Relationship Between the Built Environment, Physical Activity, and Chronic Disease Among Individuals with Disabilities in Rural Communities

Increased risk for chronic disease is closely associated with individual nutrition, tobacco use, and physical inactivity. This thesis focuses on physical activity as a means of preventing select chronic diseases. A major barrier preventing engagement in physical activity is the built environment. Populations residing in rural environment are not afforded the abundance of opportunities for physical activity prevalent in most urban networks. Of the demographic living in rural environments, individuals with disability face additional barriers to physical activity than those without disability. This leads to a higher prevalence of chronic diseases associated with sedentary lifestyles among populations with disability. Few studies address the correlation between physical activity, chronic disease, and the built environment as they relate to individuals with disability. This thesis utilized independent samples t tests to evaluate variation among physical activity levels and the prevalence of chronic disease. In the first paper, four research objectives defined the parameters for comparison: (1) physical activity for individuals with disability in rural versus urban environments; (2) physical activity in rural environments for individuals with and without disability; (3) prevalence of chronic disease for individuals with disability in rural versus urban areas; and (4) prevalence of chronic disease in rural environments for individuals with and without disability. The four research objectives of the second paper are: (1) rural and urban physical activity comparison for the highest disability classification; (2) rural and urban physical activity comparison for individuals with disability using equipment; (3) rural and urban physical activity comparison for individuals with disability resulting from physical, mental, or emotional impairments; and (4) rural and urban physical activity comparison for individuals not reporting disability. The 2011 Behavioral Risk Factor Surveillance System (BRFSS) provided the data used to evaluate the correlation between these variables. The results of both studies indicate important statistical significance relating the rural built environment to lower levels of physical activity for individuals with disability. The varied statistical significance and small effect sizes, however, were contrary to the hypothesis and warrants further exploration of the complex relationship regarding the built environment, physical activity, and chronic disease