the nation.
The factors that make a community a healthy place to live are, among other things, the quality of the physical environment and the availability of services and opportunities that promote health and wellness. So why are rural communities less healthy? In a word, access. The geographic isolation of many rural counties and small towns, and the lack of locally based businesses and services, make it more difficult for residents to access medical care, fresh food, and education about nutrition and healthy behaviors.
According to Rural Assistance Center, the incidence of chronic disorders such as obesity, diabetes, and heart and lung disease is higher in non-metro counties than in metro counties, and adequate, affordable health care is less readily available. Risk factors including poverty, poor diet and a higher prevalence of unhealthy habits such as smoking combine to make rural residents more vulnerable to physical and even mental problems than their urban counterparts.
Rural LISC’s partner CDCs provide some valuable examples of how rural community developers across the country are working to change this equation. Rural CDCs are helping residents live healthier lives by creating beneficial physical environments and expanding opportunities to make healthy choices.
Making Homes Healthier
Weatherization programs such as this one provided by North East Community Action Corporation (NECAC) in eastern Missouri make homes cleaner and greener.
The housing stock in rural America is more likely to be substandard than housing in non-metro areas, but rural CDCs are taking steps to make both new and rehabilitated homes greener and healthier. Cabrillo Economic Development Corporation (CEDC) in Ventura County, California established a set of healthy housing principles to guide its rehabilitation of rental housing. CEDC received a Ventura County Public Health Community Transformation Grant to identify how health can be improved by addressing the built environment.
The guiding principles are comprehensive in their approach, looking broadly at the factors that influence wellness. They call for the inclusion of green space and community gardens; opportunities for physical activity, such as bike lanes; non-smoking policies; improved indoor air quality through the use of hard-surfaced flooring and paint low in volatile organic compounds (VOCs); exterior environments that promote physical activity with stairs and walking trails instead of elevators and garages; and health and nutrition education for residents.
Bringing Fresh Food to the Fore
Given the prevalence of obesity and diabetes in rural America, nutrition education and healthy food are important weapons in the fight to make communities more fit. Rural CDCs have found innovative ways to increase their communities’ access to nutritious foods.
Using fresh vegetables from its own backyard, Boys, Girls, Adults Community Development Center (BGACDC) in Marvell, Arkansas is waging a campaign against obesity and diabetes, especially in children.Willie James Spriggs, former president of BGACDC and a longtime volunteer, started the BGACDC garden in 2013. The garden is an educational tool for children, who learn about the source of food and the value of healthy eating and exercise. The garden's greens, cabbage, onions, beans, tomatoes and other leafy vegetables are turned into nutritious meals at the BFT (Best Food in Town) Restaurant, located at the BGACDC headquarters.
"We encourage families to follow our example and grow their own fresh vegetables or, if they can't, seek them out at the market," said Mrs. Beatrice Shelby, executive director of BGACDC. "We hope they'll realize the connection with health and happiness and spread the word."
Encouraging Healthy Lifestyles
Nutrition and exercise are the fundamentals of a healthy lifestyle, but most rural communities face both cultural and physical barriers to physical fitness. The built environment in rural counties typically does not encourage walking, and rural residents are less likely to be physically active than urban residents and more likely to be obese.
In the former coal mining town of Tamaqua, in rural eastern Pennsylvania, Rural LISC Partner CDC Tamaqua Area Community Partnership (TACP) made a positive change in the lives of area residents by educating residents and advocating for healthy lifestyle choices. With its Live Your Life program – a year-long, community-based wellness initiative – TACP challenged common narrative of rural health deficits. The main goal of Live Your Life was to promote better eating habits and increased physical activity in Tamaqua. Those new habits contributed to the pursuit of a secondary goal, to reduce prevalence and burden of diabetes and other chronic diseases.
TACP’s efforts inspired a group of students at Tamaqua Area High School to organize a “Fit Day,” dedicated to educating students and the community about the importance of regular exercise and a healthy diet. Through the Rural LISC partner network, a community group in the Mississippi Delta heard about Tamaqua's Fit Day and became inspired in turn. TACP shared its knowledge and experience with peers in Mississippi. Subsequently, a neighborhood in the town of Indianola, Mississippi held its own Fit Day, sponsored by the Indianola Promise Community and the Mayor’s Health Council, in which more than 120 children participated.
Helping Residents Access Health Care
While healthy homes and lifestyles are important to overall good health, the picture of wellness in any community is incomplete without the presence of medical care. The National Rural Health Association reports that rural communities have fewer health practitioners than urban ones, and that rural residents are less likely to have medical insurance coverage. Rural LISC partners like Mercy Housing and Human Development (MHHD) in Gulfport, Mississippi are working to ensure that residents of rural communities have access to the care they need.
MHHD partnered with Coastal Family Health Center to open a clinic in D'Iberville, a community of 7,600 on Mississippi's Gulf Coast. Opened in 2011, the much-needed heath center makes medical care available to everyone in the community, regardless of income or insurance status. The clinic accepts all types of insurance as well as private payments, scaling payments to patients’ incomes to make care affordable.
Benefits Beyond Health
True to the nature of comprehensive community development, each of the programs described above has benefits that radiate beyond their intended purposes and improve quality of life for community residents in other ways. For example, green design principles result in healthy homes with improved indoor air quality, but those homes are also more energy efficient, reducing utility costs for the residents. And programs to produce, prepare and sell healthy foods also create economic opportunities and jobs in small towns.
A striking example of this concept comes from Hooper Bay, Alaska, where RurAL CAPresponded to staggering rates of youth suicide by creating a youth group called "Native Survivors." The group worked to revive old traditions and skills, bringing a much-needed cultural anchorage, with its accompanying peace, self-respect and integrity, back into the lives of young residents. With traditional crafts and performing arts, the group fosters mental health among the local youth while instilling pride in their heritage and their community.
Although rural residents face tough challenges to their health and wellness, rural community developers have not accepted that poor health has to be a way of life. Through big ideas and hard work, community developers are bringing healthier days to rural America.