Rural youth are at greater risk than urban youth for obesity and physical inactivity. Active living research incorporates an ecological approach to promoting physical activity (PA) by recognizing that individual behavior, social environments, physical environments, and policies contribute to behavior change. Active living research and interventions have been limited primarily to urban settings. Because rural communities have unique environmental features and sociocultural characteristics, this project combines insights from current active living models with more focused consideration of the physical and social realities of rural areas. In this study, we report on our efforts to develop, test, and refine a conceptual model describing the interaction between the individual and the environment as it enhances or thwarts active living in rural communities. Our findings revealed a host of relevant "predisposing" and "enabling" factors, including sociodemographic, environmental, policy, and programmatic elements, that extend across the four domains of active living--transportation, recreation, occupation, and household. A one-size approach to PA promotion will not fit the needs of rural youth. Given the unique challenges that rural communities face, efforts to combat childhood obesity must consider rural residents a priority population. More research, interventions, and evaluations on ways to promote rural PA are needed.
Cutler Institute for Health and Social Policy
Active Living for Rural Youth: Addressing Physical Inactivity in Rural Communities
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Dr. Ziller to speak on Rural Implementation and Impact of Medicaid Expansions
The impact of the ACA Medicaid expansion on health care coverage and access in rural areas is largely unknown and will depend on the different state policy contexts in which the expansions are implemented and on existing system capacity. Understanding how many rural residents are likely to become newly eligible for Medicaid under the ACA, as well as their characteristics and health status, will provide important information to aid policymakers in structuring outreach and enrollment strategies and ensuring that the healthcare infrastructure and delivery systems in rural areas can address the needs of these individuals.
On March 18th, Dr. Ziller, Deputy Director of the Maine Rural Health Research Center at the University of Southern Maine, will present via a SHARE webinar, nationally representative information identifying rural-urban differences among low-income non-elderly adults (18 to 65) in the following areas:
- Medicaid eligibility, pre-ACA
- Medicaid participation, pre-ACA
- New Medicaid eligibility in 2014
Dr. Ziller will also analyze the characteristics associated with any rural-urban differences in the above areas. Characteristics to be considered include age, gender, employment, education, income, Census region, health status, current relationship to primary care provider, primary care supply, and FQHC availability.