Rural Connections $9.95 Sept. 2010 wrdc.usu.edu
A Publication of the Western Rural Development Center
Healthy Communities
Improving Health and Well-Being
Rural Connections Published by the ŠWestern Rural Development Center Logan UT 84322-8335 Sept. 2010 Volume 5 Issue 1 DIRECTOR Don E. Albrecht don.albrecht@usu.edu PUBLICATION SPECIALIST Betsy H. Newman betsy.newman@usu.edu ASSISTANT EDITOR Stephanie Malin SENIOR PROGRAM OFFICER Jim Goodwin jim.goodwin@usu.edu SENIOR COORDINATOR Trish Kingsford trish.kingsford@usu.edu CHAIR-BOARD of DIRECTORS Noelle Cockett NATIONAL PROGRAM LEADER Sally Maggard
CONTRIBUTORS We extend a very special thanks to this issue’s guest editor Linda E. Kruger. Kurt Beil, Kelly S. Bricker, Jason Bocarro, Jonathan Casper, Karina Christiansen, Daniel L. Dustin, Michael Edwards, Myron Floyd, Joel Gittelsohn, Sue Goodwin, Preety Gadhoke, Karla A. Henderson, Debra Kollock, Linda E. Kruger, Akihiko Michimi, Sara Newman, Marla Pardilla, Megan Rowan, Jeremy R. Schultz, Keri A. Schwab, Bonny Specker, Michael Wimberly, and Patricia L. Winter IMAGES istockphoto.com Contributors
The Western Rural Development Center compiles this magazine with submissions from university faculty, researchers, agencies and organizations from throughout the Western region and nation. We make every attempt to provide valuable and informative items of interest to our stakeholders. The views and opinions expressed by these agencies/organizations are not necessarily those of the WRDC. The WRDC is not responsible for the content of these submitted materials or their respective websites and their inclusion in the magazine does not imply WRDC endorsement of that agency/organization/program. This material is based upon work supported by annual base funding through the National Institute of Food and Agriculture, U.S. Department of Agriculture. Any opinions, findings, conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect the views of the U.S. Department of Agriculture.
Printed on post-consumer recycled paper.
Table of Contents 5
7
38
15
11
43
21 47
33
29
3
From the Director Don E. Albrecht
5
INTRODUCTION Working Upstream: Focusing Attention on Health and Other Benefits of Nature Linda E. Kruger
7
The Forest as Nature’s Health Service Linda E. Kruger
11
Mental Health Outdoors: The Benefits of Nature Kurt Beil
15
Rural Health and Rural Landscapes: An Ecological Approach to the Study of Obesity Michael Wimberly, Akihiko Michimi, and Bonny Specker
21
The Obesity Research Prevention and Evaluation of Intervention Effectiveness in Native North Americans (OPREVENT) Joel Gittelsohn, Marla Pardilla, Preety Gadhoke, Megan Rowan, Karina Christiansen, and Sara Newman
29
Poverty Reduction Project Increases Social and Natural Capital Debra Kollock
33
Investigating Places for Active Recreation in Rural North Carolina Communities Karla A. Henderson, Michael Edwards, Jonathan Casper, Jason Bocarro, and Myron Floyd
38
Health, Economy and Community: USDA Forest Service Managers’ Perspectives on Sustainable Outdoor Recreation Kelly S. Bricker, Patricia L. Winter, and Jeremy R. Schultz
43
Community Recreation and Healthy Living in Rural Settings Sue Goodwin
47
Thermus aquaticus and You: Biodiversity, Human Health and the Interpretive Challenge Daniel L. Dustin, Keri A. Schwab, and Kelly S. Bricker
Sept. 2010 Rural Connections
From the Director M
illions of Americans enjoy a standard
significant implications that include much
retain their funding even during economic downturns when budgets become tight.
of living that previous generations and
higher rates of diabetes and other chronic
people living in other parts of the world
illnesses, reduced worker productivity, more
only dream of. To a large extent, hunger in
absences from work and school, more pain
One of the great advantages of living in
America has been eliminated. Americans are
and suffering for individuals and families,
the West in general and the rural West
spending smaller proportions of their income
and a reduced quality of life. Linda Kruger
in
on food than at any time in the past and less
and the other contributors to this issue
environment. Individuals and families will
than any other nation in the world. Advances
argue
levels
benefit extensively by spending more time
in health care are astonishing. Yet, health
of physical activity and more contact with
with nature and less time with TV and video
and wellness are becoming issues of growing
nature could be a solution to many of these
games. Additionally, when visiting nature, it
concern. Unfortunately, it seems that many
problems.
is important to follow the advice of Edward
convincingly
that
increased
Americans are translating high incomes and
3
particular
is
the
fabulous
natural
Abbey and get out of the car and really
material comforts into sedentary lifestyles
The mission of the Western Rural Development
discover the natural world. The articles in
and food consumption patterns that are
Center is to improve the quality of life for the
this issue do an excellent job of describing
resulting in steadily growing rates of both
residents of the rural West. At the center, we
why this is important and how to do it.
physical and mental health problems. As a
spend a great deal of time seeking to improve
consequence, as noted by Linda Kruger, our
economic and employment opportunities in
guest editor for this volume, 17.3 percent
rural communities. However, improved health
of the total economic output in the United
and wellness are a critical aspect of rural
States went for health care in 2009 and
development. As such, we encourage federal,
this proportion has been steadily growing.
state and local governments, and the private
In fact, it seems that for the first time in
sector to provide opportunities and develop
U.S. history, the average life expectancy for
programs that encourage individuals and
the average American is likely to decrease.
families to make physical activity and contact
In particular, skyrocketing rates of obesity
with nature a regular part of their lives. It is
among both adults and children are having
vital that parks remain open and programs
Rural Connections Sept. 2010
Don E. Albrecht is the director of the Western Rural Development Center. He may be reached via email to don.albrecht@usu.edu or by calling 435.797.9732.
From the Director
Sept. 2010 Rural Connections
4
Introduction
Working Upstream: Focusing Attention on Health and Other Benefits of Nature By Linda E. Kruger Having enjoyed camping with my family while
recommends translation of scientific findings
for understanding the influences of obesity
growing up on a farm in Michigan, then
into community and school practices to
in rural areas and outline a study that maps
working as a state park ranger in Michigan
protect the health of people where they live,
and analyzes patterns of obesity and risk
and later in Alaska, and now completing
work, learn, and play. The articles included
factors across the United States. Gittelsohn,
my 20th year doing research on recreation
in this issue of Rural Connections respond
et
and communities, I have a very personal
to this call by the CDC. I appreciate the
introducing us to the Obesity Research
interest in what is happening in outdoor
Western Rural Development Center’s interest
Prevention and Evaluation of Intervention
recreation. It is frightening! I am also very
in this topic and their invitation to be
Effectiveness
concerned about our country’s declining
guest editor for this issue. I’d also like to
(OPREVENT), an ongoing study of research,
health conditions and escalating health care
thank the contributors who have made this
prevention, and intervention effectiveness in
costs.
issue of Rural Connections so diverse and
six American Indian tribal communities in
comprehensive.
Michigan and New Mexico.
al.
focus
even
in
more
Native
specifically
North
by
Americans
Budgets for many local and state park and
been
In the first article I summarize the many
Next, Debra Kollock, a Washington State
substantially reduced. Signs that say “Park
recreation
reasons I agree wholeheartedly with the
University County Extension Director, touches
closed
due
to
departments budget
have
are
Forestry Commission of England that forests
on prevention of childhood obesity while
springing up across the country. At the same
reductions”
are “Nature’s Health Service.” From physical
drawing attention to the improved natural,
time, we are spending an ever increasing
and
social
amount of money on health care with
injuries, and even cancer, spending time in
from a community clean-up and community
17.3 percent of the total economic output
nature has been shown to improve health
garden. Both activities brought people in the
in the U.S. going to health care in 2009,
conditions, and time spent together in nature,
community together and engaged them in
up from 14 percent in 2008, and forecast
can build community capacity while improving
outdoor activities. Kollock finds that youth
to be 20 percent in 2011. That is one in
the individual health of participants. Other
are learning about the environment while
five dollars! This is happening at the same
articles in this issue cover these topics in
gaining
time that research is identifying a variety
much more depth.
break the cycle of childhood obesity and
mental
health
disorders
to
stress,
of mental and physical health benefits that
and
human
“skills
diabetes.”
and
capital
that
knowledge
resulted
that
will
Henderson and her colleagues
can be experienced from beneficial contact
In
a
at North Carolina State University and Texas
with nature. Beneficial contact ranges from
professor of Environmental Medicine, and
A&M University report on IPARC—a North
wilderness therapy, to benefits of hospital,
practitioner of naturopathic and Chinese
Carolina State University initiative to explore
school,
and
community
gardens,
the
second
article
Dr.
Kurt
Beil,
urban
medicine in Portland, Oregon, explores the
and measure the ways communities promote
nature centers and neighborhood parks, and
positive effects of nature on mental health,
physical activity. They report on findings from
includes something as simple as a walk in
mental
and
a survey of Parks and Recreation Directors
a forest. Healthy people and healthy forests
stress reduction. Beil also discusses the
in North Carolina that provide a baseline for
and healthy recreation programs depend on
benefits of nature for recovery from mentally
facilitating promotion of physical activity in
each other.
and physically stressful situations including
community settings.
activity,
cognitive
attention,
surgery and post-traumatic stress disorder
5
In support of upstream efforts that motivate
(PTSD). The next two articles draw our
Bricker et al. discuss the results from a
people to stay healthy the Centers for
attention to obesity—now a global pandemic.
study of Forest Service recreation managers.
Disease
Wimberly, et al. develop a conceptual model
The study found 90 percent agreement that
Control
and
Rural Connections Sept. 2010
Prevention
(2009)
Working Upstream: Focusing Attention on Health...
Forest Service managed lands increase the
relationship
quality of life for surrounding communities.
outdoor physical activity is equally important
complex
Respondents identified a connection between
for rural and urban youth.”
interdependencies, make environment-health
healthy recreation
communities on
Forest
and Service
with
nature
and
increasing
sustainable
employ creative approaches…that illustrate ecological
interrelationships
and
connections explicit, and motivate us to get
managed
Finally, Daniel Dustin and his colleagues at
back to nature, learn from nature, and live
lands. In her article, Sue Goodwin dispels
the University of Utah draw our attention
our lives in harmony with nature.” I hope
the myth that rural children inherently have
to the importance of understanding the
this issue of Rural Connections gets us all
a healthy relationship with nature and the
broad benefits of nature by taking us on
moving in that direction.
outdoors. She suggests that with increasing
a trip to Yellowstone National Park and
demands on parents in both rural and
providing a history of the discovery of DNA
urban environments “developing a positive
matching. To echo these authors “we must
Sept. 2010 Rural Connections
6
“The function of protecting and developing health must rank even above that of restoring it when it is impaired.” Hippocrates
W
hile we rarely talk about it, I suggest that caring for the land and serving
people, long a Forest Service motto, includes being a provider of health benefits. I think I have found support in one of the guiding
The
principles of sustainability—to contribute to a healthy population. I believe the economic
Forest as Nature’s
Health Service By Linda E. Kruger
return
on
nature
and
wild
places,
by
increasing wellness and quality of life, has the capacity to reduce health care costs. Agencies are talking about planning for and implementing sustainable recreation. I hope these discussions include attention to the health benefits of spending time in nature, because delivering health benefits contributes to a healthy future for both people and the natural landscape. Emphasizing the health benefits of forests, parks, and open space is one way to draw attention to the importance of access to these vital resources. Recreation providers and land managers need to join with health care and medical professionals in encouraging people to spend more time in nature. This is what Professor John Crompton (2008) referred to as “joined up thinking.” Spending time in forests can improve physical, psychological, and social well-being (Maller et al., 2008). I’m also borrowing from the Forestry Commission of England who suggested that we start thinking in terms of trees and woodlands as “Nature’s Health Service.” Sustaining
health
requires
effective
medical approaches coupled with healthy environments and lifestyles.
A Presidential
Proclamation (June 1, 2009) to kick off America’s Great Outdoors Month stated: “Exploring the great outdoors can also help improve one’s health. These spaces provide 7
Rural Connections Sept. 2010
The Forest as Nature’s Health Service
countless venues for walking, hiking, running,
poor nutrition, and tobacco and alcohol
to disease worldwide by 2020 (Murray and
swimming and boating among other activities.
use play a role in these diseases. Physical
Lopez, 1996).
Americans can combine the enjoyment of
activity is directly related to recreation and
being outside with the exercise we all need
spending time in nature; spending time in
Increasing
diagnoses
to stay healthy.”
nature also has benefits for reducing the
disorder
(ADD)
use and abuse of tobacco, alcohol and
hyperactivity
other drugs.
causing concern. Over two million youth
In addition to facilitating healthy lifestyles and improving mental and physical health,
and
disorder
of
attention-deficit attention-deficit-
(ADHD)
are
also
have been diagnosed with ADD/ADHD in the
other benefits of leisure (including recreation
The World Health Organization predicts that
U.S. There has recently been an explosion in
and tourism) are community regeneration,
diabetes will rise 50 percent in the next
diagnosis of adult ADHD with approximately
cultural and historic preservation, achieving
decade, with diabetes deaths doubling in
four million adults diagnosed (Kessler, 2006).
higher
the next ten years (WHO, 2010). Obesity,
Research has shown that spending even a
an
is
little time in nature reduces symptoms of
unemployment distress, fostering friendships
skyrocketing globally. In a pre-emptive strike
ADHD and “could be a lifesaver for the
and a sense of belonging and connectedness
many employers are implementing health
ten percent of children whose symptoms
(Crompton, 2008), and reducing effects of
initiatives for their employees, and as a
don’t respond to medication” (Kuo & Taylor,
Post Traumatic Stress Disorder (Maller et
result saving millions of dollars in lost work
2004). Nature is important for both adults
al., 2008).
time, productivity and health care costs.
and children with ADD/ADHD. Activity in
levels
alleviating
of
deviant
educational
attainment,
behavior,
alleviating
underlying
cause
of
diabetes,
nature can give those with ADD or ADHD the Nature
plays
role
in
the
Obesity is not the only health issue we face.
ability to manage their symptoms without
According
to
the
According to the American Institute of Stress
addictions or troublesome side effects (and
Centers for Disease Control and Prevention
(2008) over 43 percent of U.S. adults have
costs) of prescription medications (Hallowell
(CDC) (2009) the public health challenge of
adverse health conditions due to stress. The
& Ratey, 2005; Kuo and Taylor, 2004).
the 21st century is chronic disease, resulting
same report estimated 75 percent of visits
Hallowell and Ratey (2005) suggest that
in seven of ten deaths among Americans. In
to primary care physicians are stress related.
regular walks in nature can be as effective
2005, one out of two adults had at least
Stress puts people at risk for colds, heart
as medications for some people. People with
one chronic illness with 25 percent limiting
attacks, cancer, obesity, high blood pressure,
ADD report that being in nature increases
daily activity. Mental health and chronic
and elevated heart rates. Furthermore, stress
their
disease are closely related, with chronic
can reduce blood flow to the heart, cause
researchers suggest spending time in nature
disease leading to impaired mental health
migraines,
chronic
is necessary for optimal levels of attentional
including depression; and impaired mental
fatigue, increase receptiveness to allergies,
functioning for all children and adults (Kuo
condition leading to other chronic health
suppresses immune system function, and
& Taylor 2004; Taylor et al., 2001). Studies
issues in a vicious circle that can be hard
lead to hormonal imbalances that increase
of children with ADHD have shown that they
to escape from.
production
prevention
an
of
important
illness.
rheumatoid
of
arthritis,
abnormal
cells
focus
(Honos-Webb,
2008)
and
(Godbey,
may perform better throughout the day if
2009). Here again, spending time in nature
they take “green breaks” and spend time
The top three causes of death in the Unites
can make a positive contribution by lowering
in a natural environment (Taylor et al.,
States are cancer, heart disease, and stroke.
stress.
