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Investigating Socioeconomic Disparities in the Potential Healthy Eating and Physical Activity Environments of Churches

  • John A. Bernhart
  • Elizabeth A. La Valley
  • Andrew T. Kaczynski
  • Sara Wilcox
  • Danielle E. Jake-Schoffman
  • Nathan Peters
  • Caroline G. Dunn
  • Brent Hutto
Original Paper

Abstract

Faith-based settings have the potential to improve health in underresourced communities, but little research has quantified and compared health-promoting elements in church environments. This study examines the number of potential indoor and outdoor physical activity opportunities, healthy eating opportunities, healthy living media, and total environmental resources present in churches (n = 54) in a rural, southeastern US county and the relationship between these resources and neighborhood income. In our sample, most churches offered potential indoor and outdoor opportunities for physical activity and healthy eating opportunities, with more variability in the number of healthy living media items on display compared to other environmental components. Common potential opportunities present in churches for physical activity included a fellowship hall and green/open space, while potential opportunities for healthy eating frequently included a refrigerator and sink. Compared to those in medium- and high-income neighborhoods, churches in low-income neighborhoods scored higher on measures of potential outdoor physical activity opportunities and lower on measures of total potential environment resources, healthy eating opportunities, healthy living media, and indoor physical activity opportunities, though only indoor physical activity opportunities reached statistical significance. Potential opportunities for using existing resources in and around churches for health promotion should be investigated further, particularly in rural areas.

Keywords

Church Environment Physical activity Healthy eating Disparities 

Notes

Acknowledgements

This project was supported by Cooperative Agreement Number U48DP005000 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention. The authors also wish to thank Cheryl Goodwin for her substantial assistance with the Faith, Activity, and Nutrition Project.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This research did not involve the participation of any human subjects.

