The built environment in rural USA plays a role in promoting
unhealthy behaviors conducive to obesity. For example, rural
residents have limited access to healthy food choices
45,46, and
the limited recreational resources such as parks and exercise
facilities is an impediment to physical activity47,48. Additional
research is needed to identify low-cost, sustainable changes
that can improve built environments in rural areas.
Techniques that empower rural communities to increase the
availability of quality food markets and recreational resources
need to be identified and disseminated.