2001). This may hold true for all children
Obesity, a common contributor to disease,
… and adults as well. For children with
can be an underlying factor for each of
“Empirical,
theoretical,
and
anecdotal
ADHD being outdoors every day significantly
these conditions. Between 1991 and 2001
evidence demonstrates that contact with
reduced their ADHD symptoms, with green
obesity increased 75 percent among adults.
nature positively affects blood pressure,
outdoor activity more effective in reducing
Today, one in three adults is obese and one
cholesterol, outlook on life, stress reduction,
symptoms that other settings across age,
in five young people between the ages of 6
and behavioral problems among children”
gender, income, community type, geographic
and19 are obese. If current trends continue
(Godbey, 2009). This is important because
region, and diagnosis (Kuo & Taylor 2004).
one in three Americans born in 2000 will
mental health and cardiovascular disease
Nature areas near schools and housing
develop diabetes. Lack of physical activity,
are expected to be the biggest contributors
developments have been found to foster
Sept. 2010 Rural Connections
8
The Forest as Nature’s Health Service
resilience of children and promote healthy
Spending time in nature may also have
Walking recalibrates energy/fat storage so
development (Wells & Evans, 2003).
positive
the body becomes more efficient and trim.
and For
many
explosion
adults
fast
technology
pace
diabetes,
musculoskeletal
asthma,
conditions,
Walking helps the kidneys, lymphatic system,
other
maintains joints, and diminishes some types Duke University in 1999 found that a brisk
concentrating, being distracted easily by
leisurely visit to a forest providing a natural
30-minute walk three times a week was more
unimportant stimuli, feeling driven by a
aromatherapy session. A Japanese study (Li,
effective in reducing depression symptoms
motor, impulsiveness, prone to jump into
2009) involved both men and women in a
than Zoloft alone or a combination of Zoloft
a project without following directions, likely
three-day, two-night trip to a forest where
and walking, and walkers were less likely to
to mix up the order and sequence of well-
participants took short walks each of these
have a recurrence of depression (Hartmann,
defined tasks, disorganized, struggle paying
days. Blood and urine were sampled on
2006).
attention in work and recreation (Honos-
days two, three, seven and thirty. Adrenaline
In closing, linking leisure and recreation to
Webb, 2008). The natural environment can
was measured in the urine and natural killer
health and wellness helps shift our attention
provide a buffer from everyday impacts
(NK) cells were measured in the blood. The
to “upstream” efforts to prevent ill health
of life stresses—having a variable impact
increase in NK cells lasted more than thirty
rather than only working “downstream” on
depending on level of nature exposure.
days suggesting that trips in nature once a
rescue and care of people already suffering
month could provide maintenance levels of
illness (Maller et al., 2008). Much of the
In their review of literature documenting
NK cells which release anticancer proteins
literature reviewed suggests that outdoor
the health benefits of contact with nature
into the blood that work to prevent cancer
nature-based activity deserves a position
in parks, Maller et. al. (2008) stressed the
generation and development. Researchers
both upstream as part of disease prevention
need for additional information describing
suggest that breathing in wood essential oils
and downstream as part of rehabilitation
the vital role that access to nature plays
with antimicrobial compounds while walking
and recovery. We frequently hear about
in
These
through the forest results in relaxation
the importance of a healthy diet and daily
authors
suggested
and a
well-being. link
between
including
arthritis,
and
of arthritis (Hartmann, 2006). Research at
human-health
maladies,
prevention
Japan,
like
resulted
control,
injury
Shinrinyoku or forest bathing is a short,
ADHD/ADD
has
and
for
symptoms—difficulty
in
of
the
benefits
cancer.
In
loss
and improves stress management resulting
physical activity. Two additional pillars of
of contact with nature and alcohol, food
in significantly increased vigor, decreased
health worthy of more attention are daily
and drug addictions and then referred to
anxiety,
may
activity that connects us to nature and
nature as “a fundamental health resource,
decrease the risk of psychosocial stress
social interaction with others. Together these
particularly in terms of disease prevention.”
related diseases (Li, 2009).
four pillars provide a stable foundation for
depression,
anger
–
and
Studies included in the review document
improved physical, psychological, emotional
the positive effects of nature on blood
People who walk 15-30 minutes a day
and social health and wellbeing, increased
pressure, cholesterol, outlook on life and
are
interest in nature, and increased community
stress (Maller et al., 2008). Studies in Japan,
they have fewer diseases, are less likely
engagement,
Scandinavia
have
to get cancer, have a lower risk of heart
community
documented links between spending time in
attack and stroke, and better bone density
at work and school, and lower health care
nature and longevity and decreased risk of
(DeYoung, 2009). Walking improves digestion
costs (See Figure 1).
mental illness (Takano et al., 2002; DeVries
and decreases the risk of intestinal cancer,
et al., 2003; Grahn & Stigsdotter, 2003).
reduces
and
the
Netherlands
healthier
risk
than
of
people
Type
II
who
don’t—
Diabetes,
and
reduces insulin dependency of diabetics.
9
Rural Connections Sept. 2010
resulting capacity,
in
higher
increased performance
The Forest as Nature’s Health Service
About the Author Linda E. Kruger is a research social scientist with the U.S. Forest Service, Pacific Northwest Research Station, Juneau Forestry Sciences Lab.
References
American Institute of Stress. (2008). America’s No. 1 Health Problem. http://www.stress.org/about. htm. Centers for Disease Control and Prevention. (2009). The Power of prevention: Chronic disease…the public health challenge of the 21st century. Downloaded from http://www.cdc.gov/ chronicdisease/resources/publications/ Crompton, J.L. (2008). Empirical evidence of the contributions of leisure services to alleviating social problems: a key to repositioning the leisure services field. World Leisure 4: 243-258. De Vries, S. R. Verheij, H. Groenewegen, and P. Spreeuwenberg. (2003). Natural environments— Healthy environments? An exploratory analysis of the relationship between green space and health. Environment and Planning 35(10): 1717-31. DeYoung, R. (2009). Coping with environmental transitions: Some attentional benefits of walking in natural settings. Ecophsycology (2):1: 1-10. Godbey, G. (2009). Outdoor recreation, health, and wellness: understanding and enhancing the relationship. Prepared for the Outdoor Resources Review Group, Resources for the Future. 42 pages. Grahn, P. and U.A. Stigsdotter. (2003). Landscape planning and stress. Urban Forestry & Urban Greening 2: 1-18.
Honos-Webb, L. (2008). The gift of adult ADD: how to transform your challenges and build on your strengths. Oakland, CA: New Harbinger Publishers, Inc. 230 pages. Kessler, R.C. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. American Journal of Psychiatry 163: 716-723. Kuo, F. and W. Sullivan. (2001). Aggression and violence in the inner city: Effects of environment via mental fatigue. Environment and Behavior 33(4): 543-71. Kuo, F. and A. Taylor. (2004). A potential natural treatment for Attention-Deficit-Hyperactivity Disorder: evidence form a national study. American Journal of Public Health 94 (9): 158086. Li, Qing. (2009). Effect of forest bathing trips on human immune function. Environmental Health and Preventive Medicine vol. 15 (1):9-17. Maller, C.; M. Townsend; L. St. Leger; C. Henderson-Wilson; A. Pryor; L. Prosser; M. Moore. (2008). Healthy parks, healthy people: the health benefits of contact with nature in a park context. Burwood, Melbourne, Australia: Deakin University and Parks Victoria. 96 pages.
Murray, C.J.L. and A.D. Lopez. (1996). The global burden of disease: a comprehensive assessment of mortality and disability from disease, injuries, and risk factors in 1990 and projected to 2020-summary. Geneva: The World Health Organization, The World Bank, and The Harvard School of Public Health. OPM. (2010). April 7, 2010 Annual call letter for benefit and rate proposals. Accessed April 20, 2010. http://www.myfederalretirement.com. Taylor, A.F., Kuo, F.E. and Sullivan, W.C. (2001). Coping with ADD: The surprising connection to green play settings. Environment and Behavior 33 (1): 54-77. USDA (2009). Agriculture Secretary Vilsack presents national vision for America’s Forests www.usda.gov/wps/portal/usda/!ut/p/c5/ldC9. Accessed April 20, 2010. Wells, N.M. and G.W. Evans. (2003). Nearby nature: a buffer of life stress among rural children. Environment and Behavior 35(3): 311330. World Health Organization (WHO) (2010). http:// www.who.int/diabetes/en/. Accessed June 1, 2010.
Mowen, A.J. and B.L. Baker. (2009). Parks, recreation, fitness, and sport sector recommendations for a more physically active America: A white paper for the United States National Physical Activity Plan. Journal of Physical Activity and Health 6(suppl2) S236-244. Accessed April 20, 2010.
Hartmann. T. (2006). Walking your blues away: How to heal the mind and create emotional wellbeing. Rochester, VT: Park St. Press. 102 pages. Hallowell, E.M. and J.J. Ratey. (2005). Delivered from distraction: Getting the most out of life with Attention Deficit Disorder. New York: Random House. 379 pages.
Figure 1. A solid foundation for health and well-being and engaged communities.
Sept. 2010 Rural Connections
10
Mental Health Outdoors: The Benefits of Nature By Kurt Beil
E
very year, the U.S. Centers for Disease Control and Prevention (CDC) conduct a national survey to assess the health of the country. In
2007, this survey (known as the Behavioral Risk Factor Surveillance System, or BRFSS) revealed a surprising fact: living in a rural area decreased the risk of suffering from psychological disturbance by 17 percent, compared to the risk for urban residents. (Dhingra et al., 2009; See Figure 1). Studies of other mental health conditions such as depression have shown similar results when comparing rural and urban living (Paykel et al., 2000).
11
Rural Connections Sept. 2010
Mental Health Outdoors
Enviro-Mental Health and Biophilia
While this awareness of the ability of nature
This mirrors many other studies that show
The contributing factors for mental health
to effect changes in mental health status
similar emotional responses and suggests
concerns
is not new, it is only recently that science
that there is something inherent about a
has
positive emotional response to nature.
despite
are
multiple
accounting
for
and
varied.
genetic,
Yet
socio-
investigated
this
phenomenon.
The
economic and behavioral influences, rural
majority of investigation has occurred in
residents still demonstrate greater mental
response to Harvard biologist and author
Mental Restoration and Health
health (on average) than city dwellers. One
E.O. Wilson’s suggestion that human beings
The ability of nature to positively impact mental
explanation for this finding that is slowly
have an evolutionarily inherited affinity for
health is supported by two complementary
gaining recognition is the importance of
natural places (1984). This affinity, known
theories that utilize biophilia as a guiding
the physical environment itself in shaping
as “Biophilia,” draws us to places that
principle. One theory, advocated by Stephen
mental health (Lundberg, 1998). While the
are similar to the pristine savannahs and
and Rachel Kaplan of the University of
field of “environmental psychology” is broad,
forests in which our genetic ancestors lived
Michigan, suggests that natural environments
this article will focus on one aspect in
for millennia.
decrease
particular that has relevance to the rural/
hypothesis, we are not only psychologically
mental fatigue. This “Attention Restoration
urban disparity in mental health: the natural
attracted to such places, but are also
Theory” (ART) proposes that our minds
environment.
physiologically
respond
are evolutionarily adapted to cognitively
According to the biophilia
programmed
to
our
minds’
tendency
toward
favorably to them. These natural places are
process the stimuli provided by the natural
The claim that exposure to the natural
our environmental “set-point” to which we
environment of our ancestors (Kaplan, 1995).
environment can be beneficial to mental
are conditioned to favorably respond.
In contrast, modern industrialized settings
health is neither surprising nor new. For
provide environmental stimuli that require
centuries poets and writers have extolled the
The evidence seems to support Wilson’s
more mental effort to process. The moving
virtues of nature and its ability to soothe
biophilia hypothesis: people are measurably
cars, electronic billboards and construction
the psyche and inspire the soul. Anyone that
happier after contact with the natural world,
sounds that are synonymous with urban
has ever been outside of a city instantly
particularly when compared to urban settings.
development decrease our mental capacity
recognizes these benefits from their own
In one study, measures of positive affect (i.e.
for cognitive attention and, ultimately, erode
lived experience. There is a “natural” ability
positive emotions such as happiness and joy)
our mental health. These concepts have been
of landscapes to soften the heart, relax the
improved significantly upon taking a walk in
demonstrated experimentally in the study by
mind and help a person feel connected to
a lightly forested area, while walking in an
Hartig et al. (2003): Cognitive attention and
something larger than themselves. All of
area of light suburban development had the
task performance were affected by exposure
these experiences are properties of good
opposite impact (Hartig et al., 2003; See
to nature and urban environments in a
mental health.
Figure 2). Inverse responses were noted with
manner similar to emotions.
regard to sadness, anger, and aggression.
Figure 1. Prevalence of mild and serious psychological disturbance in urban (grey) and rural (white) populations in the U.S. (Dhingra et al., 2009).
Figure 2. Positive Effect Measures.
Sept. 2010 Rural Connections
12
Mental Health Outdoors
Cognitive attention is one of the basic
known as “stress.” The stress response is a
of chronic stress on mental health. For
aspects
a
set of physiological reactions that occur in
example, people that walked regularly in a
determining
response to perceived threats to an individual’s
forest were found to have greatly improved
mental health status. This is most evident
well-being. These threats can be real or
mood, less anxiety and depression, and less
in the mental health condition known as
imagined, and may even be undetectable
production of the “stress hormone” cortisol
Attention Deficit Hyperactivity Disorder, or
to a person’s conscious awareness. Through
than people that walked in an area of light
ADHD. This condition is very prevalent in
complex processes in the body and brain
suburban development (Morita et al., 2007;
today’s population, particularly in children,
(known in the medical field as “Psycho-
Park et al., 2010). A new study from the
and
that
neuro-endocrino-immunology”, or PNEI) the
Netherlands has shown that the presence of
environmental stimuli play some role in
accumulated effects of stress can have
nature within close proximity to a person’s
the lack of cognitive attention in affected
many negative impacts on mental health.1
home has a buffering effect on how stress
individuals. Children diagnosed with ADHD
The PNEI effects on neurotransmitters and
impacts mental health status (van den Berg
have significant reductions in symptoms when
other hormones that affect brain function
et al., 2010).
exposed to natural outdoor environments.
have been definitively shown to contribute
This is particularly true when compared
to depression, anxiety, schizophrenia, and
Exposure to nature can also aid in mental
with children exposed to typical urban or
other mental health conditions (Goodkin &
recovery from acutely stressful situations,
suburban
Visser, 2000).
as
of
mental
fundamental
evidence
activity,
process
supports
environments,
and
in
the
in
idea
keeping
is
with
by
Roger
Ulrich
and
colleagues in a set of now-classic nature
the tenets of ART. These reductions have been measured for long-term exposure to
Stress comes from a variety of sources,
and stress studies (1984, 1991). In one
nature; such as the finding that changing
and
particular
study, post-surgery patients were found to
the amount of nature around a child’s
environmental
especially
recover more quickly and with fewer stress-
home resulted in corresponding changes in
problematic. The traffic, lights and noise of
related complications when their hospital
ADHD symptoms (Wells, 2000). Short-term
the city are constant low-grade stressors
room overlooked a wooded park than when
exposures to nature have also proven to
that have demonstrable effects on mental
it overlooked another wing of the hospital.
be beneficial in reducing ADHD symptoms
health
In
The second study measured physical and
(Faber-Taylor & Kuo, 2009). Researchers
contrast, the stimuli that we encounter in
mental stress after an acutely stressful
have noted the numerous other benefits that
nature are typically relaxing and help us to
situation, and found that people that were
exposure to nature has on children, including
slow down and “de-stress.” This is exactly
exposed
improvements
performance,
why many people chose to live away from
superior recovery times. This information
social skill development and creative thinking
busy urban centers and why many urban
has been useful in developing treatment
ability. Author and journalist Richard Louv
residents choose to take their vacations in
for a number of mental health conditions,
has summarized these benefits in his 2005
the mountains or on the beach. The calm,
including treatment for post-traumatic stress
book “Last Child in the Woods: Saving Our
vibrant scenery of natural landscapes helps
disorder, or PTSD (Ottosson & Grahn, 2008).
Children from Nature-Deficit Disorder.”
people relax and recover from the stresses
PTSD is particularly responsive to this type of
of daily life. It feels healthy and natural to
“ecotherapy” because it reduces a person’s
be in such places.
level of stress while providing a stable, non-
in
academic
Stress-Reduction and Mental Health
for
urban
residents stresses
(Freeman
&
in
are
Stansfeld,
1998).
to
natural
scenery
had
vastly
threatening context that can be returned to
The other theory of how biophilia and
13
demonstrated
urbanization contribute to mental health and
The
natural
multiple times for cumulative benefit. Even
illness is based on an understanding of the
environments
preventive
when vast expanses of natural landscape
set of psychosomatic processes commonly
agent to guard against the negative effects
are unavailable, small vegetable or flower
Rural Connections Sept. 2010
stress-reducing can
capacity act
as
a
of
Mental Health Outdoors
gardens can provide enough stress-reducing
advocates for a holistic approach to health
nature exposure to create a therapeutic
for both people and planet.
experience for people in need (Applebome,
Morita E, Fukuda S, Nagano J, Hamajima N, Yamamoto H, Iwai Y, Nakashima T, Ohira H, Shirakawa T. (2007). Psychological effects of forest environments on healthy adults: Shinrinyoku (forest-air bathing, walking) as a possible method of stress reduction. Public Health. 121(1):54-63.
ENDNOTES
2009).
1
The physical impacts of stress are also
Protection of Nature
numerous and are thought to cost hundreds
The information
of billions of dollars annually through worker
evidence
that
in this article provides direct
contact
with
the
absenteeism and contribution to healthcare
natural world is beneficial for mental health.
conditions such as heart disease, high blood
While this evidence matches most peoples
pressure, obesity, and diabetes.
directly lived experience, the implications of such have not yet been considered in applicable
areas
such
as
environmental
resource management, land use policy or public health modeling. As urban, suburban, and rural development continue, it will be useful to consider what effects the presence or absence of natural environments have on the long term health and well-being of potentially affected populations. Particularly at a time when environmental degradation and biodiversity loss are increasing at an accelerating pace, an examination of the reciprocal relationship between the health of human beings and the health of the environment seems appropriate. The natural world provides us with more than the physical means to maintain life; it gives us the visual and experiential resources we need to make that life worth living.
About the Author Kurt
Beil
is
professor
of
Environmental
Medicine at the National College of Natural Medicine in Portland, Oregon, where he sees and treats patients using a combination of
naturopathic
and
Chinese
medicine
techniques. He is also a public health consultant on the topic of green spaces for
sustainable
urban
development,
and
Lundberg, A. (ed) (1998). The Environment and Mental Health: A Guide for Clinicians. New Jersey: Lawrence Erlbaum Associates.
