Bicycling, Walking, Health, and Obesity in Rural Communities in Missouri

A recent discussion with Missouri Senator Claire McCaskill revolved around rural and small-town Missouri. Do Missourians who live outside the major metropolitan areas support better bicycling and walking? Do they need better bicycling and walking facilities?

This document provides some concrete answers and research data to inform our discussion of these questions.

This document is also available in printable PDF format.

Bicycling, Walking, Health, and Obesity in Rural Communities in Missouri

State and federal highways in rural communities discourage walking and bicycling, leading to serious public health consequences

Summary: Because of scarce resources in smaller towns, bicycling and walking facilities are typically poor. State and federal roads often serve as commercial and city centers, carrying the highest amount of traffic, yet have the lowest accommodation for bicycling and walking. Because of the poor walking and bicycling facilities and lack of connectivity, people in small towns and rural areas walk and bicycle less than average This has serious consequences for public health, physical fitness, and obesity rates in rural parts of Missouri.

  • Rural residents experience higher rates of obesity and overweight than people living in urban areas, even after correcting for age, education, income level, and other factors.1

  • Rural children are more likely to be overweight or obese than urban children and are less likely to participate in physical activity. Rural children in the Midwest are less physically active than any other region of the U.S.2

  • The popular image of active rural lifestyle is no longer accurate. Rural
    residents tend to be less physically active than urban residents.3

  • The built environment in small towns is far more likely to lack proper facilities for bicycling and walking, including sidewalks, crosswalks, bicycle accommodations, and trails. In this situation, exercise as a part of daily activity and outdoor exercise to go places is much more difficult. This has a measurable impact in reducing resident level of fitness, increasing obesity, and impacting community health.4

  • Even in rural and small-town Missouri, the vast majority of the population lives or works in areas where bicycle, pedestrian, and transit programs are capable of making a significant impact. 70% of Missourians live in cities or towns; an additional 15% live in the immediate area of a city or town.5 Making rural towns and their immediate surroundings walkable and bicycleable is a problem that can be solved.

  • Increasing the amount of walking and bicycling has a dramatic effect on increasing healthy life expectancy and reducing health care costs.6

  • Increasing the amount of walking and bicycling facilities increases the amount of bicycling and walking. More facilities and more complete bicycle/pedestrian networks mean more bicycling and walking; fewer, less connected facilities lead to less bicycling and walking.7, 8, 9

  • State and federal roads are the biggest part of the problem. Local neighborhood streets in rural towns are usually low-traffic and quite friendly for walking and bicycling. The main streets--usually state or federal highways--are the biggest problem. These highways--which carry the heaviest, fastest traffic-- almost always lack sidewalks, bicycle lanes, crosswalks, and pedestrian signals. These "big bad roads" typically divide small towns right down the middle.

  • State and federal roads in small towns are usually the town's commercial center. To make bicycling and walking truly viable transportation modes, we need to provide access to destinations.10 The most appealing destinations in most small towns are typically on or near main highways--just the place where bicycle and pedestrian access is lowest.

  • MoDOT usually expects local funding of sidewalks, bicycle lanes and other bicycle/pedestrian accommodations on MoDOT roads. This puts small towns at a disadvantage because of their limited budgets.

Conclusion: Small rural towns have less walking and bicycling than larger cities; impact on health and fitness is serious; lack of bicycling and walking accommodation on state and federal highways through these rural towns is among the largest contributors to the problem.

Federal standards and guidelines that provide funding for roads and highways through rural towns but do not require proper bicycle and pedestrian accommodations on these roads are a major cause to this problem.


1 "Obesity and Physical Activity in Rural America," by Patterson, Moore, Probst & Shinogle,
Journal of Rural Health, Spring 2004, pp. 151-159

2 "Overweight and Physical Inactivity among Rural Children Aged 10-17: A National and State
Portrait," South Carolina Rural Health Research Center,

3 "Obesity and Weight Control Frequently Asked Questions," Rural Assistance Center,; Obesity and Physical Inactivity in Rural America, The Journal of Rural Health, Volume 20 Issue 2, Pages 151 - 159.

4 "Obesity and Weight Control Frequently Asked Questions, "Rural Assistance Center,

5 "Ten Things to Know about Urban Vs. Rural," Missouri Census Data Center,

6 "Urban-Rural Differences in Mobility and Mode Choice: Evidence from the 2001 NHTS," by John Pucher and John L. Renne, p. 14,

7 "Bridging the Gaps: How the Quality and Quantity of a Connected Bikeway Network Correlates with Increasing Bicycle Use," by Mia Birk and Roger Geller,

8 "Obesity and the Built Environment," by K. Booth, M. Pinkston, and W. Poston, Journal of the
American Dietetic Association, Volume 105, Issue 5, Pages 110-117.

9 "Community Design and Physical Activity: What Do We Know? – and what DON’T we know?" Susan Handy, University of California Davis,

10 "What Constitutes an Obesogenic Environment in Rural Communities?" by Tegan K. Boehmer, Sarah L. Lovegreen, Debra Haire-Joshu, and Ross C. Brown, American Journal of Health Promotion, Volume 20, Issue 6 (July 2 006), p 411-421,