Lack of safe, accessible places for physical activity in rural areas directly contributes to rising type 2 diabetes rates, especially among children and low-income families. Without affordable, culturally appropriate exercise options, patients face greater challenges managing their diabetes, leading to worsening health outcomes and deepening disparities.
Rural diabetes patients and low-income families
Underserved racial/ethnic groups (African American, Hispanic)
Motivated by their diagnosis, patients may initially attempt to make lifestyle changes such as walking regularly, jogging on local roads, or participating in informal community fitness groups. However, these efforts are frequently short-lived due to structural limitations. Financial constraints make gym memberships or fitness classes unaffordable, and rural environments often lack the built infrastructure needed to support safe and sustained activity.
For example, patients in towns like Albany, GA, may try to walk for exercise but encounter roads without sidewalks, minimal street lighting, or aggressive stray dogs, which are particularly unsafe and unwelcoming for older adults or those with mobility limitations. Parents of children newly diagnosed with Type 2 diabetes may wish to enroll them in physical activity programs but find few local options: Albany has a limited number of basketball courts or swimming pools, and school-based extracurriculars may be full or nonexistent in under-resourced districts.
Some patients try to follow online workout videos or use smartphone fitness apps, but access to reliable internet, a working phone, and the digital literacy to navigate these tools are not consistent in low-income, rural households. Group exercise classes tailored to local interests (e.g., line dancing, walking clubs, or family-based fitness programs) could help reinforce regular activity, but such opportunities often take place during the workday or at community hubs far from where patients live.
NEEDS STATEMENT:
Support the development of community-driven programs that use local spaces and/or virtual coaching to overcome safety and transportation barriers, increasing safe physical activity in rural areas for diabetes patients.
REQUIREMENTS:
Reflect local interests or activities and engage trusted community members or local leaders as instructors or facilitators.
Embed simple education on the benefits of physical activity for diabetes management, ensuring that materials and coaching are easy to understand regardless of literacy level.
Build in low-burden mechanisms for tracking participation, physical activity levels, and self-reported health outcomes to support ongoing program refinement and potential reimbursement.
ADDITIONAL CONSIDERATIONS:
Consider identifying existing groups working on physical activity initiatives and explore how technology can support or amplify their efforts.
Use tech-enabled activities to encourage exercise even before policy changes allow new playgrounds or green spaces.
Leverage pockets of community that already exist (churches, 4-H clubs, food pantry pickup locations, barbershops, and beauty salons).