References
Applebome, P. (2009). After War, Finding Peace and Calm in a Garden. New York Times. 11/29/09. Retrieved from http://www.nytimes.com/2009/11/30/ nyregion/30towns.html?_r=2&emc=eta1 Dhingra S, Strine T, Holt J, Berry J, Mokdad A. (2009). Rural-urban variations in psychological distress: findings from the Behavioral Risk Factor Surveillance System, 2007. Int J Pub Health. 54(51):16-22. Faber-Taylor, A., Kuo, F. (2009). Children With Attention Deficits Concentrate Better After Walk in the Park. Journal of Attention Disorders. 12(5):402-9. Freeman, H., Stansfeld, S. (2005). Psychosocial Effects of Urban Environments, Noise and Crowding. In Lundberg (ed). The Environment and Mental Health: A Guide for Clinicians. Lawrence Erlbaum Associates, New Jersey. Goodkin, K., Visser, A. (2000). Psychoneuroimmunology: Stress, Mental Disorders, and Health. American Psychiatric Press, Progress in Psychiatry Number 59, Washington, DC. Hartig T, Evans G, Jamner L, Davis D, Gärling T (2003). Tracking restoration in natural and urban field settings. Journal of Environmental Psychology. 23(2):109-123. Kaplan, S. (1995). The restorative benefits of nature: Toward an integrative framework. Journal of Environmental Psychology. 15(3):169-182.
Ottosson J, Grahn P. (2008). The role of natural settings in crisis rehabilitation: how does the level of crisis influence the response to experiences of nature with regard to measures of rehabilitation? Landscape Research. 33(1):51-70. Park B, Tsunetsugu Y, Kasetani T, Kagawa T, Miyazaki Y. (2010). The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environmental Health and Preventive Medicine. 15(1)18-26. Paykel, E., Abbott, R., Jenkins, R., Brugha, T., Meltzer, H. (2000). Urban–rural mental health differences in Great Britain: findings from the National Morbidity Survey. Psychological Medicine. 30(2):269-280. Ulrich, R. (1984). View through a window may influence recovery from surgery. Science. 224(4647): 420-421. Ulrich RS, Simons R, Losito BD, Fiorito E, Miles M, Zelson M. (1991). Stress recovery during exposure to natural and urban environments. Journal of Environmental Psychology. van den Berg A, Maas J, Verheij RA, Groenewegen PP. (2010). Green space as a buffer between stressful life events and health. Social Science & Medicine. 70(8):1203-1210. Wells, N. (2000). At home with nature: effects of” greenness” on children’s cognitive functioning. Environment and Behavior. 32(6):775-95. Wilson, Edward O. (1984). Biophilia. Cambridge: Harvard University Press.
Louv, R. (2005). Last Child in the Woods: Saving Our Children From Nature-Deficit Disorder. New York: Algonquin Books of Chapel Hill.
Sept. 2010 Rural Connections
14
Rural Health and
Rural Landscapes:
An Ecological Approach to the Study of Obesity By Michael Wimberly, Akihiko Michimi, and Bonny Specker
15
Rural Connections Sept. 2010
Rural Health and Rural Landscapes
T
he
obesity
still largely based on research conducted
implications for studying obesity in rural
global
in urban and suburban environments. In
landscapes. Finally, we present an overview
pandemic, and has been linked to a wide
contrast, our understanding of the spatial
of a recent study that mapped and analyzed
range of chronic diseases including Type 2
patterns and determinants of obesity within
geographic patterns of obesity and associated
Diabetes, hypertension, breast cancer, gall-
rural areas is based on far fewer studies. In
risk factors within the conterminous U.S.
bladder disease, asthma, and depression.
the 2000 Census, rural areas encompassed
We discuss how this type of ecologically
The causes of obesity are multifaceted, and
more than 97 percent of the total U.S.
focused, spatially explicit research can lead
are related to individual-level factors such as
land area and were home to 59 million
to novel insights about the characteristics
age, gender, and education as well as area-
people (21 percent of the U.S. population).
of rural obesogenic environments, and we
level factors that determine the environments
Given the uniqueness and diversity of rural
address the implications for future research
in
efforts and public health applications.
is
increasing now
which
prevalence
considered
people
live.
to
In
of
be
a
the
environments, it is not possible to generalize
development of obesogenic environments
findings from studies focused on cities
is hypothesized to increase the risk of
and suburbs. Instead, novel perspectives
Conceptual Model
obesity by discouraging physical activity,
and approaches are needed to elucidate
Most research on obesogenic environments
increasing
consumption
of
particular,
energy-dense
the environmental determinants of obesity
has examined populations living in and
foods, and limiting the availability of healthy
in rural areas, and to develop appropriate
around cities, and has focused primarily
foods (Egger & Swinburn, 1997). Obesogenic
strategies for reducing the health burden of
on aspects of the built environment. For
environments can be further dissected based
obesity in these environments.
example,
on the environment type (physical, economic,
suburban
sprawl
may
reduce
physical activity by necessitating automobile
political, and sociocultural) and spatial scale
In this article, we address several topics
use and discouraging walking and bicycling
(micro- and macro-environments) (Swinburn
relevant to the problem of understanding
as means of transportation and recreation
et al., 1999).
obesity
(Leal & Chaix, 2010). Thus, newer suburban
in
rural
environments.
First,
we
outline a conceptual ecological model for
neighborhoods
Although comparisons of rural and urban
understanding the influences of physical,
segregate
populations have frequently found higher
economic, and sociocultural environments
areas should have higher rates of obesity
rates of overweight and obesity in rural
on obesity in rural areas. Next, we examine
compared to more traditional urban mixed-
areas,
existing
use neighborhoods.
our
current
knowledge
of
the
environmental determinants of obesity is
frameworks
for
classifying
rural
that
lack
residential
sidewalks
and
and
commercial
areas and discuss their limitations and the
Sept. 2010 Rural Connections
16
Rural Health and Rural Landscapes
In addition to the physical structure of
minority neighborhoods often have relatively
modeling landscapes (Forman & Godron,
communities, socioeconomic characteristics
low access to supermarkets and other stores
1986).
also
with a wide selection of healthy foods,
increasingly applied in the health sciences,
particularly
mainly in the ecological study of vector-
contribute
obesogenic
to
the
environments
development (Leal
&
of
Chaix,
fresh
fruits
and
vegetables.
and
approaches
zoonotic
are
diseases.
being
2010). Residents of neighborhoods with high
Instead, deprived neighborhoods frequently
borne
levels of material deprivation, as measured
have high concentrations of convenience
similar approaches can also be applied in
by factors such as high unemployment
stores and fast food outlets.
the context of human ecology for studying
and low income, frequently have higher
However,
the environmental determinants of obesity
levels of overweight and obesity than less
Whereas cities and suburbs are dominated
deprived neighborhoods. Several proximal
by the built environment, the character of
environmental
these
rural communities is molded by aspects of
In rural areas, elements of the natural
concerns
the natural environment including climate,
environment including climate, physiography,
about their safety or negative perceptions
vegetation,
idea
and vegetation, exert a strong influence on
of neighborhood aesthetics, then outdoor
of the cultural landscape has long been
the type of land use that is practiced (Figure
physical
recognized as a framework for understanding
1). Land uses can vary widely in rural areas,
the
and
ranging from agriculture and natural resource
relationships.
factors If
may
residents
activity
may
drive
have
be
reduced.
Furthermore, residents of low-income and
terrain,
relationships
and
soils.
between
Figure 1: Conceptual ecological model of rural obesogenic environments.
Rural Connections Sept. 2010
The
humans
their
17
These
and other chronic diseases.
environment
extraction to emerging economies linked to
(Sauer, 1925). The
recreation and outdoor amenities. These
development of the
land uses determine the range of human
field
of
landscape
activities that occur in rural landscapes, and
ecology,
coupled
also shape the socioeconomic status and
with the emergence
demographic structure of the populations
of
that
computerized
inhabit
landscapes.
information systems
economies also affects the culture of rural
(GIS)
populations and influences social norms
has
provided
suite
of
natural
Regional
variability
technology,
in
these
g e o g r a p h i c
environments
and
a
related to food consumption and physical
concepts
activity (Hartley, 2004). Rural areas exhibit
and
techniques
considerable
for
measuring,
patterns of human settlement, ranging from
classifying,
and
variability
in
their
spatial
exurban developments at the fringes of
Rural Health and Rural Landscapes
metropolitan areas to isolated communities
on core counties with dense, urbanized
new approaches for modeling and mapping
located hundreds of miles from a city.
populations, but also incorporate adjacent
relevant environmental variability.
This
increase
counties that have a high degree of social
automobile dependence and limit access
geographic
isolation
may
and economic integration as measured by
Geographic Patterns of Obesity
to health care facilities, sources of healthy
commuting ties. All counties that do not fit this
One way to avoid the subjective nature
foods, and recreational opportunities.
definition are considered nonmetropolitan.
of the urban-rural dichotomy is through
Although metropolitan and nonmetropolitan
exploratory spatial data analysis. Instead of
classifications
as
making comparisons based on an a priori
The word rural evokes a variety of images,
proxies for “urban” versus “rural” counties,
classification, spatial smoothing and clustering
including
landscapes,
both types of counties typically contain
techniques
mosaics of farms and forests, and small
a mixture of urban and rural populations
geographic areas with high and low obesity
towns. However, the classification and study
(Figure 2a, see next page).
prevalence. We recently completed a study
Definitions–What is Rural? sparsely
populated
are
often
interpreted
of specific areas as rural or non-rural
can
be
applied
to
highlight
of the spatial patterns of obesity, physical
requires a more clear-cut definition. The U.S.
A key point of this comparison is that the
activity, and fruit and vegetable consumption
Census Bureau classifies urban and rural
definition of rural is both subjective and
across
areas at the spatial resolution of the census
scale dependent. Furthermore, neither the
(Michimi & Wimberly, 2010). The analysis
block group–an area containing a population
rural nor the nonmetropolitan classification
was based on seven years of national data
of 600-3000 people. Urban areas, including
arises from a specific conceptual model of
from the Behavioral Risk Factors Surveillance
large urbanized areas and smaller urban
rurality. Instead, they both encompass areas
System (BRFSS), an annual survey conducted
clusters, are identified using a complex
that are left over following the classification
by the Centers for Disease Control and
algorithm that takes into account population
of
environments.
Prevention in collaboration with state health
thresholds,
the
Furthermore, the very act of classification
departments. Because of the small sample
spatial arrangement of the population. In
belies the considerable physical and social
sizes in most nonmetropolitan counties, a
contrast, rural areas are the remaining block
heterogeneity
For
spatial smoothing method (weighted head-
groups that do not meet the urban criteria.
all these reasons, simple comparisons of
banging) was used to reduce local variability
obesity in urban versus rural areas are
and elucidate broader geographic trends in
Another commonly-used definition of rural
likely to be of limited utility. Instead, obesity
obesity and associated risk factors (Mungiole
areas
research should focus on identifying specific
et al., 1999).
is
population
based
nonmetropolitan
on
density,
the
county
and
metropolitan/ classification
more
environmental
urbanized
of
rural
landscapes.
characteristics
that
the
conterminous
United
States
are
developed by the U.S. Office of Management
associated with obesity in rural areas. This
The obesity map generated using these
and Budget. Metropolitan areas are centered
knowledge can then be applied to develop
techniques clearly illustrates regional clusters
Sept. 2010 Rural Connections
18
Rural Health and Rural Landscapes
of higher and lower obesity prevalence (Figure
obesity counties in the West and in New
direct influences on physical activity, diet,
2b). Although obesity statistics are frequently
England have a higher proportion of adults
and other risk factors for obesity.
summarized and mapped at the state level,
with a college degree (Figure 2d). A key
these smoothed county-level patterns do not
insight from this visual assessment is that
Connecting these ideas with the ecological
necessarily correspond with state boundaries.
the associations between obesity and the
conceptual model outlined previously (Figure
For example, multi-state regions such as the
environment can be spatially heterogeneous.
1) offers the potential for new perspectives
Mississippi Delta, the Southern Appalachians,
A particular environmental variable may be
and insights into the complex web of factors
and the Piedmont and Coastal Plains of
strongly associated with obesity in some
that affect obesity and other rural health
the southeastern United States emerge as
geographic regions (e.g., poverty in the
problems. For example, over the past several
higher-obesity regions. In contrast, much
Southeast), but not in others.
decades the “recreation county” has emerged
of the interior West along with portions of
as a unique type of non-metropolitan area
the upper Midwest and New England have
Previous research has focused on identifying
(Johnson & Beale, 2002). These are defined
lower obesity prevalence. These geographic
environmental determinants of obesity at
as counties that have high concentrations
patterns of obesity are negatively correlated
the scale of neighborhoods, or “micro-
of outdoor recreational amenities such as
with physical activity, and also have weaker
environments” where people purchase food,
mountains, water, and forest. As a result
negative correlations with fruit and vegetable
exercise,
of these amenities, they also have large
consumption (Michimi & Wimberly, 2010).
(Swinburn et al., 1999). In contrast, the
proportions
and
carry
out
daily
activities
employment
that
to
structural
industries, including hotels and restaurants,
Environments
influences of industries, governments, and
outdoor recreation, real estate, and other
In addition to highlighting regions with high
other sectors operating at regional, national,
service industries.
and low obesity prevalence, this type of
and international levels. Our national-level
exploratory analysis can provide insights
study suggests that there is an intermediate
Natural amenities are known to be a major
into the underlying obesogenic environments.
level of “meso-environmental” influences that
force of migration that attracts workers and
For
obesity
reflects regional and sub-regional variability
retirees to move from elsewhere. Thus, high-
prevalence map suggests correlations with
in the natural environment, land use, human
rates of population growth in recreation
metrics of the social environment. Higher-
settlement patterns, and culture (Michimi
counties are driven by this combination of
obesity counties appear to be spatially
& Wimberly, 2010). These factors help to
desirable
associated
determine
micro-
and economic opportunities. The natural
broader
environment determines whether counties will
example,
inspection
with
of
the
higher-poverty
counties
broader
characteristics
across much of the eastern United States,
environments
but not in the West (Figure 2c). Many lower-
meso-environments,
nested
of
within and
can
the the
also
have
outdoor
from
income
term “macro-environment” has been used much
derived
or
New Insights into Obesogenic
characterize
are
of
recreation-related
recreational
amenities
develop a recreation base, and the existence
Figure 2. Spatial patterns of obesity and socioeconomic characteristics in the conterminous United States. (a) percent of population living in rural areas; (b) smoothed prevalence of obese adults (aged +18 years) with body mass index of over 30kg/m2; (c) percent of population with income below the poverty
19
Rural Connections Sept. 2010
Rural Health and Rural Landscapes
of
desirable
amenities
and
recreational
of public policies that encourage healthier
opportunities
influences
the
demographic
communities. Our future research will aid in
makeup and socioeconomic status of the
these efforts by testing a set of hypotheses
population.
about
environments
This
combination
that
of
encourages
natural
the
influences
of
supermarket
outdoor
accessibility, outdoor recreational amenities,
activity, local culture focused on outdoor
and other environmental variables on the
recreation, higher socioeconomic status, and
prevalence of obesity in rural areas. We
selection by residents who are predisposed
are also working to develop more refined
to engage in physical activity may help
classification schemes for rural landscapes
to explain the relatively low prevalence
that emphasize the environmental factors
of obesity across many non-metropolitan
most relevant to obesity, integrate elements
counties in the West (Figure 2b).
of the natural and built environments, and effectively capture the broad variability in
Conclusions
rural landscapes.
An ecological approach to the study of obesity addresses questions about spatial
About the Authors
patterns of obesity and their relationships
Michael Wimberly is an associate professor
with obesogenic environments and other risk
in
factors. The spatially explicit nature of this
Center of Excellence at South Dakota State
type of research makes it particularly relevant
University.
the
Geographic
Information
Science
to the development and implementation of public health efforts to reduce the burden
Akihiko Michimi is a postdoctoral fellow
of
in
obesity.
For
example,
mapping
the
the
Geographic
Information
Science
geographic distribution of obesity and its
Center of Excellence at South Dakota State
environmental correlates can help ensure
University.
that community health efforts are directed toward the areas where they are most needed.
Bonny Specker is a professor and director
Furthermore, research that improves our
of the EA Martin Program in Human Nutrition
understanding of obesogenic environments
at South Dakota State University.
can aid in the design of appropriate health interventions and inform the development
References
Egger, G. and B. Swinburn. 1997. An ‘’ecological’’ approach to the obesity pandemic. British Medical Journal 315:477-480. Forman, R. T. T. and M. Godron. 1986. Landscape Ecology. John Wiley and Sons, New York. Hartley, D. 2004. Rural health disparities, population health, and rural culture. American Journal of Public Health 94:1675-1678. Johnson, K. M. and C. L. Beale. 2002. Nonmetro recreation counties - their identification and rapid growth. Rural America 17:12 19. Leal, G. and B. Chaix. 2010. The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment, and a research agenda. Obesity Reviews In Press. Michimi, A. and M. C. Wimberly. 2010. Spatial patterns of obesity and associated risk factors in the conterminous U.S. American Journal of Preventive Medicine 39:e1-e12. Mungiole, M., L. W. Pickle, and K. H. Simonson. 1999. Application of a weighted headbanging algorithm to mortality data maps. Statistics in Medicine 18:3201-+. Sauer, C. O. 1925. The Morphology of the Landscape. Geography 2:19-54. Swinburn, B., G. Egger, and F. Raza. 1999. Dissecting obesogenic environments: The development and application of a framework for identifying and prioritizing environmental interventions for obesity. Preventive Medicine 29:563-570.
level; (d) percent of population (aged +25 years) with a college degree. Sources: 2000 U.S. Census Population Data for (a), (c), and (d) and 2000-2006 Behavioral Risk Factor Surveillance System for (b).