References

  1. Baruth, M., & Wilcox, S. (2013). Multiple behavior change among church members taking part in the faith, activity, and nutrition program. Journal of Nutrition Education & Behavior, 45(5), 428–434.  https://doi.org/10.1016/j.jneb.2013.03.002.CrossRefGoogle Scholar
  2. Baruth, M., Wilcox, S., Laken, M., Bopp, M., & Saunders, R. (2008). Implementation of a faith-based physical activity intervention: Insights from church health directors. Journal of Community Health, 33(5), 304–312.  https://doi.org/10.1007/s10900-008-9098-4.CrossRefPubMedGoogle Scholar
  3. Baruth, M., Wilcox, S., Saunders, R. P., Hooker, S. P., Hussey, J. R., & Blair, S. N. (2013). Perceived environmental church support and physical activity among Black church members. Health Education & Behavior, 40(6), 712–720.  https://doi.org/10.1177/1090198113477110.CrossRefGoogle Scholar
  4. Befort, C. A., Nazir, N., & Perri, M. G. (2012). Prevalence of obesity among adults from rural and urban areas of the United States: Findings from NHANES (2005–2008). The Journal of Rural Health, 28(4), 392–397.  https://doi.org/10.1111/j.1748-0361.2012.00411.x.CrossRefPubMedPubMedCentralGoogle Scholar
  5. Belza, B., Walwick, J., Shiu-Thornton, S., Schwartz, S., Taylor, M., & LoGerfo, J. (2004). Older adult perspectives on physical activity and exercise: Voices from multiple cultures. Preventing Chronic Disease, 1(4), A09.PubMedPubMedCentralGoogle Scholar
  6. Bopp, M., Lattimore, D., Wilcox, S., Laken, M., McClorin, L., Swinton, R., et al. (2007). Understanding physical activity participation in members of an African American church: A qualitative study. Health Education Research, 22(6), 815–826.CrossRefPubMedGoogle Scholar
  7. Bopp, M., Peterson, J. A., & Webb, B. L. (2012). A comprehensive review of faith-based physical activity interventions. American Journal of Lifestyle Medicine, 6(6), 460–478.  https://doi.org/10.1177/1559827612439285.CrossRefGoogle Scholar
  8. Bopp, M., Wilcox, S., Oberrecht, L., Kammermann, S., & McElmurray, C. T. (2004). Correlates of strength training in older rural African American and Caucasian women. Women and Health, 40(1), 1–20.CrossRefPubMedGoogle Scholar
  9. Brownson, R. C., Boehmer, T. K., & Luke, D. A. (2005). Declining rates of physical activity in the United States: What are the contributors? Annual Review of Public Health, 26, 421–443.  https://doi.org/10.1146/annurev.publhealth.26.021304.144437.CrossRefPubMedGoogle Scholar
  10. Campbell, M. K., Hudson, M. A., Resnicow, K., Blakeney, N., Paxton, A., & Baskin, M. (2007). Church-based health promotion interventions: Evidence and lessons learned. Annual Review of Public Health, 28, 213–234.  https://doi.org/10.1146/annurev.publhealth.28.021406.144016.CrossRefPubMedGoogle Scholar
  11. Cleland, C. L., Hunter, R. F., Tully, M. A., Scott, D., Kee, F., Donnelly, M., et al. (2014). Identifying solutions to increase participation in physical activity interventions within a socio-economically disadvantaged community: A qualitative study. The International Journal of Behavioral Nutrition and Physical Activity, 11, 68.  https://doi.org/10.1186/1479-5868-11-68.CrossRefPubMedPubMedCentralGoogle Scholar
  12. Durand, C. P., Andalib, M., Dunton, G. F., Wolch, J., & Pentz, M. A. (2011). A systematic review of built environment factors related to physical activity and obesity risk: Implications for smart growth urban planning. Obesity Reviews, 12(5), e173–e182.  https://doi.org/10.1111/j.1467-789X.2010.00826.x.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Eberhardt, M. S., & Pamuk, E. R. (2004). The importance of place of residence: Examining health in rural and nonrural areas. American Journal of Public Health, 94(10), 1682–1686.  https://doi.org/10.2105/AJPH.94.10.1682.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Ecumenical Ministries of Oregon. (2010). Oregon’s Public Health Institute. Congregational Health Index. Available at: http://www.emoregon.org/pdfs/IFFP/Congregational_Health_Index.pdf. Accessed 8 Aug 2017.
  15. Edwards, M. B., Theriault, D. S., Shores, K. A., & Melton, K. M. (2014). Promoting youth physical activity in rural southern communities: Practitioner perceptions of environmental opportunities and barriers. The Journal of Rural Health, 30(4), 379–387.  https://doi.org/10.1111/jrh.12072.CrossRefPubMedGoogle Scholar
  16. Engelberg, J. K., Conway, T. L., Geremia, C., Cain, K. L., Saelens, B. E., Glanz, K., et al. (2016). Socioeconomic and race/ethnic disparities in observed park quality. BMC Public Health, 16, 395.  https://doi.org/10.1186/s12889-016-3055-4.CrossRefPubMedPubMedCentralGoogle Scholar
  17. Everett Jones, S., & Wendel, A. M. (2015). Characteristics of joint use agreements in school districts in the United States: Findings from the School Health Policies and Practices Study, 2012. Preventing Chronic Disease.  https://doi.org/10.5888/pcd12.140560.PubMedPubMedCentralCrossRefGoogle Scholar
