Rural areas aren't always pedestrian friendly. But communities can solve these problems creatively with "park and walk" lots, walking trails and using facilities like shopping centers. There's only one way to do it, and that's to do it.

[imgcontainer] [img:rural_walking_no_sidewalks.jpg] Rural areas aren't always pedestrian friendly. But communities can solve these problems creatively with "park-and-walk" lots, walking trails and using facilities like shopping centers. There's only one way to do it, and that's to do it. [/imgcontainer]

With more open space and natural amenities, you might think rural people would walk more than folks who live in suburban or urban areas. But, in fact, the opposite is true. Rural people walk and bicycle, on average, less than their city counterparts.

That’s a shame, because nothing beats walking for curing what ails the health of many rural residents.

If walking were considered medicine, you can bet it would be the most popular product in the physician’s black bag. I’ll bet your doc can’t name a medicine – even two or three medicines taken together – that will do as much good for as many different ailments as walking several times a week. 

Walking and other exercise cut down on a person’s risk of heart attack, stroke, type 2 diabetes (the kind related to obesity), breast and colon cancer, depression, falls and weak bones.  It helps arthritic knees and lowers blood pressure.  It improves sleep, increases endurance and may even revitalize a person’s sex life, according to the Harvard Health Letter. 

But for all its benefits – including the fact that it’s free and requires no co-pay – walking can be much harder to promote than the latest new drug. “My patients don’t want me to help them stay healthy,” a doctor friend told me.  “They want me to give them a pill so they can do what they want and not die.”

Rural areas and small towns are more likely to lack the kinds of infrastructure that make walking safe and convenient. Distances between home and businesses are farther, and there are fewer sidewalks and crosswalks. Many country roads simply aren’t safe for walking.

I don’t have instant solutions to barriers like these.  But there are creative answers. A walking trail in Perry County Park in Hazard, Kentucky, was used frequently from the day it was opened. In Iowa, schools and parents are organizing “park and walk” lots where children ride to a common location and walk together on a safe route to school.  Other residents walk the aisles of large stores to get out of the weather and stay safe from traffic.

Once people realize that these problems are worth solving, they can be managed or worked around.  Communities can organize to help.  Helping others get started walking is a worthy calling.  That’s how Saints Peter and John started their careers. (See Acts, chapter 3.)

Another impediment to walking is people themselves. Again, the most important thing is to simply get started. Some really heavy people barely move from the recliner where they eat and sleep.  A few trips to the bathroom are about it.  For them, walking the length of the house a few times a day would be progress.  Maybe after that, they could do more. 

For other folks, going out to get the mail from the mailbox, even if it meant getting somebody to put banisters on the front steps, would be worth it.  After a while maybe they could make it down to the next driveway and back.

The point is to set a goal and increase it just a little bit each week.  Ideally, within a few months  a person ought to be walking four or five hours every week.

The kids need to be included in the walking.  Where I live kids are driven a few hundred yards to meet the school bus. That isn’t good. If it seems essential that the youngsters have an escort, let the driver get out and walk with them. 

Childhood type 2 diabetes was unknown 40 years ago.  Now it’s so common we have clubs for obese diabetic kids.  Wouldn’t it be great if we had hiking and even running clubs for these kids? Do the schools where you live have outdoor recesses and gym classes?

People in Finland say the things you need for getting things done in rural communities are already there.  You just have to find them and use them, not wait for help from elsewhere.  Walking is a neat place to start a health program because it doesn’t take special stuff; it just takes decent shoes and outdoor clothes. 

Walking won’t solve all our rural health problems.  We’ll still have drug abuse including tobacco, too much sugar in soda pop and all the issues related to poverty and unemployment.  But it’s literally a step in the right direction.

It’s not very smart to run your car to wreckage and then expect the mechanic to fix it.  Lots of people, though, wreck their bodies and expect the docs to fix them. 

Life and bodies don’t work that way.  You wreck it, you still own it.  There’s no trade in.

We need to do what we can, when we can, with what we know and what we’ve got.   That means start walking.

Wayne Myers is a retired pediatrician and rural medical educator. He was formerly director of the federal Office of Rural Health Policy and president of the National Rural Health Association in 2003. He and his wife, JoAnn, farm in rural Maine.

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