Sept. 2010 Rural Connections
20
The Obesity Research Prevention and Evaluation of Intervention Effectiveness in Native North Americans (OPREVENT) By Joel Gittelsohn, Marla Pardilla, Preety Gadhoke, Megan Rowan, Karina Christiansen, and Sara Newman.
21
Rural Connections Sept. 2010
Image from istockphoto.com. Used with permission.
Sept. 2010 Rural Connections
22
The Obesity Research Prevention...OPREVENT
A
merican Indians have the highest burden
The
of chronic diseases among all ethnic
Evaluation of Intervention Effectiveness in
sustainable intervention strategies
groups in the United States. Cardiovascular
Native North Americans (OPREVENT) is an
that would occur in local worksites
disease is twice that of the general US
intervention trial that is designed to address
that would lead to increased
population and diabetes is diagnosed 2.2
the following two research questions:
physical activity and improved
times greater among American Indians than the general US population.
The adjusted
energy intake, and total fat intake; (b) total energy counts and percent
2005-06. Health and economic consequences
of time spent in sedentary activity?;
of chronic conditions that limit American including
(c) body-weight index (BMI), waist
higher
circumference, and percent body
prevalence of end-stage kidney disease and
fat?
lower life expectancy than the U.S. average.
2. Is exposure to the intervention associated with improvements
Interventions designed to address chronic
in knowledge, self-efficacy, risk
conditions to date tend to focus upon
perception, outcome expectations,
individual behavior change with little impact
behavioral intentions, and social
upon reversing and stopping these trends.
support?
Novel interventions are needed at multiple levels of influence to address the rising obesity trend. In this newsletter article, we provide
and
of (a) fruits and vegetables, total
across all U.S. regions from 1995-1996 to
serious,
Prevention
multi-institutional trial on the intake
than 25 percent within a ten-year period
are
Research
1. What is the impact of a multi-site,
prevalence of obesity has increased more
Indians
Obesity
diet among American Indian (AI) community members? Indigenous peoples globally suffer very high rates of obesity and related conditions, as a result of the role of multifactorial determinants. AI adult BMI in both urban and rural reservation settings have been on a steady rise, with women having higher burden of overweight and obesity than men. Obesity is a primary risk factor for diabetes mellitus, cardiovascular disease, and other chronic conditions. Research indicates a direct association between dietary fat and energy intake and obesity. On average, AI diets are high in fat and caloric content, and
Additional research questions are:
a synopsis of our most recent community-
2. What are the feasible and
1. What are the feasible and
physical activity is low. Environmental factors such as the presence of food stores are associated with diet patterns. Limited worksite
based obesity prevention intervention that is
sustainable intervention strategies
wellness programs in AIs have achieved diet
currently being implemented to tackle adult
that would permit children to serve
and physical activity goals, increased energy
obesity. This effort is funded by the U.S.
as change agents in their homes
expenditure, and led to a reduction in body
Department of Agriculture.
to improve diet and increase
fat. Body image perceptions also influence
physical activity of adult household
AI communities’ motivation for action. Family
members?
environment and social support, particularly
SOCIAL CONTEXT
AI Culture
INSTITUTIONAL FACTORS
HOUSEHOLD FACTORS
INDIVIDUAL FACTORS
MEDIA
Acculturation HOUSEHOLD Food Policy
SCHOOL
Environ Policy Health Agency
FOOD STORE
University extension WORKPLACE Figure 1. The conceptual framework of OPREVENT.
23
Rural Connections Sept. 2010
SocioDemographics Size Food patterns Activity patterns Parenting style Communication Social support
ADULT HOUSEHOLD MEMBER Self-efficacy Knowledge Intentions Persuasion Decision Implementation Confirmation
Fruit, Vegetable and Fat Intake Obesity Physical activity level
The Obesity Research Prevention...OPREVENT
Table 1. Study Phases.
Phase & Description
Timeline
Sample Size
Phase 1: Tribal approvals/CACs, Formative Research, Measurement protocol preparation
Months 1-9
N=60 N=90
Phase 2: Baseline data collection, Intervention development, Process evaluation
Months 10-27
N=504 (84/community)
Phase 3: Intervention implementation (Round 2), maintenance data collection
Months 28-45
N=504 (84/community)
Phase 4: Data analysis and dissemination
Months 31-48
N=504 (84/community)
through the extended family network, is vital
program
to adult dietary and physical activity habits
activity in seven First Nations communities.
among AIs. Children can impact adult diets,
Our intervention improved overall knowledge
The conceptual framework of OPREVENT
such as increasing adult fruit and vegetable
and healthy food acquisition frequency.
depicts a visual graphic of how we envision
to
improve
diet
and
physical
(FV) intake per day, and decreasing fat
the change agent.
the role of the media, food stores, schools,
consumption. Overall, modest improvements
Our
theoretically
households, and worksites in the prevention
in diet and physical activity can reduce the
informed by the Social Cognitive Theory
of adult obesity among AI communities
risk of obesity and heart disease among
and the Diffusion of Innovations Theory. The
(Figure 1).
adults, such as walking 15 minutes per day
Social Cognitive Theory (SCT) suggests that
and eating 100 kilocalories less at each
individuals are both products and producers
The OPREVENT study design is a randomized,
meal or substituting high calorie drinks with
of
that
controlled community trial in six American
diet drinks.
there is a dynamic, reciprocal relationship
Indian communities in Michigan and New
between personal factors, the environment,
Mexico
OPREVENT is being led by a multidisciplinary
and
OPREVENT are outlined in Table. 1.
team that has years of experience designing,
Innovations Theory provides a systematic
implementing, and evaluating community-
framework
based AI interventions. Our school-based,
adopted by the target population. Diffusion
comparison (delayed intervention) communities.
food store and multi-disciplinary projects
is the process by which an innovation is
Delayed intervention communities will receive
have reported significant improvements in
communicated (planned and spontaneous)
all the benefits of the study including our
diet and physical activity related knowledge,
through certain channels over time within
training materials and intervention materials.
self-efficacy, and intentions, reduced fat
social systems that involve interpersonal
The study consists of formative research
intake, increased healthy food purchasing
social networks. Antecedent variables that
and pre-post intervention surveys. OPREVENT
habits, and positive policy changes. Our most
affect the process of innovation diffusion
involves community engagement, including
recent project, Zhiwaapenewin Akinomaagewin
include the characteristics of the innovation,
Community Advisory Councils (CACs) and
(ZAFT) was implemented between 2003 and
nature of the adopter, the social context,
workshops
2006
communication channels, and the nature of
partnerships with health agencies and
as
a
multi-level
multi-institutional
project,
their
OPREVENT,
social
health
environment,
behaviors. for
is
how
an
The
and
Diffusion
innovation
of gets
There
(Table
are
1).
three
and
The
four
intervention
stakeholder
phases
and
to
three
participation,
Sept. 2010 Rural Connections
24
The Obesity Research Prevention...OPREVENT
Table 2. Intervention Components.
School Program Phase
Theme
Curriculum
Child Change Agent
3rd: What is Healthy? 4th: Body Clues
Training basic principles
Work Program
Breakfast demo
Group for PA challenge
Breakfast demo; Community media2
Pedometer challenge
Cooking contest; Drain/rinse demo
media)
1
Start Your Day Moving
2
Living Lower Fat
3
Healthy Drinks
3rd: Sometimes Foods 4th: Sugar Facts
Family goals: food buying 1
Drinks taste test
Healthy Office Snacks
Family Fun Night; Drinks taste test;
4
Healthy Breaks
3rd: Being Active, Everyday Snack Attack; 4th: Fiber Facts
Family goals: snacks
Snacks taste test
Smart Lunch Choices
Take an exercise break; Healthy snacks taste test
5
5 a Day/Shop wisely
3rd: Next Year 4th: Label Reading
Family goals: food buying 2
FV taste tests
Cross-worksite challenge
Store tours, Gardening
6
Reinforcement
Additional teacher training
Summer family goal setting
Summer Materials
Team Walk-aThon
Health Fair
3rd: Everyday Foods Family goals: Drain & rinse 4th: Activity healthy cooking demo Pyramid, Fat
Pictured: OPREVENT’s two Michigan American Indian tribal communities.
25
Health Services Program (incl.
Food Store Program
Rural Connections Sept. 2010
The Obesity Research Prevention...OPREVENT
Our school-based, food store and multi-disciplinary projects have reported significant improvements in diet and physical activity related knowledge, self-efficacy, and intentions, reduced fat intake, increased healthy food purchasing habits, and positive policy changes. University extension personnel. There are
obesity prevention program through
diabetes prevention in Native American
four OPREVENT components: a community
collaborative partnerships with tribal
communities.
media campaign, school to home, worksite,
leadership, health agencies, schools,
and food stores (Table 2). For the school-
worksites, local USDA extension
Preety Gadhoke is a PhD Candidate in the
to-home component, OPREVENT will modify
programs.
Department of International Health, Division
existing school-based curriculum that was developed for grades three through five and
relationship between behavioral and
that have been administered and evaluated
environmental factors and obesity
in previous American Indian interventions by
among American Indian populations.
Dr. Gittelsohn and colleagues. OPREVENT
3. To reduce obesity in American
will expand upon previous interventions by
Indians communities. This is the first
developing a curriculum for grades two and
study of its kind to address the
six. The study’s program evaluation methods
multifactorial nature of adult obesity
are outlined in Table 3. Currently, our researchers are in the first phase of the study in both Michigan and New Mexico.
of Social and Behavioral Interventions at
2. To advance knowledge of the
in these six communities.
following: 1. To develop sustainable community
Public Health. Megan Rowan is a senior program manager at the Johns Hopkins School of Public Health, Center for Human Nutrition. Karina Christiansen is a Master’s Candidate in Public Policy focusing on Environmental Health Policy at Johns Hopkins University.
About the Authors Joel Gittelsohn is a professor in the Department of International Health at Johns
Overall, the goals of our study include the
the Johns Hopkins Bloomberg School of
Hopkins University.
Sara Newman is a Master’s Candidate in the Department of International Health, the Division of Social and Behavioral Interventions at Johns Hopkins University.
Marla Pardilla is a behavioral health researcher, mainly focused on obesity and
For references, see next page.
Table 3. Program Evaluation Methods.
Evaluation Method Quantitative Food Frequency Questionnaire
Comments Developed for American Indian/Alaska Native populations
Anthropometry, body composition, accelerometry Pre- and post-intervention assessment Impact Questionnaires
Pre- and post-intervention (Household adult, food stores, worksite, school)
Environmental observation checklists
Pre- and post-intervention (Worksites, food stores)
Process Evaluation forms
During intervention (Worksites, schools, food stores, family/household)
Sept. 2010 Rural Connections
26
The Obesity Research Prevention...OPREVENT
REFERENCES
Bachar JJ, Lefler LJ, Reed L, McCoy T, Bailey R, Bell R. Cherokee Choices: a diabetes prevention program for American Indians. Prev Chronic Dis. 2006;3:A103. Ballew C, White LL, Strauss KF, Benson LJ, Mendlein JM, Mokdad AH. Intake of nutrients and food sources of nutrients among the Navajo: findings from the Navajo Health and Nutrition Survey. J Nutr. 1997;127:2085S-2093S. Bandura A. Social foundations of thought and action. Englewood Cliffs, NJ: Prentice Hall, 2001. Beresford SA, Locke E, Bishop S et al. Worksite study promoting activity and changes in eating (PACE): design and baseline results. Obesity (Silver Spring). 2007;15 Suppl 1:4S-15S Borys JM, Lafay L. Nutritional information for children to modify the food habits of the whole family. Rev Med Suisse Romande. 2000;120:207-209. Burrows NR, Geiss LS, Engelgau MM, Acton KJ. Prevalence of diabetes among Native Americans and Alaska Natives, 19901997: an increasing burden. Diabetes Care. 2000;23:1786-1790. Coble JD, Rhodes RE. Physical activity and Native Americans: a review. Am J Prev Med. 2006;31:36-46. Davis M, Baranowski T, Hughes M, Warneke C, deMoor C, Mullis R. Using children as change agents in increase fruit and vegetable consumption among lower-income African American parents: Process evaluation results of the Bringing it Home program. In: Steckler A, Linnan L, eds. Process Evaluation in Public Health Interventions. San Francisco: JosseyBass; 2002:249-67. Delisle HF, Rivard M, Ekoe JM. Prevalence estimates of diabetes and of other cardiovascular risk factors in the two largest Algonquin communities of Quebec. Diabetes Care. 1995;18:1255-1259. Delisle HF, Ekoe JM. Prevalence of noninsulin-dependent diabetes mellitus and impaired glucose tolerance in two Algonquin communities in Quebec. CMAJ. 1993;148:41-47. Denny CH, Holtzman D, Cobb N. Surveillance for health behaviors of American Indians and Alaska Natives. Findings from the Behavioral Risk Factor Surveillance System, 1997-2000. MMWR Surveill Summ. 2003;52:1-13 Eyler AA, Brownson RC, Donatelle RJ, King AC, Brown D, Sallis JF. Physical activity social support and middle- and older-aged minority women: results from a US survey. Soc Sci Med. 1999;49:781-789. Felton GM, Parsons MA. Factors influencing physical activity in average-weight and overweight young women. J Community Health Nurs. 1994;11:109-119 French SA, Story M, Jeffery RW. Environmental influences on eating and physical activity. Annu Rev Public Health. 2001;22:309-335.
27
Rural Connections Sept. 2010
Galloway JM. Cardiovascular health among American Indians and Alaska Natives: successes, challenges, and potentials. Am J Prev Med. 2005;29(5 Suppl 1): 11-17. Gittelsohn J, Anliker J, Ethelbah B et al. A food store intervention to reduce obesity in two American Indian communities: impact on food choices and psychosocial indicators. FASEB. 2005;19:Abstract #594.7 Gittelsohn J, Harris SB, Thorne-Lyman AL, Hanley AJ, Barnie A, Zinman B. Body image concepts differ by age and sex in an Ojibway-Cree community in Canada. J Nutr. 1996;126:2990-3000. Glanz K, Lankenau B, Foerster S, Temple S, Mullis R, Schmid T. Environmental and policy approaches to cardiovascular disease prevention through nutrition: opportunities for state and local action. Health Educ Q. 1995;22:512-527. Goran MI. Metabolic precursors and effects of obesity in children: a decade of progress, 1990-1999. Am J Clin Nutr. 2001;73:158-171. Harris SB, Zinman B, Hanley A et al. The impact of diabetes on cardiovascular risk factors and outcomes in a native Canadian population. Diabetes Res Clin Pract. 2002;55:165-173. Henderson KA, Ainsworth BE. A synthesis of perceptions about physical activity among older African American and American Indian women. Am J Public Health. 2003;93:313-317. Hill DL. Sense of belonging as connectedness, American Indian worldview, and mental health. Arch Psych Nurs 2006;20(5); 210-216. Hill JO. Can a small-changes approach help address the obesity epidemic? A report of the Joint Task Force of the American Society for Nutrition, Institute of Food Technologists, and International Food Information Council. Am J Clin Nutr. 2009;89:477-484. Hill JO, Wyatt HR, Reed GW, Peters JC. Obesity and the environment: where do we go from here? Science. 2003;299:853-855. Hill JO, Peters JC. Environmental contributions to the obesity epidemic. Science. 1998;280:1371-1374. Ho LS, Gittelsohn J, Rimal R et al. An integrated multi-institutional diabetes prevention program improves knowledge and healthy food acquisition in northwestern Ontario First Nations. Health Educ Behav. 2008;35:561-573 Ho L, Gittelsohn J, Sharma S et al. Foodrelated behavior, physical activity, and dietary intake in First Nations - a population at high risk for diabetes. Ethn Health. 2008;13:335349.
Indian Health Service (IHS). Regional differences in Indian Health. Rockville, MD, 2000-01. Jernigan VBB, Duran B, Ahn D, Winkleby M. Changing patterns in health behaviors and risk factors related to cardiovascular disease among American Indians and Alaska Natives. Am J Public Health 2010;100:677-683. Johannsen DL, Redman LM, Ravussin E. The role of physical activity in maintaining a reduced weight. Curr Atheroscler Rep. 2007;9:463-471. King H, Rewers M. Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults. WHO Ad Hoc Diabetes Reporting Group. Diabetes Care. 1993;16:157-177. Knowler WC, Bennett PH, Hamman RF, Miller M. Diabetes incidence and prevalence in Pima Indians: a 19-fold greater incidence than in Rochester, Minnesota. Am J Epidemiol. 1978;108:497-505. Knowler WC, Barrett-Connor E, Fowler SE et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393-403. Kwak L, Kremers SP, Werkman A, Visscher TL, van Baak MA, Brug J. The NHF-NRG In Balance-project: the application of Intervention Mapping in the development, implementation and evaluation of weight gain prevention at the worksite. Obes Rev. 2007;8:347-361. Lee ET, Begum M, Wang W et al. Type 2 diabetes and impaired fasting glucose in American Indians aged 5-40 years: the Cherokee diabetes study. Ann Epidemiol. 2004;14:696-704. Lee ET, Welty TK, Cowan LD et al. Incidence of diabetes in American Indians of three geographic areas: the Strong Heart Study. Diabetes Care. 2002;25:49-54 Lee ET, Howard BV, Savage PJ et al. Diabetes and impaired glucose tolerance in three American Indian populations aged 45-74 years. The Strong Heart Study. Diabetes Care. 1995;18:599-610. Lichtenstein AH, Kennedy E, Barrier P et al. Dietary fat consumption and health. Nutr Rev. 1998;56:S3-19 Lytle LA, Kubik MY, Perry C, Story M, Birnbaum AS, Murray DM. Influencing healthful food choices in school and home environments: results from the TEENS study. Prev Med. 2006;43:8-13. MMWR. Diabetes prevalence among American Indians and Alaska Natives and the overall population—United States, 1994-2002. MMWR Morb Mortal Wkly Rep. 2003;52:702-704.
