Rural Connections

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

Additional research questions are:

a synopsis of our most recent community-

1. What are the feasible and

2. What are the feasible and

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 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

Figure 1. The conceptual framework of OPREVENT.

23

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

Rural Connections Sept. 2010

The Obesity Research Prevention...OPREVENT

Table 1. Study Phases.

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.

Pictured: OPREVENT’s two Michigan American Indian tribal communities.

25

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 that have been administered and evaluated in previous American Indian interventions by Dr. Gittelsohn and colleagues. OPREVENT will expand upon previous interventions by developing a curriculum for grades two and six. The study’s program evaluation methods are outlined in Table 3.

Currently, our researchers are in the first phase of the study in both Michigan and New Mexico.

Overall, the goals of our study include the following: 1. To develop sustainable community

of Social and Behavioral Interventions at

2. To advance knowledge of the relationship between behavioral and environmental factors and obesity among American Indian populations.

3. To reduce obesity in American Indians communities. This is the first study of its kind to address the multifactorial nature of adult obesity in these six communities.

the Johns Hopkins Bloomberg School of 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 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.

Sept. 2010 Rural Connections

26

The Obesity Research Prevention...OPREVENT

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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

email

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.

wrdc.usu.edu