  18. Fan, J. X., Wen, M., & Kowaleski-Jones, L. (2014). Rural-urban differences in objective and subjective measures of physical activity: Findings from the National Health and Nutrition Examination Survey (NHANES) 2003–2006. Preventing Chronic Disease.  https://doi.org/10.5888/pcd11.140189.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Fitzgerald, N., Morgan, K. T., & Slawson, D. L. (2013). Practice paper of the Academy of Nutrition and Dietetics abstract: The role of nutrition in health promotion and chronic disease prevention. Journal of the Academy of Nutrition and Dietetics, 113(7), 983.  https://doi.org/10.1016/j.jand.2013.05.007.CrossRefPubMedGoogle Scholar
  20. Hardison-Moody, A., Edwards, M. B., Bocarro, J. N., Stein, A., Kanters, M. A., Sherman, D. M., et al. (2017). Shared use of physical activity facilities among North Carolina Faith Communities, 2013. Preventing Chronic Disease.  https://doi.org/10.5888/pcd14.160393.PubMedPubMedCentralCrossRefGoogle Scholar
  21. Harmon, B. E., Blake, C. E., Thrasher, J. F., & Hébert, J. R. (2014a). An evaluation of diet and physical activity messages in African American Churches. Health Education & Behavior, 41(2), 216–224.  https://doi.org/10.1177/1090198113507449.CrossRefGoogle Scholar
  22. Harmon, B. E., Chock, M., Brantley, E., Wirth, M. D., & Hébert, J. R. (2016). Disease messaging in churches: Implications for health in African–American communities. Journal of Religion and Health, 55(4), 1411–1425.  https://doi.org/10.1007/s10943-015-0109-3.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Harmon, B. E., Kim, S.-H., Blake, C. E., & Hébert, J. R. (2014b). Health care information in African American churches. Journal of Health Care for the Poor and Underserved, 25(1), 242–256.  https://doi.org/10.1353/hpu.2014.0047.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Huang, T. T.-K., Sorensen, D., Davis, S., Frerichs, L., Brittin, J., Celentano, J., et al. (2013). Healthy eating design guidelines for school architecture. Preventing Chronic Disease.  https://doi.org/10.5888/pcd10.120084.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Hughey, S. M., Kaczynski, A. T., Child, S., Moore, J. B., Porter, D., & Hibbert, J. (2017). Green and lean: Is neighborhood park and playground availability associated with youth obesity? Variations by gender, socioeconomic status, and race/ethnicity. Preventive Medicine, 95(Suppl), S101–S108.  https://doi.org/10.1016/j.ypmed.2016.11.024.CrossRefGoogle Scholar
  26. Hughey, S. M., Walsemann, K. M., Child, S., Powers, A., Reed, J. A., & Kaczynski, A. T. (2016). Using an environmental justice approach to examine the relationships between park availability and quality indicators, neighborhood disadvantage, and racial/ethnic composition. Landscape and Urban Planning, 148(Supplement C), 159–169.  https://doi.org/10.1016/j.landurbplan.2015.12.016.CrossRefGoogle Scholar
  27. Jacob Arriola, K. R., Hermstad, A., Clair Flemming, S., Honeycutt, S., Carvalho, M. L., Cherry, S. T., et al. (2016). Promoting policy and environmental change in faith-based organizations: Outcome evaluation of a mini-grants program. Health Promotion Practice, 17(1), 146–155.  https://doi.org/10.1177/1524839915613027.CrossRefPubMedGoogle Scholar
  28. Kaczynski, A. T., & Henderson, K. A. (2007). Environmental correlates of physical activity: A review of evidence about parks and recreation. Leisure Sciences, 29(4), 315–354.  https://doi.org/10.1080/01490400701394865.CrossRefGoogle Scholar
  29. Kaczynski, A. T., Jake-Schoffman, D. E., Peters, N. A., Dunn, C. G., Wilcox, S., & Forthofer, M. (2018). Development and testing of the Church Environment Audit Tool. American Journal of Health Behavior, 42(3), 17–26.  https://doi.org/10.5993/AJHB.42.3.2.CrossRefPubMedGoogle Scholar
  30. Kaczynski, A. T., Wilhelm Stanis, S. A., & Besenyi, G. M. (2012). Development and testing of a Community Stakeholder Park Audit Tool. American Journal of Preventive Medicine, 42(3), 242–249.  https://doi.org/10.1016/j.amepre.2011.10.018.CrossRefPubMedGoogle Scholar
  31. Kamphuis, C. B. M., Giskes, K., de Bruijn, G.-J., Wendel-Vos, W., Brug, J., & van Lenthe, F. J. (2006). Environmental determinants of fruit and vegetable consumption among adults: A systematic review. British Journal of Nutrition, 96(4), 620–635.  https://doi.org/10.1079/BJN20061896.PubMedCrossRefGoogle Scholar
  32. Kegler, M. C., Escoffery, C., Alcantara, I. C., Hinman, J., Addison, A., & Glanz, K. (2012). Perceptions of social and environmental support for healthy eating and physical activity in rural southern churches. Journal of Religion and Health, 51(3), 799–811.  https://doi.org/10.1007/s10943-010-9394-z.CrossRefPubMedGoogle Scholar
  33. Lipka, M., & Wormald, B. (2016). How religious is your state? Retrieved December 14, 2017 from http://www.pewresearch.org/fact-tank/2016/02/29/how-religious-is-your-state/.