Ho LS, Gittelsohn J, Harris SB, Ford E. Development of an integrated diabetes prevention program with First Nations in Canada. Health Promot Int. 2006;21:88-97
Naylor JL, Schraer CD, Mayer AM, Lanier AP, Treat CA, Murphy NJ. Diabetes among Alaska Natives: a review. Int J Circumpolar Health. 2003;62:363-387.
Ho L, Gittelsohn J, Roscreans A, Sharma S, Ford E, Harris SB. Baseline Assessment for a Multi-institutional Diabetes Prevention Program for First Nations. FASEB. 2006;20.
Oser CS, Harwell TS, Strasheim C et al. Increasing prevalence of cardiovascular risk factors among American Indians in Montana. Am J Prev Med. 2005;28:295-297.
The Obesity Research Prevention...OPREVENT
Rimal R, Flora J. Bidirectional familial influences in dietary behavior: Test of a model of campaign influences. Hum Commun Res. 1998;24:610-637 Ritenbaugh C, Teufel-Shone NI, Aickin MG et al. A lifestyle intervention improves plasma insulin levels among Native American high school youth. Prev Med. 2003;36:309-319 Rogers, EM. Diffusion of Innovations, Fourth Edition. New York, NY: The Free Press, 1995. Rosecrans AM, Gittelsohn J, Ho LS, Harris SB, Naqshbandi M, Sharma S. Process evaluation of a multi-institutional community-based program for diabetes prevention among First Nations. Health Educ Res. 2008;23:272-286 Sallis JF, Hovell MF, Hofstetter CR, Barrington E. Explanation of vigorous physical activity during two years using social learning variables. Soc Sci Med. 1992;34:25-32. Schmitz MK, Jeffery RW. Public health interventions for the prevention and treatment of obesity. Med Clin North Am. 2000;84:491-512, viii. Seymour JD, Yaroch AL, Serdula M, Blanck HM, Khan LK. Impact of nutrition environmental interventions on point-of-purchase behavior in adults: a review. Prev Med. 2004;39 Suppl 2:S108-S136. Sharma S, Cao X, Gittelsohn J et al. Dietary intake and development of a quantitative foodfrequency questionnaire for a lifestyle intervention to reduce the risk of chronic diseases in Canadian First Nations in north-western Ontario. Public Health Nutr. 2008;11:831-840 Sharma S, Harris R, Cao X, Hennis AJ, Leske MC, Wu SY. Nutritional composition of the commonly consumed composite dishes for the Barbados National Cancer Study. Int J Food Sci Nutr. 2007;58:461-474 Sharma S, Cao X, Gittelsohn J, Anliker J, Ethelbah B, Caballero B. Dietary intake and a food-frequency instrument to evaluate a nutrition intervention for the Apache in Arizona. Public Health Nutr. 2007;10:948-956
Sharma S, Cruickshank JK. Cultural differences in assessing dietary intake and providing relevant dietary information to British African-Caribbean populations. J Hum Nutr Diet. 2001;14:449-456.
Welty TK, Lee ET, Yeh J et al. Cardiovascular disease risk factors among American Indians. The Strong Heart Study. Am J Epidemiol. 1995;142:269-287.
Story M, Stevens J, Himes J et al. Obesity in American-Indian children: prevalence, consequences, and prevention. Prev Med. 2003;37:S3-12.
White LL, Ballew C, Gilbert TJ, Mendlein JM, Mokdad AH, Strauss KF. Weight, body image, and weight control practices of Navajo Indians: findings from the Navajo Health and Nutrition Survey. J Nutr. 1997;127:2094S-2098S.
Story M, Evans M, Fabsitz RR, Clay TE, Holy RB, Broussard B. The epidemic of obesity in American Indian communities and the need for childhood obesity-prevention programs. Am J Clin Nutr. 1999;69:747S-754S Thompson JL, Allen P, Cunningham-Sabo L, Yazzie DA, Curtis M, Davis SM. Environmental, policy, and cultural factors related to physical activity in sedentary American Indian women. Women Health. 2002;36:59-74 Treiber FA, Baranowski T, Braden DS, Strong WB, Levy M, Knox W. Social support for exercise: relationship to physical activity in young adults. Prev Med. 1991;20:737-750.
Will J, Denny C, Serdula M, Muneta B. Trends in Body Weight Among American Indians: Findings from a Telephone Survey, 1985 Through 1996. American Journal of Public Health. 1999; 89 (3). Yeates K, Tonelli M. Indigenous health: update on the impact of diabetes and chronic kidney disease. Curr Opin Nephrol Hypertens. 2006;15:588-592. Young TK, Reading J, Elias B, O’Neil JD. Type 2 diabetes mellitus in Canada’s first nations: status of an epidemic in progress. CMAJ. 2000;163:561566.
Tremblay MS, Perez CE, Ardern CI, Bryan SN, Katzmarzyk PT. Obesity, overweight and ethnicity. Health Rep. 2005;16:23-34.
Yurgalevitch SM, Kriska AM, Welty TK, Go O, Robbins DC, Howard BV. Physical activity and lipids and lipoproteins in American Indians ages 45-74. Med Sci Sports Exerc. 1998;30:543-549.
Warne D. Research and educational approaches to reducing health disparities among American Indians and Alaska Natives. J Transcultural Nurs, 2006;17(3):266-271.
Zapka J, Lemon SC, Estabrook BB, Jolicoeur DG. Keeping a Step Ahead: formative phase of a workplace intervention trial to prevent obesity. Obesity (Silver Spring). 2007;15 Suppl 1:27S-36S.
Webber LS, Johnson CC, Rose D, Rice JC. Development of ACTION! Wellness Program for Elementary School Personnel. Obesity (Silver Spring). 2007;15 Suppl 1:48S-56S.
Zephier EM, Ballew C, Mokdad A et al. Intake of nutrients related to cardiovascular disease risk among three groups of American Indians: the Strong Heart Dietary Study. Prev Med. 1997;26:508-515.
Welty TK, Rhoades DA, Yeh F et al. Changes in cardiovascular disease risk factors among American Indians: The Strong Heart Study. Ann Epidemiol. 2002;12(2): 97-106. Indian Health Service, Division of Diabetes and Treatment and Prevention, Fact Sheet, June 2008. Available at: http://www.ihs.gov/MedicalPrograms/Diabetes/ index.cfm?module=resourcesFactSheets_AIANs08. Last accessed on June 8, 2010.
Zimmet P, Alberti KG, Shaw J. Global and societal implications of the diabetes epidemic. Nature. 2001;414:782-787.
Health and economic consequences of chronic conditions that limit American Indians are serious, including higher prevalence of end-stage kidney disease and lower life expectancy than the U.S. average.
Image from istockphoto.com. Used with permission.
Sept. 2010 Rural Connections
28
Poverty Reduction Project
Increases Social and Natural Capital It’s hard to care for the environment when you can’t see beyond the garbage in your yard. By Debra Kollock
29
Rural Connections Sept. 2010
Poverty Reduction Project Increases Social and Natural Capital
M
embers of a small rural community
payments, and limited time conspire against
council assigned two employees to the
just seven miles south of the Canadian
these and other remote community residents’
trash removal project and allowed them to
border have mobilized their town to remove
efforts to dispose of trash. The Horizons
use the city’s heavy equipment to clean up
over 53 tons of garbage, win a grant to
group determined that, in their town, this
Northport’s alleys and sidewalks and remove
upgrade the town’s boat launch, and start
situation could best be addressed together
debris from a fire-damaged home.
a community garden. For these citizens of
and a Community Clean-up was scheduled
Northport, Washington, simple conversations
as the first action item.
The
about reducing poverty have become a
group’s
unwavering
“how
can
we
serve” attitude has won over some of the
community-wide demonstration of the power
The first clean-up was held on “Earth Day”
community’s most vocal skeptics. The team
of dialogue over disagreement and a spirit
weekend in 2007 and has happened every
distributes
of service over blame.
third week of April since. Volunteers meet at
residents what they need. In one instance,
Northport’s old gas station and bring gloves,
group
While
this
a
local
church to repair a resident’s fence while
is community-funded and volunteers are
the resident participated as she could by
breathtaking scenery, 27 percent of its
reimbursed for gas and dump fees. In the
rolling her wheelchair across the yard, and
families live below the poverty level. With
past four years, the community has raised
delivering small tools to the volunteers.
this level of poverty, the community has
enough money to cover these costs through
been eligible, since 2006, to participate in
recycling aluminum cans (2,985 pounds) and
While 158 homes and families have been
Horizons, a grant-funded poverty-abatement
vehicle batteries (27,768 pounds).
helped through the Community Clean-up,
mountains,
leadership
residents
with
asks
tools, and heavy equipment. The clean-up
and
301
partnered
and
is
by
of
members
door-to-door
and
surrounded
town
flyers
a
river,
development
removing trash is not the only
program. In the early stages of the
program,
78
of
Thriving Communities Discussion Sessions:
Northport’s
• How Are We Connected to Our Community and to Poverty?
youth and adults participated in facilitated discussions about poverty
• A Vision for Our Community: What Does Poverty Look Like Here?
issues in their community. Thriving Communities: Working together to
• Why is There Poverty in Our Community?
move from poverty to prosperity
of
ability
and
all ages, income
levels participate–including many youth. At the end of each cleanup
day,
hold
a
community potluck
members
barbeque
and
and personal pride have been
• Moving to Action
problem solving process. Using the
Residents
physical
reports abound that community
• Reaching Our Vision and Reducing Poverty
for all is a public dialogue and
benefit.
enhanced by the simple collective
study guides, in their Community
act of removing trash.
Conversation Groups, the Northport participants
worked
through
topics
Restored Marina
that
ultimately led them to an action plan (see
In addition to the 53 tons of garbage
The leadership development phase of the
inset.)
and appliances, volunteers have removed
Horizons program provided an opportunity
178 tons of scrap metal. With their town’s
for members of two typically disengaged
designation as a permanent location for
groups
As they discussed the topic “What Does
scrap metal collection, disposing of scrap
leaders–youth and people in poverty. Through
Poverty
community
is easy for Northport residents as is pick
Horizons, Wheatley’s (2008) definition of
members acknowledged that mounds of
up for a private recycling contractor. A
a leader emerged. This author suggests
trash and run-down houses gave their town
designated compost area for green waste
that, “A leader is anyone willing to help,
the appearance of being poor. Inadequate
also decreases the amount of trash taken
anyone willing to step forward to change
transportation,
to the nearby landfill. In 2010, the town
things. Communities everywhere are filled
Community Clean-up Look
Like
lack
Here?”
of
money
for
fee
to
see
themselves
as
potential
Sept. 2010 Rural Connections
30
Poverty Reduction Project Increases Social and Natural Capital
with these leaders; they reveal themselves
passion for their surroundings.
learning about the environment, the goal is
when the issues appear.” As a result of
to teach the youth skills and knowledge that Growing a Community Garden
will break the cycle of childhood obesity and
leadership education, community members
Following more community conversations,
diabetes.
created Northport Community Preservation &
the Horizon’s group selected a Community
Restoration (NCPR), a non-profit corporation
Garden as its next priority project. NCPR
The Community Garden has sold 16 beds,
dedicated to community improvement.
received a donation of land in the middle of
and has the remaining 19 planted for
town and organized volunteers to establish
community use and provides nutritious food
Since its inception, a representative of NCPR
the garden, erect a fence, and obtain a
for the twice-weekly Senior Meals and Food
has attended every monthly city council
grant to build a greenhouse.
Bank. Plans also include building wheelchair
their
participation
in
Horizon’s-sponsored
meeting to listen, learn, and offer support
accessible and walker-friendly raised beds
for community improvement projects and
The project has further strengthened group
where seniors and individuals with disabilities
tasks identified by the council. With trust
members’ leadership abilities and increased
can work in the garden alongside youth. The
earned through this regular level of positive
their understanding of food systems and
drip-water irrigation system was designed by
engagement, NCPR was asked by the council
the environment. The intent is now to ignite
a Master Gardener and funded through one
to assume responsibility for applying for a
this same level of understanding among
of the grants and the water for the garden
grant to improve the boat marina on Lake
other members of the community, as noted
is donated by a neighbor. Home-schooled
Roosevelt, one of the area’s most important
by Nina Grobben, NCPR community garden
youth are also planting three seasonal items
natural
committee chair, “If we could help show
in the greenhouse for year-round fundraising
grant
a garden friend how to steward the land,
activities.
from the Washington State Recreation and
perhaps it would lead them to becoming
Conservation Office to upgrade the marina
a better steward of themselves, their loved
Conclusion
and boat launch. When complete, the project
ones, their homes, and their communities.”
The lesson of Northport, Washington is
wrote
assets. and
The
received
group a
subsequently
$400,000
will provide a safe place for local residents
that
change
can
start
with
to launch their boats, a new park for families
In addition to the donation of land, the
simple conversations. In this remote, rural
to enjoy, and is very likely to improve the
group has received four truckloads of bark,
community, the investment in talking to
local economy by attracting water recreation
wood for 35 raised beds, and carpet for
each other has created conditions to foster
enthusiasts to the area and bringing outside
weed control on the paths. They have been
change. Projects launched in Northport were
tourism dollars to local businesses. The
awarded five grants totaling $25,500 for initial
initially intended to solve one problem –
project has already increased community
construction of the garden, greenhouse, and
clean up a dumpy looking town. From a
involvement, demonstrated by the successful
educational programs. Youth have learned
community development perspective, it has
collection of a cash match for the grant.
construction
morphed into so much more. The projects
NCPR has been busy with other projects as
contractor to build the greenhouse.
skills
by
working
with
the
well. In 2010, Washington State Fish and
31
community
improved their natural capital, the marina, the streets of Northport, and individual homes.
Wildlife announced its intention to close 12-
The group has now hired a VISTA Volunteer
These actions then resulted in increased
15 miles of the river adjacent to Northport.
who will become the “Garden Keeper.” When
social capital because people who needed
With a new sense of empowerment and
this person begins work in fall of 2010,
assistance felt supported and understood by
newly acquired leadership skills, NCPR rallied
his primary responsibility will be to work
those who could help. And it was possible
15 people to drive 40 miles to testify at
with the elementary school to develop a
because of the increased human capital
the public hearing. Two members of the
curriculum that teaches K-8th graders about
encouraged through the Horizon’s program
committee also spoke at a regional meeting,
healthy food systems–from planting seeds,
(Emery & Flora, 2006). Through this process,
and convinced Fish and Wildlife that the
to growing, to harvesting, to preparing,
community members learned about their
local economy relies on the tourism dollars
and finally to eating. Fifty-two percent of
community needs and developed leadership
from river visitors. NCPR members report
the students in Northport qualify for free
skills that enabled them to act in productive
that engaging in environmental issues has
and reduced lunches–another indicator of
ways.
created
the extreme level of poverty. In addition to
a
better
understanding
Rural Connections Sept. 2010
of
and
Poverty Reduction Project Increases Social and Natural Capital
Pictured: Northport, Washington residents participate in the Community Clean-up.
Real change begins with the simple act of
About the Author
people talking about what they care about,”
Debra Kollock is the Stevens County Director
states Wheatley (2002). The success of the
for Washington State University Extension.
Community Clean-up project started with discussions between neighbors and it has resulted in physical and social change. Working
together
to
do
something
as
simple as picking up trash has created the momentum of change. The key to their success has been a consistent, long-term attitude of service in place of judgment or blame. Before the clean-up people felt overwhelmed by the garbage in their yard, but
with
simple
conversations
they
are
moving toward NCPR’s vision: “to have a sense of community; a sense of pride; and a sense of place for our young, endeavoring to show and amaze our visitors this beautiful
Additional Resources
Everyday Democracy: Ideas and Tools for Community Change (2005). Everyday Democracy (formerly the Study Circles Resource Center). www.everyday-democracy.org Emery, M. and C.B. Flora. (2006). SpiralingUp: Mapping Community Transformation with Community Capitals Framework. Community Development: Journal of the Community Development Society 37: 19-35. http://www. ncrcrd.iastate.edu/pubs/flora/spiralingup.htm. Wheatley, M. (2002). Turning to One Another: Simple conversations to restore hope to the future. Berrett-Koehler, San Francisco. Wheatley, M. (2005). The World Café: Shaping our futures through conversations that matter. Berrett-Koehler, San Francisco.
place.”
