Significance of the built environment to physical activity in rural areas

2011-12-20

Significance of the built environment to physical activity in rural areas – a knowledge compilation for the government assignment “Built environment and physical activity”. Approximately 20 percent of the Swedish population lives in rural areas if we define rural as all areas outside urban areas.

It is well established that rural residents, compared to their urban counterparts, carry a higher burden of poor health and chronic diseases, for example due to higher prevalence of coronary heart disease, overweight/obesity and musculoskeletal diseases such as pain in shoulders and back. The higher public health burden in the rural population is believed not to be due to higher risks of living in rural areas per se, but rather associated with the demographic shift when young and healthy adults leave rural communities and move to cities.

Therefore, health-enhancing strategies in rural areas are very important to prevent poor health, to promote quality of life and good living conditions, as well as to attract new and former inhabitants. One way of promoting public health in rural settings is to create a built environment conducive to a physically active lifestyle. Research on the effects of the built environment in urban areas on physical activity shows the importance of pleasant scenery, safe and walkable neighbourhoods, multiple destinations within walking distance, high access to resources for physical activity including parks, sidewalks and light traffic.

However, little attention has been given to the built environment in rural areas. Perceived barriers and opportunities to physical activity might be different in rural areas compared to urban areas. Rural populations, compared to urban populations, have lower accessibility to resources for physical activity. In addition, great distances between destinations and low access to street lighting can make active living (e.g., walking and cycling to work or school) difficult in rural areas. This report is based on a systematic review by Frost et al ((Frost et al., 2010)) of the effects of the built environment on physical activity in adults in rural settings.

The review shows that the most promising evidence-based interventions/strategies to date, concern:

• Promoting a pleasant scenery
• Creating multi-use trails
• Having many destinations within walking distance from home
• Having access to parks and other green areas
• Having access to recreational facilities
• Perceiving the environment as safe (e.g., from crime and traffic)

There is, according to the review, a great need for additional research on the effects of the built environment on physical activity in rural settings to improve knowledge of possible effective interventions/strategies.
The research and developmental needs in Sweden concern:

• To design studies investigating the effects of the built environment in rural settings on physical activity in Sweden, since hardly any studies in Swedish settings exist to date
• To conduct more interventions and longitudinal studies
• To investigate the effects in other groups than young adults and middle-aged adults, such as the elderly, the disabled, children, people with chronic diseases, ethnic minorities, etc.
• To develop new, and improve existing, assessment tools to investigate the links between built environment in rural settings and physical activity, since most existing tools are focused on the built environment in urban areas. 
• To investigate the effects of the built environment on different types of physical activity behaviour, such as walking/cycling to work/school, recreational walking/ cycling, sports, indoor exercise, etc.

The research and developmental needs in urban and rural areas are very similar. However, in order to improve knowledge of the effects of the built environment on physical activity in rural areas, researchers and planning officers must agree on a suitable definition for what constitute rural areas, and then collect data/information that will make possible analyses of explicit rural settings.