Sept. 2010 Rural Connections
32
Investigating Places for
Active Recreation
in Rural
North Carolina Communities
By Karla A. Henderson, Michael Edwards, Jonathan Casper, Jason Bocarro, and Myron Floyd
T
he contributions of regular physical activity
public parks and recreation agencies address
ecological model of health promotion. This
(PA) to health are well-documented. The
physical activity promotion, faculty at North
model proposes that health is based on
role that parks and recreation settings play
Carolina State University in the Department of
intrapersonal/individual, interpersonal/social,
in helping people become physically active,
Parks, Recreation, and Tourism Management
institutional/organizational,
and thus healthier, has been evident since
undertook an ongoing initiative to explore
and
the recreation movement began over a
and measure the ways that communities
conceptualization of how these contexts in
century ago. Although a logical connection
promote PA. The initiative, IPARC-Investigating
rural as well as urban areas can enhance
exists between PA promotion and parks and
Places for Active Recreation in Communities,
behaviors by promoting certain actions and
recreation, these settings have only begun
aims to advance the science of how park,
discouraging or prohibiting other behaviors.
to be acknowledged. For example, Healthy
recreation, sport, and tourism environments
McLeroy
People 2010 (U.S. Department of Health and
support active recreation and to provide
intrapersonal factors include psychological
Human Services, 2000) emphasized that the
empirical evidence to facilitate practices and
and biological variables as well as the
design of communities and the presence of
policies to promote PA. The purpose of this
developmental
parks, trails, and other public recreational
article is to describe the work IPARC faculty
Interpersonal factors refer to relationships
facilities affected people’s abilities to reach
undertook to examine issues confronting
with others such as family, friends, and
the recommended level of PA. Parks and
park and recreation directors in urban and
coworkers. Institutional aspects of social
recreation agencies in both urban and rural
rural communities, and to discuss briefly
ecology include the role of organizations
areas have great potential for promoting PA
the role that an initiative like IPARC can
such
as
schools,
by virtue of the resources they manage and
have in documenting and promoting PA in
and
parks
and
the services they provide.
communities of all types.
Community
policy
contexts,
et
al.
community
and
(1988)
history
described
of
health
recreation
factors
provides
address
a
how
individuals.
organizations, departments. the
social
environments and the relationships among Because of the lack of data about how
33
Rural Connections Sept. 2010
The framing of IPARC’s work is the social
groups in a geographic area. Public policy
Investigating Places for Active Recreation
Significant gaps in health outcomes between rural and urban areas mean negative quality of life for rural populations and a strain on rural economic resources. encompasses the laws and policies as well
(Johnson, 2003) including PA opportunities.
as the views of policy makers at local, state,
A total of 134 usable questionnaires were
and national levels. Although intrapersonal
For the IPARC study, all county and municipal
returned for a 64% response rate. Returns
and
important,
park and recreation (P&R) directors in NC
included 92 from urban areas and 42
institutional, community, and policy aspects
interpersonal
issues
are
were surveyed to ascertain: (a) how rural
from rural areas. Results showed that rural
must also be explored regarding how PA
and urban P&R directors perceived their
P&R
access can be further promoted. Research
citizen and political support surrounding
significantly
has shown that programs that target multiple
PA, (b) barriers effectiveness in providing
departments must form partnerships. Rural
levels will be more likely to affect longer-
PA opportunities, and (c) priorities for the
directors reported significantly higher need
term change (e.g., Sallis et al., 2006).
future. More details about the study can
to form partnerships compared to urban
be found in the article by Bocarro et al.
departments. Directors in urban areas were
(2009).
significantly more likely to say they:
Assessing Issues in Rural and Urban Communities A first task of IPARC was to survey county
The survey was developed with input from
and municipal parks and recreation directors
a focus group comprised of P&R directors
in North Carolina to collect baseline data
as well as a literature review. It included 67
about institutional, community, and policy
questions about PA in communities (i.e., 20
issues faced in facilitating PA opportunities
on opinions about the role of P&R, 18 about
for NC citizens. One goal of this study
extent and adequacy of existing programs
was to examine differences in community
and partnerships, 12 about barriers, 11
settings.
about priorities, and seven about general demographic data).
departments
were
only
statistically
on
one
item:
higher
P&R
• Had enough parks and open spaces. • Were taking a lead in promoting PA. • Had elected officials who saw the importance of PA. • Believed residents were willing to pay for PA opportunities. • Thought that all income groups had access to equal quality of facilities. • Believed that PA opportunities were
Because rural areas are vitally interconnected A
raw materials), maintaining the vitality and
a community or county was considered
sustainability of rural areas is important
rural or urban. The jurisdiction name was
Although the urban agreement scores were
to the country. Significant gaps in health
identified
determine
higher, both rural and urban averaged on
outcomes between rural and urban areas
this rural/urban designation, we used the
the agree side of the scale except that
mean
rural
2006 U.S. Census estimates of population
rural P&R directors did not believe they had
populations and a strain on rural economic
to designate a county as urban (including
“enough parks and open spaces.”
resources.
Attention to increasing rates
suburban) or rural. Municipalities located
of leisure-time PA for rural residents has
within a designated Metropolitan Statistical
Although the P&R directors in North Carolina
been a response to significant changes to
Area (MSA) were considered urban, while
generally believed that PA was important
rural structures. Shifts in economic activities
communities located outside an MSA were
in their municipalities and counties, they
away from agriculture have led to less
coded as rural. Although differences between
also indicated that such programs needed
occupational PA and longer commute times
rural and urban populations are widely
additional funding. Interestingly, not having
(Lobao,
discussed, there is little agreement about
enough staff was the most important barrier
negative
2004).
quality
of
life
Furthermore,
for
population
coding
process
on
the
categorized
survey.
To
whether
generally adequately funded.
with urban areas (e.g., source of food and
to
their definitions. Therefore, although county-
followed by funding and then, quality and
urban-proximate rural areas since the 1970s
level measures may be less than ideal, the
amount
increased strains on community capacity to
use of rural and non-rural ideal types was
comparison of barriers based on rural or
provide essential services for many residents
needed to compare places.
urban designation found four statistically
migration
from
urban
and
suburban
of
facilities
and
equipment.
Sept. 2010 Rural Connections
A
34
Investigating Places for Active Recreation
significant
knowledge
lacking the capacity to develop, maintain,
about promoting PA, no clear standards
differences:
and sustain facilities and programs (Paluck
about what should be provided, lack of
et al., 2006). Because of fewer resources,
A third goal is to advance the state of
support
(i.e.,
rural directors saw the critical need to form
knowledge about evidence-based research
commissions, board, or councils), and the
partnerships to improve levels of PA. Although
regarding active recreation in communities
number of low income residents. For each
rural P&R directors in our study perceived
through projects, publications, and training
item, directors from rural counties perceived
a higher need to form partnerships, Mowen
workshops and seminars. We sponsored an
the barriers as more important than their
et al. (2009) found that rural P&R agencies
Active Recreation Counts Summit to bring
urban counterparts. As noted however, none
nationwide may be less likely than their
together researchers and practitioners from
of these barriers were perceived as a major
urban counterparts to actually engage in
throughout the state who were interested
detriment.
these types of partnerships. More research
in
is needed in this area.
programs on PA involvement. We have also
from
staff
government
authority
This study provided a useful baseline for
measuring
the
impact
of
community
presented research at national and state
determining future directions that might be
IPARC Responds to the Challenge
conferences and published almost three-
taken to facilitate the promotion of PA in
of Promoting Physical Activity in
dozen papers pertaining to issues of active
community settings. An understanding of the
Communities
recreation.
role of public P&R services in rural areas has
The mission of IPARC is to advance the
not been fully developed. One assumption
science
sport
IPARC fits at NCSU since the Department of
that has inhibited exploration of this topic
environments to promote active living. IPARC
Parks, Recreation and Tourism Management
is a perception that proximity to natural
faculty and staff members seek to facilitate
is one of the oldest, largest, and most
resources and open space encourages higher
the application of evidence-based policies
respected programs in the nation. In addition,
levels of participation in outdoor recreation
and
the location in a College of Natural Resources
(Hendee, 1969).
for
Therefore, rural residents
of
park,
practices PA
to
to
recreation,
enhance
enhance
and
opportunities To
provides a unique perspective on PA as a
are expected to participate in unstructured
these ends we are conducting research
quality
of
life.
public health issue. Faculty have related and
outdoor recreational activities (Cordell et al.,
about opportunities for PA for community
concurrent interests and expertise in topics
2002), and may have less need for local
residents in parks, recreation, schools, and
such as the human dimensions of natural
P&R programs to facilitate PA.
other community settings (e.g., the study
resources,
described previously). A study of rural and
natural resource planning, urban wildlife, and
Generalizations that rural communities are
urban community partnerships is planned to
youth development. We also work closely
amenity-rich fail to recognize the complex
begin in fall 2010.
with the NCSU Recreation Resources Service
and contextual conditions of rural areas.
35
only a few.
urban
forestry,
participatory
(RRS), a state supported unit that provides
Many remote rural areas do not possess the
We also seek to facilitate collaborative
technical assistance to communities in NC.
level of natural amenities (e.g., mountains,
research
State
Further, NCSU has a nationally recognized
water areas, scenic vistas, public lands)
faculty
the
Geographic Information Systems Technology
necessary to be available for recreation use
past two years, we have invited a number
(Krannich & Petrzelka, 2003). Additionally,
of local, as well as nationally respected
rural residents often describe constraints to
researchers, to share their work with us and
Future proposed projects include webinars
participating in outdoor recreation including a
to explore opportunities for partnerships.
to
lack of accessible resources, fear of hunters
We have established ongoing relationships
of PA, further opportunities to use GIS,
and criminal activity in isolated stretches of
with other units including NC Division of
making connections between PA and food
land, and lower levels of social support for
State Parks, NCSU College of Design, East
environments, and determining means to
spontaneous activity (Moore et al., 2010;
Carolina, Appalachian State University, NCSU
influence policy gathered from evidence-based
Yousefian et al., 2009). A reliance on limited
Cooperative Extension, and UNC-Chapel Hill
research. The IPARC faculty is committed
local tax dollars and insufficient volunteer
School of Public Health and Department of
to addressing PA through research about
support has led to many rural communities
Urban and Regional Planning, to mention
parks, open spaces, urban forests, schools,
Rural Connections Sept. 2010
opportunities and
other
among
colleagues.
NC Over
program.
address
issues
regarding
promotion
Investigating Places for Active Recreation
and community non-profit organizations. For additional information about projects and publications please visit the project’s website at http://cnr.ncsu.edu/iparc/
About the Authors Karla A. Henderson is a professor in the Department of Parks, Recreation and Tourism Management, College of Natural Resources, at North Carolina State University. Michael Edwards is an assistant professor in the Department of Parks, Recreation and Tourism Science, College of Agriculture and Life Sciences at Texas A&M University. Jonathan Casper is an assistant professor in the Department of Parks, Recreation and
Tourism
Management,
College
of
Natural Resources at North Carolina State University. Jason Bocarro is an associate professor in the Department of Parks, Recreation and
Tourism
Management,
College
of
Natural Resources at North Carolina State University. Myron
Floyd
is
a
professor
in
the
Department of Parks, Recreation and Tourism Management, College of Natural Resources at North Carolina State University.
Additional Resources Investigating Places for Active Recreation in Communities http://cnr.ncsu.edu/iparc/
References
Bocarro, J. N., Casper, J., Henderson, K.A., Floyd, M. F., Moore, R., Kanters, M.A., Laven, K., & Edwards, M. (2009). Physical Activity promotion in North Carolina: Perceptions of public park and recreation directors. Journal of Parks and Recreation Administration, 27(1), 1-27.
Cordell, H. K., Green, G. T., & Betz, C. J. (2002). Recreation and the environment as cultural dimensions in contemporary American society. Leisure Sciences, 24(1), 13-41. Hendee, J. C. (1969). Rural-urban differences reflected in outdoor recreation participation. Journal of Leisure Research, 1, 333-341. Johnson, K. M. (2003). Unpredictable directions of rural population growth and migration. In D. L. Brown & L. E. Swanson (Eds.), Challenges for rural America in the twenty-first century (pp. 1931). University Park, PA: The Pennsylvania State University Press.
Yousefian, A., Ziller, E., Swartz, J., & Hartley, D. (2009). Active living for rural youth: Addressing physical inactivity in rural communities. Journal of Public Health Management Practice, 15(3), 223-231.
Krannich, R. S., & Petrzelka, P. (2003). Tourism and natural amenity development: Real opportunities? In D. L. Brown & L. E. Swanson (Eds.), Challenges for rural America in the twentyfirst century (pp. 190-202). University Park, PA The Pennsylvania State University Press. Lobao, L. (2004). Continuity and change in place stratification: Spatial inequality and middle-range territorial units. Rural Sociology, 69(1), 1-30. McLeroy, K.R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Heath Education Quarterly, 15, 351-377. Moore, J. B., Jilcott, S. B., Shores, K. A., Evenson, K. R., Brownson, R. C., & Novick, L. F. (2010). A qualitative examination of perceived barriers and facilitators of physical activity for urban and rural youth. Health Education Research, 25(2), 355-367. Mowen, A. J., Payne, L. L., Orsega-Smith, E., & Godbey, G. C. (2009). Assessing the Health Partnership Practices of Park and Recreation Agencies: Findings and Implications from a National Survey. Journal of Park & Recreation Administration, 27(3), 116-131. Paluck, E. C., Allerdings, M., Kealy, K., & Dorgan, H. (2006). Health promotion needs of women living in rural areas: an exploratory study. Canadian Journal of Rural Medicine, 11(2), 111-116. Sallis, J.F., Cervero, R.B., Ascher, W., Henderson, K.A., Kraft, M.K., & Kerr, J. (2006). An ecological approach to creating active living communities. Annual Review of Public Health, 27, 297-322. US Department of Health and Human Services. (2000). Healthy People 2010: Understanding and improving health. Washington, D.C: US Government Printing Office.
Sept. 2010 Rural Connections
36
37
Rural Connections Sept. 2010
Health, Economy
& Community: USDA Forest Service Managers’ Perspectives on Sustainable Outdoor Recreation By Kelly S. Bricker, Patricia L. Winter, and Jeremy R. Schultz Introduction
been measured by Cordell et al. (2008) since
“Everybody needs beauty as well as bread,
2000. Prominent among the top seventeen
places to play in and pray in, where nature
activities, viewing or photographing flowers
may heal and cheer and give strength to the
and trees and natural scenery ranked the
body and soul alike.” John Muir
highest, with growth rates of nearly 26 percent and 14 percent respectively. Cordell et al.
Nature-based recreation is believed to be
(2008) suggest that “Americans’ interest in
the fastest growing sector of the recreation
nature and nature-based recreation, though
and tourism industry globally, generating
changing is not declining; rather, is strong
an
estimated
10-12
and growing” (p. 10).
in
international
travel
percent per
year
growth (World
Tourism Organization, 2001). The United
Increased use comes with concerns. Major
Nations Environmental Programme (UNEP)
initiatives and forums in the 1980’s such as
and Conservation International (CI) have
the creation of the World Commission on
indicated that most of the growth in leisure
Environment and Development (WCED) and
travel is occurring in and around the world’s
its subsequent 1987 report, Our Common
remaining
2005).
Future (United Nations, 1987); and the 1992
Within the United States, demonstrating the
Earth Summit, resulting in the Rio Declaration
highest increases (double digits from 2008),
on
were backpacking, mountain biking, and trail
Agenda 21 (Hall & Lew, 1998) brought
running; with hiking and camping increasing
to the forefront that “current generations
slightly
respectively).
were imposing too great a demand upon
Participation in nature-based activities has
the natural environment to allow it to
(7
natural
and
areas
9
(Christ,
percent
Environment
and
Development,
and
Sept. 2010 Rural Connections
38
HEalth, Economy & Community
continue to reproduce and maintain itself
and other non-material benefits (Millennium
of this study were to examine USDA FS
at its previous level of stability” (Butler,
Ecosystem Assessment, 2005). Sustainability
personnel
1998, p. 26). Evolving as Agenda 21 for the
becomes
recreation and:
Travel and Tourism Industry (WTTC, WTO,
strategy to prevent ecological degradation,
Earth Council, 1995), Agenda 21 laid the
and hence enhance ecosystem services vital
groundwork and guidance for sustainable
to healthy species existence (Chivian, 2004).
recreation and tourism in a broad sense.
Public lands in the United States provide
It also prompted an expanded discourse on
large corridors to protect and conserve
recreation in protected areas, which included
biodiversity, as well as provide areas for
the notion of “operating in harmony with the
healthy
local environment, community, and cultures,
benefits to local communities by way of
so
recreation and tourism development, and
that
these
become
the
permanent
synonymous
recreational
with
a
pursuits,
conscious
increase
development” (WTTC, WTO, Earth Council,
communities. These ideas are also supported
1995, p. 30).
by the USDA Forest Service’s mission: “To
quality
of
life
for
surrounding
of
development,
as
to meet the needs of present and future
storehouses for biodiversity1, and contribute
generations.” (United States Department of
to human health and well-being, through
Agriculture Forest Service (USDAFS), 2009).
direct and indirect benefits. The benefits
Sustainable recreation, conceptualized by
that
as
global initiatives and supported through our
“ecosystem services” are often used to
public land managing agencies missions, is
understand this relationship. These benefits
a multi-faceted complex idea, which has not
include: 1) provisioning such as food and
been explored through public land manager’s
freshwater; 2) regulating services, such as
perspective.
climate regulation and water purification; 3)
This paper explores how public land managers
supporting services, such as soil formation
perceive sustainability within the context of
and nutrient cycling; and 4) cultural services,
managing for sustainable recreation2
such
USDA FS managed lands. The objectives
healthy
as
protected
areas
environments
recreational,
serve
support
spiritual,
religious,
the
Nation’s
forests
and
grasslands
on
sustainable
public; 2. Increased appreciation for surrounding communities; 3. Cooperation with surrounding communities in policy and decisionmaking processes; 4. Improved quality of life for surrounding communities; and, 5. The economic benefits of sustainable recreation.
sustain the health, diversity, and productivity When placed in the context of human
of
1. Improved health for the recreating
economic
beneficiaries not the victims of [recreation]
perceptions
Methods The study population was USDA FS managers in decision-making roles regarding recreation. The levels of responsibility were regional, forest, district, and location. A total of 872 employee’s names and email addresses were gathered and 433 individuals participated. Our final response rate was 50.5 percent, after
eliminating
non-functioning
addresses. Survey Instrument Development of our questionnaire was a multi-phased process. In our first phase we gathered impressions from the field. Suggestions were sought from USDA FS regional recreation managers to discuss the study concept and proposed objectives, which in turn provided insights
on
sustainable
critical
issues
recreation
in and
tourism concerns. Survey items were derived from a sustainable operations survey (Winter, 2008), sustainable management concepts explored by Cottrell and others (see Cottrell & Vaske, 2006; Cottrell et Figure 1. Importance of Sustainable Recreation.
39
Rural Connections Sept. 2010
al., 2007), and unique items of
HEalth, Economy & Community
interest to this study such as responses to
and averaged 7.4 years in their current
Sustainable Recreation and Community
global climate change which were based on
assignment. More than half (59.1 percent)
When considering SR and communities, Forest
previous work for the California State Parks
held Bachelor’s Degrees, and almost one-
Service
Public Opinions and Attitudes Survey on
third had completed graduate degrees (21.7
several aspects of community life were
outdoor recreation in California (Hendricks
percent Master’s, 8.5 percent Ph.D.).
important to sustainable recreation (see
managers
generally
agreed
that
Figure 2). The majority (80 percent) agreed
et al., 2007). The survey draft was then provided to research colleagues and agency
Forest Service Manager’s Perceived
to strongly agree that recreation created
personnel interested in sustainability and/or
Responsibility for Sustainable Recreation
new job opportunities and diversified the
recreation and tourism for their review and
Results
that
local economy; and, almost 90 percent felt
comment, which resulted in a reduction of
respondents
recreation
recreation brings new income to surrounding
the number of survey items and rewording
(SR) as important both professionally and
communities. And, 92 percent felt economic
several of the items. Review by a union
personally
impacts
representative and a pretest with a random
90
segment of our sample rounded out our
they
survey development preparatory steps.
recreation. Further, 94 percent felt they
of
percent were
the
survey
view (Figure of
indicated
sustainable 1).
the
concerned
Specifically,
respondents about
over agreed
sustainable
of
communities
recreation was
an
on
surrounding
important
to
very
important aspect of sustainable recreation.
had a professional responsibility to practice
Respondents were also asked about aspects
Survey Questionnaire
sustainable operations and have SR in their
of quality of life and sustainable recreation
The final survey was specifically designed
management area. Almost all (90 percent) felt
(see Figure 2). A vast majority (87 percent)
for online administration through a program
that SR warranted additional investment of
felt that improved health for the recreating
FS resources; however, they were somewhat
public was important to very important when
called
Our
Zoomerang.3
selected
respondent
survey
included (e.g.,
split on whether or not SR was a FS priority
considering sustainable recreation. Quality
length of time in area, and highest level
characteristics
(i.e., approximately 50 percent agreed that
of life for surrounding communities, with 90
of education completed); and respondent
it was).
percent agreeing that FS managed lands
position in the USDA FS (e.g., job title and time
in
Service
assignment). managers’
To
explore
understanding
Forest of
the
relationship between sustainable recreation and tourism and surrounding communities, sections of the survey included questions surrounding economic benefits, quality of life, and community involvement in decisionmaking processes. Two items also explored the importance of sustainable recreation in the employee’s management area (e.g., importance within the management area and sustainable recreation as a FS priority), and these were evaluated based on a five-point scale where 1=very unimportant and 5=very important. Findings
represent
responses
from
433
participants, the vast majority (97.9 percent) who
worked
district-level
full-time, (57.0
primarily
percent).
Most
at
the
served
as recreation managers (47.8 percent) or recreation
staff
officers
(28.9
percent),
Figure 2. Agreement on Community Benefits.
Sept. 2010 Rural Connections
40
HEalth, Economy & Community
increased the quality of life for residents in
lands
sustainable
continue, but become more symbiotic if
surrounding communities.
recreation in the broader sphere of public
system.
The
role
of
[these areas] are to continue to perform their
land management responsibilities might also
multiple functions into the third millennium”
Lastly, while most respondents agreed that
be important to know. It is at the broader
(p. 335). And, while we understand that
residents should be involved in decision-
sphere
sustainable recreation must safeguard the
making (85 percent), only half (50 percent)
allocation and agency priorities are made.
that
decisions
about
resource
natural environment in order to meet the
actually felt there was good communication
needs of the host population and satisfy
among parties involved in the policy and
The consequences of nearly 700 million
its
decision-making
visitors (WTO, 2001) roaming the globe at
whether or not this is actually taking place
the start of the new millennium has increased
in practice (Cater, 1993). The USDA Forest
processes
surrounding
recreation.
we
have
yet
to
determine
awareness of the importance of creating
Service embraces as its motto: “Caring for
Discussion
and
the land and serving the people.” Inherent
This study demonstrated that our respondents
environments
communities
in its mission and motto is guidance that
agreed there is a connection between healthy
upon which nature-based recreation survival
culminates in sustainable recreation (USDA
communities and sustainable recreation on
depends.
FS, 2010). For example:
FS managed lands. While many managers
organizations,
surveyed
critical need for research to address these
in
this
study
understood
the
sustaining
the
and
healthy
Governments,
non-governmental
communities
that this is a Forest Service priority may
recreation industry, with the aid of research,
provide
to
has an opportunity to play a leadership
increase their emphasis on conservation
role in shaping a more sustainable society,
and sustainable management of public lands
one that brings real benefit to biodiversity
as portals to enhancing ecosystem services
conservation and protection of ecosystems
(i.e., provisioning, regulating, supporting, and
at all levels.
for
managers
The
a
public
incentive
issues.
have
linkages to community, further assurance an
policy
and
biologically-diverse
nature-based
promoting the health, productivity, diversity, and beauty of forests and associated lands. • Listening to people and responding to their diverse needs in making decisions.
Forests and Grasslands so they best We
generally
accept
that
sustainable
This study focused on recreation managers
recreation development must be inclusive
and aspects of communities with respect to
of not only environmental considerations,
sustainable recreation development. Yet we
but also needs social and economic pillars.
know that protected areas not only provide
By
direct economic benefits, but also create
relationship to protection of natural areas,
venues for a range of environmental services
including biodiversity and protected areas
such
watershed
such as public lands, we can begin to
protection, water purification, and pollination
understand ways in which sustainability can
(Dudley et. al., 2008). The importance of
be incorporated into all aspects of this
ecosystem
services
and
complex industry. As Butler (2000) suggests,
economic
well-being
need
the “relationship between [recreation] and
for a broader understanding of managers’
[protected areas] will never be an easy
perspectives from all resource areas (i.e.,
one, but for the mutual well-being of both
water, botanical, wildlife) within our public
partners, the relationship must not only
as
• Advocating a conservation ethic in
• Protecting and managing the National
cultural).
41
visitors,
climate
regulation,
Rural Connections Sept. 2010
to
livelihoods
suggests
the
exploring
nature-based
recreation’s
demonstrate the sustainable multipleuse management concept. • Providing technical and financial assistance to State and private forest landowners, encouraging them to practice good stewardship and quality land management in meeting their specific objectives. • Providing technical and financial assistance to cities and communities to improve their natural environment by planting trees and caring for their forests. • Providing international technical
HEalth, Economy & Community
assistance and scientific exchanges to
ENDNOTES
sustain and enhance global resources
1
organisms from all sources, including terrestrial,
and to encourage quality land
marine, and other aquatic ecosystems and the
management.
ecological complexes of which they are a part;
• Helping States and communities to wisely use the forests to promote rural economic development and a quality rural environment.
and technical knowledge aimed at improving our capability to protect, manage, and use forests and
to the unemployed, underemployed, elderly, youth, and disadvantaged in pursuit of our mission.
sustainability in nature-based recreation by land managers that address these issues in their daily work. Further research is needed the
relationships
between
sustainable nature-based recreation and the health and viability of adjacent communities. Whether, rural, urban, or somewhere in between, the pillars of sustainable recreation offer guides to beneficial delivery of services across scales and ecosystem types.
About the Authors Kelly S. Bricker is an associate professor in the Department of Parks, Recreation, and Tourism at the University of Utah. L.
Winter
with
Conservation of biological diversity means
that we use various management practices to areas of ecosystems” (IUCN, 2001, p. 1). Sustainable recreation is envisioned as an
the
is
a
USDA
research Forest
social Service,
Pacific Southwest Research Station. Jeremy R. Schultz is a doctoral candidate in the Department of Parks, Recreation, and Tourism at the University of Utah.
Cottrell, S. P., Vaske, J. J., Shen, F., Ritter, P. (2007). Resident perceptions of sustainable tourism in Chongdugou, China. Society and Natural Resources. 20(6): 511-525. Dudley, N., Mansourian, S., Stolton, S., & Suksuwan, S. (2008). Safety Net: Protected Areas and Poverty Reduction. World Wildlife Fund for Nature and Equilibrium, The Arguments for Protection Series, Gland, Switzerland. Hall, C. M. and Lew, A. A. (1998). The geography of sustainable tourism development: An introduction. In C.M. Hall & A.A. Lew (Eds.), Sustainable tourism: A geographical perspective (pp. 1-12). Essex: Longman.
2
all encompassing term to include both local
recreation/tourism industry in local communities. The use of trade or firm names in this
Hendricks, W.W., Bricker, K.S., Greenwood, J.B., Goldenberg, M., Jacobs, J. (2007). Survey on Public Opinions and Attitudes on Outdoor Recreation in California. An element of the California Outdoor Recreation Planning Program. California State Parks, State of California Natural Resources Agency. Sacramento, CA.
3
IUCN (2001). Strategic Approach for Integrating Biodiversity in Development Cooperation. Biodiversity in Development Project European Commission, Brussels, Belgium/IUCN, Gland, Switzerland and Cambridge, UK.
paper is for reader information and does not imply endorsement by the U.S. Department of
This study shed some light on support for
scientist
VIII).
public lands (tourists), which potentially creates a
• Providing work, training, and education
Patricia
species and of ecosystems” (IUCN, 2001, p.
recreationists (visitors) and those who travel to
rangelands.
address
this includes diversity within species, between
“maintain the populations of genes, species and
• Developing and providing scientific
to
Biological diversity is the “variability among living
Agriculture of any product or service.
Millennium Ecosystem Assessment (MEA) (2005). Millennium Ecosystem Synthesis Report. Washington, DC: Island Press.
References
Butler, R.W. (1998). Sustainable tourism-Looking backwards in order to progress? In C.M. Hall & A.A. Lew (Eds.), Sustainable tourism: A geographical perspective (pp. 25-34). Essex: Longman.
United Nations. 1987. Report of the World Commission on Environment and Development, General Assembly Resolution 42/187, 11 December 1987. Retrieved: 2007-11-14
Cater, E. (1993). Ecotourism in the third world: problems for sustainable tourism development. Tourism Management. 14: 85-90.
United States Department of Agriculture Forest Service (USDA FS). Forest Service Mission. Retrieved July 10, 2010 from http://www.fs.fed. us/aboutus/mission.shtml.
Chivian, E. (2004). Beyond wildlife-health and conservation. In D. Roe (Ed.), The millennium development goals and conservation: Managing nature’s wealth for society’s health (pp. 25–35). London: International Institute for Environment and Development. Christ, C. “Ecotourism is Transforming the Travel Industry.” Maine Center for Economic Policy. June 24, 2005, http://www.mecep.org/MeChoices05/ ch_06242005.htm. Cordell, H.K. (2008). The latest on trends in nature-based outdoor recreation. Forest History Today, Spring, pp. 4-10. Last retrieved on October 20, 2008, from http://www.foresthistory. org/Publications/FHT/FHTSpring2008/Cordell.pdf Cottrell, S. P., Vaske, J. J. (2006). A framework for monitoring and modeling sustainable tourism. e-Review of Tourism Research, 4(4), 74-84.
Winter, P L. (2008). Pacific Southwest Research Station and Region 5 sustainable operations survey report. Misc-08-083. Albany, CA: U.S. Department of Agriculture, Forest Service, Pacific Southwest Research Station. Retrieved from www.fs.fed.us/psw/publications/documents/ psw_misc8083.pdf. World Tourism Organization (WTO) (2001). Tourism highlights 2001. Madrid: World Tourism Organization. World Travel and Tourism Council, World Tourism Organization, Earth Council (1995). Agenda 21 for the Travel and Tourism Industry: Towards Environmentally Sustainable Development. WTTC, WTO, Earth Council, London, UK.
Sept. 2010 Rural Connections
42
Community Recreation and Healthy Living in Rural Settings
By Sue Goodwin
M
y
happy
of
while over 70 percent of today’s mothers
rural
and
recalled playing outdoors every day as
fewer municipal funding resources and lack
playing outside for hours upon hours, make
children, only 26 percent said that their own
of access to commercial fitness facilities
me concerned about the lack of exposure
children played outside everyday.
in rural areas, limit the health and fitness
growing
childhood up
in
memories
Massachusetts
to outdoor recreation and nature for today’s
lack
of
transportation,
opportunities available to rural residents.
children, no matter where they live. While
“Surprisingly, the responses did not vary a
Deborah John of Plymouth State University
some may assume that rural children and
great deal between mothers living in rural
states that,
adults spend more time outside recreating
and urban areas.” Rhonda L. Clements, as
in nature, recent studies have shown that
quoted in “Last Child in the Woods,” by Richard
“While rural living is associated with quality
this just isn’t the case. In his book, “Last
Louv (2005).
of life, access to outdoor recreation, …
Child in the Woods,” Richard Louv draws our
43
population,
inherently more active, the reality is that
attention to the work of Rhonda Clements,
The
rural
people living in rural areas have limited
of Manhattanville College in New York, who
communities have healthier lifestyles has
access to health care, commercial exercise
surveyed 1,800 urban and rural mothers
been challenged by recent research as
facilities,
and compared their answers to those of
well, revealing many of the long-standing
physical
mother’s a generation ago. She found that
challenges rural communities face. The aging
rural municipalities have fewer resources to
Rural Connections Sept. 2010
assumption
that
people
in
and activity
community programs.
or In
corporate addition,
While almost anyone can appreciate nature’s beauty and most understand the importance of having active lifestyles to sustain good health, not everyone views access to the natural world in the same way.
support healthy active living. Consequently,
Electronic Media, Isolation and Nature
a sense of isolation and providing greater
people living in rural areas are more prone
Deficit Disorder in Rural Living
access to information is a good thing,
to
Do
develop
conditions
associated
with
rural
children
suffer
“Nature
Deficit
finding a balance is critically important. The
inactivity, such as heart disease, diabetes,
Disorder?”
lack
question is, where does the time allocated
and obesity, than their urban and suburban
of outdoor physical activity? It would be
for electronic media time come from? In
neighbors.”
a
Do
they
experience
a
children
other words, what activities are displaced
are any less susceptible to the draw of
by the use or over use of electronic
Access, Safety and Proximity Matter
electronic media (video games, the Internet
media? Recent research on this issue at
Rural children, often living great distances
or television) than urban children. Are they
the University of Waterloo, using random
from
more or less isolated given today’s access
sampling and multivariate analyses, found
to the virtual social networks online?
that electronic media use displaced both
their
schools
and
village
centers,
may actually have less opportunity to ride
mistake
to
think
that
rural
their bikes or walk to school than urban
social and physical activities at significant
children and often have to arrange extra
When blogger Mick Ly asked the question,
levels (-.37 and -.23 respectively). The same
transportation if they wish to stay after
“Does Internet make us isolated?” he got
study found that use of electronic media did
school to participate in sports programs
some interesting responses:
not interfere with activities at school, so it
or use the school’s gymnasium or other
“I think sometimes the Internet really
follows that the most likely source of time
community facilities. Even if a rural child
makes us isolated. We don’t often go to
displaced is a family’s 1:1 time before and
lives near their school, parents may have
have the outdoor activities. We just stay
after school, weekends and holidays.
safety
of
at home and get online. We contact our
bicycling on rural roads. Rural roads can
friends and family by emails and chatting
One balanced approach is more effective
be very dangerous. In a study of traffic
software. But we don’t often visit them in
time management allocating limited time for
accidents in 2002, by the Washington State
person. Even we go shopping via the net
sedentary activities without denying access
Department of transportation, it was found
today. This is the disadvantage of Internet
to electronic media altogether combined
that the number of fatal accidents on rural
to take people apart.” Youless
with
concerns
about
the
safety
frequent,
regularly
planned
family,
community and age group nature-based
roadways was more than double that of urban roadways. Parents may not want their
“… I hear parents complain about their
children walking or riding alone on rural
kids spending more time on the computer
roads and trails.
and have stopped playing outdoor games,
Nature and Rural Values: Finding our
and have very limited time socializing with
Common Ground
Proximity matters in access to recreation,
family members and friends. So in my
Many rural families have lived in their
nature and increased physical activity. Living
opinion, while Internet gives us a wider
community for generations and may have
in rural areas often means great distances
reach to the people around the world,
differing views and beliefs about nature
between important locations. In urban settings,
it also isolates us from the people who
than
providing appropriate access to recreation
matter more to us–our family and personal
to a rural setting from an urban area
takes proximity into account. An urban park
friends.” Dory Vien
specifically to live closer to nature. This
activities and outdoor recreation.
newer
residents
who
have
moved
doesn’t mean that these values are in any
or recreation facility’s “Neighborhood Service Area” is considered to be a half-mile from
Others felt that Internet access can also
way in conflict with each other, just that a
its perimeter or, as some have determined,
allow
others,
respectful and sensitive acknowledgement of
within walking distance for a healthy person.
broader perspectives, and online networks
these differences in perspective exist and
It’s fairly rare to find this convenience in a
of virtual friends, essentially reducing our
employing the “assumption of good intent”
rural setting.
self-perception of isolation. While reducing
are important for a cohesive, inclusive,
interaction
with
distant
Sept. 2010 Rural Connections
44
positive
and
community-based
approach.
developing
rural
communities
over
vast
Finding common ground and sharing specific
and sometimes isolating distances and in
goals is a good place to start. While almost
many instances doing so with few financial
anyone can appreciate nature’s beauty and
resources. In “The Recreation Road – A Rural
most understand the importance of having
Route to Planning,” the Leisure Information
active lifestyles to sustain good health, not
Network provides a step-by-step workbook
everyone views access to the natural world
for rural communities attempting to provide
in the same way. Barbara McCahan, director
recreation
of the Center for Active Living and Healthy
members. Written for volunteers, one of the
Communities at Plymouth State University,
great things about this workbook is that
highlights these different perspectives, “…
they have built in methods for planning
the woods can be as much of a deterrent
community recreation that any lay person
to being physically active as a freeway,
can understand and use. Conclusions and
depending on how you look at it.”
recommendations are based on research
activities
for
their
community
combined with interviews with community
45
a greater chance for a successful rural recreation effort. Some good ideas include: • Partnership efforts with community service non-profits like the Kiwanis Club to organize and support team sports, fishing derbies, hiking and walking clubs, nature workshops, sports challenges and village fairs. • Tapping into cultural traditions of rural indigenous communities can expose the community at large to a more meaningful experience with nature that is based in diverse perspectives and
Individual and Community-Based
leaders in rural settings. The conclusions,
Solutions and Resources
or “impressions” as they are referred to
Rural children are likely to be dependent on
in the workbook, suggest culturally-sensitive
their families for their recreation experiences
and useful methods to identify community
and exposure to nature. With rural families
strengths,
working harder than ever to make ends
for local recreation. One of the interesting
meet and most parents working more hours
insights provided by the Leisure Information
and walking paths. In rural areas, trails
per day than ever before, what is a rural
Network of Canada is that many well-
and pathways often pass through
family to do to provide exposure to nature
meaning efforts at developing rural recreation
private land and require permission to
and recreational activities for their family
programs do not actually ask rural residents
cross and this can complicate access.
members? Knowing the problem is good,
what they want. The workbook provides
One shared goal might be establishing
knowing effective solutions is even better.
ways of identifying what local people want
a positive relationship with these land
Canada has a long history of proactively
in recreation programs and this provides
owners. Having established standards
Rural Connections Sept. 2010
challenges,
needs,
and
goals
historical values. Enriched experience and breadth of exposure enhances a child’s understanding and respect for nature. • Provide easier access to local trails
for hikers that respect the land
In conclusion, it’s clear that many of the
owners needs while gaining permission
myths about rural living are being dispelled
to walk freely on private hiking trails
and many of the challenges of rural living are
can increase access to nature while
coming to light. Far from the “rose colored
building positive relationships within
glasses” view of the idyllic nature of rural
the community. A local trail map could
living held in the past, a more balanced view
be produced with efforts to increase
taking in the significant challenges along with
eco-tourism.
the positive benefits of rural living is helping
• Provide positive nature-based experiences can help children develop mentally and physically. Two excellent books, filled with activities, are “Sharing Nature with Children II” by Joseph Cornell and “Nature’s Playground,” by Fiona Danks and Jo
communities advocate for themselves and create positive change for their community members. relationship
Actively with
developing nature
and
a
positive
increasing
outdoor physical activity is equally important for rural and urban kids.
Schofield. Both books are suitable
About the Author
for use by families or with larger
Sue
community groups (and frankly, adults
director with Seattle Parks and Recreation.
would enjoy them too). • Invite county recreation organizations to participate with mobile recreation programs that bring new experiences into rural communities periodically throughout the year. • Find out what local seniors feel would reduce isolation and increase activity.
Goodwin
is
the
recreation
division
References and Resources
Leisure Information Network. The Recreation Road: A Rural Route to Planning. Workbook for Rural Communities, Ontario Ministry of Tourism and Recreation, Ontario, Canada. Website: http://lin.ca/ resource-details/4231 Leisure Information Network. (multiple rural recreation articles and research) - There are a lot of readerfriendly, useful and downloadable articles on the development of rural recreation and targeted solutions for rural communities on a searchable database at the LIN website http://lin.ca/keywordsearch-results?Type=All&Key=Rural+Recreation&Area =All. Louv, Richard (2005). Last Child in the Woods: Saving Our Children from Nature-Deficit Disorder, Workman Publishing Company, New York, NY. Website: http:// richardlouv.com/ Mannell, Roger C., Zuzanek, Jiri & Aronson, Ryan (2005). Internet/Computer Use and Adolescent Leisure Behavior, Flow Experiences and Psychological Well-Being: The Displacement Hypothesis, Canadian Association for Leisure Studies, Leisure Information Network, Canada. Rural Recreation Articles, Projects and Programs Indiana State University: Rural Recreation Development Project http://www.indstate.edu/inrrdp/ programs.htm USDA http://www.ers.usda.gov/amberwaves/September05/ Features/RuralAreasBenefit.htm
Cornell, Joseph (1989). Sharing Nature with Children II, Dawn Publications, Nevada City, CA.
http://www.ers.usda.gov/Publications/err7/err7_ reportsummary.pdf
Danks, Fiona & Schofield, Jo (2007). Nature’s Playground: Activities, Crafts, and Games to Encourage Children to Get Outdoors, Frances Lincoln Limited, London.
Ottawa’s “Rural Connections: Proud to be Rural” http://www.ottawa.ca/residents/rural_connections/ recreation/index_en.html
John, Deborah. Promoting Active Rural Living and Healthy Communities, Plymouth State University, Center for Active Living and Healthy Communities, Plymouth, NH. Website: http://www.plymouth.edu/
UK’s RuralRecreation website http://www.ruralrecreation.org.uk/ The Daily Yonder: Keep it Rural http://www.dailyyonder.com
• Form a Community Action Council.
Sept. 2010 Rural Connections
46
Thermus aquaticus and You: Biodiversity, Human Health, and the Interpretive Challenge
By Daniel L. Dustin, Keri A. Schwab, and Kelly S. Bricker
47
Rural Connections Sept. 2010
Thermus aquaticus and You
I
magine being imprisoned for a crime
grandfather died while Ochoa served 12
unexpected happy ending. Since Gary
you didn’t commit. How would it affect
years in prison. Such was the case of
Dotson was first set free by a DNA
your
physical,
emotional
Neil Miller who was incarcerated for nine
matching technique in 1989, more than
How would it affect the health
years after a wrongful rape conviction.
250 convictions have been reversed in the
of your family and friends? Imagine your
Such was the case of Earl Washington
United States, leading to innocent people
sense of helplessness when everyone
who
being set free. DNA is a spiral molecule
who should have helped set you free—
years after discrimination, manipulation,
found
eyewitnesses, investigators, police, and
and poor legal representation led to
specific genetic information unique to
attorneys—all conspired instead to build
his
conviction for rape and murder.
each one of us. For an individual accused
a strong case against you. After your trial
And such was the case of Gary Dotson
of a crime, DNA testing can often help
and sentencing, imagine how you would
who spent eight years in prison on
determine beyond a reasonable doubt if
feel after more than a decade behind
aggravated kidnapping and rape charges,
that person committed the crime. It is
bars for something you didn’t do.
after a victim misidentified him as the
a powerful diagnostic tool for both the
perpetrator.
prosecution and the defense. But how
health?
mental,
and
was
wrongly
imprisoned
for
17
Such was the case of Christopher Ochoa,
in
all
organisms.
It
contains
did DNA testing come to be?
who, in 1988, was coerced into confessing
Fortunately, thanks to deoxyribonucleic
to a murder he didn’t commit, and whose
acid
(DNA),
these
stories
have
an
Sept. 2010 Rural Connections
48
Thermus aquaticus and You
Polymerase Chain Reaction
was driving cross-country to a summer
We often think of Yellowstone as a tourist
On a hot dry evening in May of 1983,
job in Seattle. He did some climbing in
attraction to be enjoyed for its recreational
Kary Mullis, a researcher with the Cetus
the Grand Tetons and then, against his
amenities. Indeed, inscribed on the Roosevelt
Corporation, was driving north from Berkeley,
better judgment, made a detour north to
Arch at the Gardiner entrance to Yellowstone
California through Mendocino County. He was
Yellowstone National Park. (Dr. Brock had
is “For the benefit and enjoyment of the
enjoying the smell of blossoming California
avoided
several
people.” While we think of these benefits as
buckeyes and thinking about a way to read
previous occasions, because of his aversion
being largely recreational, they represent but
the sequence of, as he put it, the “King”
to tourists and crowds.) He stopped briefly
a fraction of the overall benefits Yellowstone
of molecules, DNA. If he could do that, he
at the West Thumb Geyser Basin on the
has to offer. Benefits come in many forms,
felt he could change the world. As he drove
western shore of Yellowstone Lake, and, to
and
on, Dr. Mullis understood that he had to
his amazement, saw what he described as
illustrates, the health benefits have turned
arrange a series of chemical reactions that
“algae mats, bright orange, red, and green,
out to be enormous. Clearly, the National
would represent and display the sequence
spread out along the silica channels under
Park Service’s (NPS) custodial responsibility
of a stretch of DNA. He could do this, he
sheets of hot, steaming water” (Brock, 1978,
is much larger than we typically give it credit
thought, by attaching a short synthetic piece
p. 441). Fascinated by what he observed,
for. By preserving Yellowstone’s biodiversity,
of DNA to a long strand of DNA if the
Dr. Brock spent the next ten years studying
the
sequences matched up somewhere on the
microorganisms
thriving
the health of people everywhere. This is a
longer strand. He then focused on to how
geyser
The
proved
benefit well beyond the context of recreation.
to do it. Later on that evening and farther
to be wonderful natural laboratories. The
One can only wonder what other potential
down Highway 128, Dr. Mullis worked out in
crowning achievement of Dr. Brock’s decade
health benefits lay hidden in the Yellowstone
his mind the rudimentary chemistry for what
of research was the discovery of a new
ecosystem awaiting future Dr. Brocks of the
would come to be known as the polymerase
bacterium, Thermus aquaticus, in October
world?
chain reaction (PCR), the key to the DNA
of 1966, the bacterium from which the heat
matching technique. Ten years later, in
resistant
1993, he won the Nobel Prize in Chemistry
eventually isolated and adopted for use in
The Thermus aquaticus story demonstrates
for that night’s conceptual work.
the DNA matching process.
the connection between biodiversity and
Integral to PCR’s utility as an amplification
Thermus aquaticus and You
connection must be communicated to the
technique for reading DNA is Taq polymerase,
The story of Thermus aquaticus’s discovery in
general public in a way that resonates with
a heat resistant enzyme that makes it easier
Yellowstone National Park, and its subsequent
their personal experience if the implications of
to duplicate specific pieces of DNA. Taq
role in creating a 1993 Nobel Prize-winning
the connection are to be clearly understood.
polymerase, in turn, is found in bacteria
technology that makes it possible to read
Because our scientific understanding of the
that thrive at extremely high temperatures.
DNA, is a clear illustration of human health’s
working of things typically outpaces our
These thermophilic bacteria are considered
dependence on biodiversity. Had President
common
unusual
because
thought
to
visiting
basins.
Yellowstone
enzyme,
in
hot
Taq
on
Yellowstone’s
springs
polymerase,
was
as
NPS
49
contributed
story
immensely
to
health
vividly.
understanding,
But
we
this
kind
believe
of
the
were
Ulysses S. Grant not protected those thermal
real challenge is an interpretive one. We
“laboratories” in the form of a national park
must design effective ways to communicate
limits of life (> 55 degrees Celsius or >131
in 1872, and had Dr. Brock not made his
complex
degrees Fahrenheit). Indeed, the bacterium
fateful detour to Yellowstone in the summer
interdependencies
from which Taq polymerase was isolated
of 1966, who knows when, if ever, Kary
in everyday language if we are to gain
thrives in scalding water. And where on
Mullis and his colleagues would have pieced
widespread public support for biodiversity
earth was that bacterium, that source of
together the chemical puzzle that resulted
conservation.
Taq polymerase, found?
in
the
upper
what
aquaticus
temperature
be
defy
has
Thermus
The Interpretive Challenge
human
they
the
the
PCR
technique
so
ecological
interrelationships to
everyday
and
people
indispensable
to DNA matching. And who knows when
We have told the story of Thermus aquaticus
Thermus aquaticus
Gary Dotson, Earl Washington, Neil Miller,
in a way that reflects Freeman Tilden’s (1967)
In the summer of 1966, Thomas Brock,
Christopher Ochoa, and those 250 innocent
principles of interpretation by allowing the
a microbiologist from Indiana University,
others would, if ever, have been set free.
story itself to reveal its relevance to you,
Rural Connections Sept. 2010
Runoff from the West Thumb Geyser Basin, Yellowstone National Park.
thereby provoking you to reconsider the
and harder to do if the context for most
meaning of the story to your own life. Who
people’s life experiences is confined to the
among us cannot relate to the horror of an
city. Helping people really, truly understand
innocent person being wrongly imprisoned?
that human health is dependent on the
Who
a
health of ecosystems far removed from
scientific breakthrough that could exonerate
human populations, and that humans must
us from a false accusation? Who among us
modify livelihoods and lifestyles to ensure
would not want to protect the origin of that
the continued good health of those distant
scientific breakthrough? Who among us, then,
reservoirs of biodiversity, is a daunting
does not now feel a little more committed
educational task. To accomplish it, we must
to protecting Yellowstone National Park and
employ creative approaches to interpretation
the biodiversity it represents?
that employ vivid examples that illustrate
among
us
would
not
welcome
complex
ecological
interrelationships
and
Reconnecting with Nature
interdependencies, make environment-health
This interpretive challenge is heightened
connections explicit, and motivate us to get
by our society’s increasing disengagement
back to nature, learn from nature, and live
from the natural world. The United States of
our lives in harmony with nature. Therein
America is now more than 85% urbanized. We
resides the connection between Thermus
are, by and large, city dwellers far removed
aquaticus and you.
Recommended Reading
Brock, T. (1978). Thermophilic microorganisms and life at high temperatures. New York, NY: Springer-Verlag. Brock, T. (1997). The value of basic research: Discovery of Thermus aquaticus and other extreme thermophiles. Genetics, 146: 1207-1210. Chivian, E., & Bernstein, A. (2008). Sustaining life: How human health depends on biodiversity. New York, NY: Oxford University Press. Dustin, D., Bricker, K., & Schwab, K. (2010). People and nature: Toward an ecological model of health promotion. Leisure Sciences, 32: 1-14. Innocence Project, The Benjamin N. Cardozo School of Law at Yeshiva University (n.d). Retrieved from http://www.innocenceproject.org. Mullis, K. (2000). Dancing naked in the mind field. New York, NY: Vantage Books. Sulzbach, D. (2006). DNA Shall Prevail: Postconviction DNA Evidence: An Annotated Bibliography. Legal Reference Services Quarterly, 25(1), 39-58.
from the sources of biodiversity that sustain us. The danger in this separation rests in
About the Authors
the possibility that we may lose sight of our
Daniel L. Dustin serves as professor and
dependency on nature for our sustenance.
chair of the Department of Parks, Recreation,
We may not miss what we do not know and
and Tourism at the University of Utah.
Tilden, F. (1967). Interpreting our heritage. Chapel Hill, NC: University of North Carolina Press.
do not see. And in distancing ourselves from nature, we may behave increasingly in ways
Keri A. Schwab is a PhD candidate in
that are detrimental to the health of us all.
the Department of Parks, Recreation, and Tourism at the University of Utah.
Getting
people
more
than
and
emotional
back
to
enhancing health,
nature
physical,
means mental,
important
as
they are. It means reestablishing a basic
Kelly S. Bricker is an associate professor in the Department of Parks, Recreation, and Tourism at the University of Utah.
understanding of humankind’s dependence on the natural world. This will be harder
Sept. 2010 Rural Connections
50
Engaging the Future Hosted by Utah State University with generous support from USU’s Cooperative Extension and Agricultural Experiment Station.
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