  34. Lumpkins, C., Greiner, K., Daley, C., Mabachi, N., & Neuhaus, K. (2013). Promoting healthy behavior from the Pulpit: Clergy share their perspectives on effective health communication in the African American Church. Journal of Religion and Health, 52(4), 1093–1107.  https://doi.org/10.1007/s10943-011-9533-1.CrossRefPubMedPubMedCentralGoogle Scholar
  35. Macintyre, S. (2007). Deprivation amplification revisited; or, is it always true that poorer places have poorer access to resources for healthy diets and physical activity? International Journal of Behavioral Nutrition and Physical Activity, 4, 32.  https://doi.org/10.1186/1479-5868-4-32.CrossRefPubMedGoogle Scholar
  36. Martin, L., & Griswold, S. (2009). Healthy Vending Toolkit. Available at: http://blindmerchants.org/wp-content/uploads/2015/09/HealthyVendingToolkit_accessible.pdf. Accessed 8 Aug 2017.
  37. Martin, S. L., Kirkner, G. J., Mayo, K., Matthews, C. E., Durstine, J. L., & Hebert, J. R. (2005). Urban, rural, and regional variations in physical activity. The Journal of Rural Health, 21(3), 239–244.CrossRefPubMedGoogle Scholar
  38. Morland, K., Wing, S., Diez Roux, A., & Poole, C. (2002). Neighborhood characteristics associated with the location of food stores and food service places. American Journal of Preventive Medicine, 22(1), 23–29.  https://doi.org/10.1016/S0749-3797(01)00403-2.CrossRefPubMedGoogle Scholar
  39. Morton, L. W., Bitto, E. A., Oakland, M. J., & Sand, M. (2005). Solving the problems of Iowa food deserts: Food insecurity and civic structure. Rural Sociology, 70(1), 94–112.  https://doi.org/10.1526/0036011053294628.CrossRefGoogle Scholar
  40. Noyes, P., Fung, L., Lee, K. K., Grimshaw, V. E., Karpati, A., & DiGrande, L. (2014). Cycling in the city: An in-depth examination of bicycle lane use in a low-income urban neighborhood. Journal of Physical Activity & Health, 11(1), 1–9.  https://doi.org/10.1123/jpah.2011-0429.CrossRefGoogle Scholar
  41. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2013). Prevalence of obesity among adults: United States, 2011–2012. NCHS Data Brief, 131, 1–8.Google Scholar
  42. Omura, J. D., Carlson, S. A., Paul, P., Sliwa, S., Onufrak, S. J., & Fulton, J. E. (2017). Shared use agreements between municipalities and public schools in the United States, 2014. Preventive Medicine, 95(Supplement), S53–S59.  https://doi.org/10.1016/j.ypmed.2016.09.026.CrossRefPubMedGoogle Scholar
  43. Parks, S. E., Housemann, R. A., & Brownson, R. C. (2003). Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States. Journal of Epidemiology and Community Health, 57(1), 29–35.CrossRefPubMedPubMedCentralGoogle Scholar
  44. Physical Activity Guidelines Advisory Committee. (2008). Physical activity guidelines advisory committee report, 2008. Washington, DC: US Department of Health and Human Services.Google Scholar
  45. Richter, D. L., Wilcox, S., Greaney, M. L., Henderson, K. A., & Ainsworth, B. E. (2002). Environmental, policy, and cultural factors related to physical activity in African American women. Women and Health, 36(2), 91–109.CrossRefPubMedGoogle Scholar
  46. Sallis, J. F., Slymen, D. J., Conway, T. L., Frank, L. D., Saelens, B. E., Cain, K., et al. (2011). Income disparities in perceived neighborhood built and social environment attributes. Health & Place, 17(6), 1274–1283.  https://doi.org/10.1016/j.healthplace.2011.02.006.CrossRefGoogle Scholar
  47. Schoenberg, N. E., Howell, B. M., Swanson, M., Grosh, C., & Bardach, S. (2013). Perspectives on healthy eating among Appalachian residents. The Journal of Rural Health, 29(Suppl 1), s25–s34.  https://doi.org/10.1111/jrh.12009.CrossRefPubMedPubMedCentralGoogle Scholar
  48. Seguin, R., Connor, L., Nelson, M., LaCroix, A., & Eldridge, G. (2014). Understanding barriers and facilitators to healthy eating and active living in rural communities. Journal of Nutrition and Metabolism, 2014, 146502.  https://doi.org/10.1155/2014/146502.CrossRefPubMedPubMedCentralGoogle Scholar
  49. Sharkey, J. R., & Horel, S. (2008). Neighborhood socioeconomic deprivation and minority composition are associated with better potential spatial access to the ground-truthed food environment in a large rural area. The Journal of Nutrition, 138(3), 620–627.CrossRefPubMedGoogle Scholar
  50. Taylor, W. C., Franzini, L., Olvera, N., Carlos Poston, W. S., & Lin, G. (2012). Environmental audits of friendliness toward physical activity in three income levels. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 89(2), 296–307.  https://doi.org/10.1007/s11524-011-9663-5.CrossRefGoogle Scholar
  51. Taylor, W. C., Poston, W. S. C., Jones, L., & Kraft, M. K. (2006). Environmental justice: Obesity, physical activity, and healthy eating. Journal of Physical Activity & Health, 3(s1), S30–S54.  https://doi.org/10.1123/jpah.3.s1.s30.CrossRefGoogle Scholar
  52. Tristão Parra, M., Porfírio, G. J. M., Arredondo, E. M., & Atallah, Á. N. (2017). Physical activity interventions in faith-based organizations: A systematic review. American Journal of Health Promotion.  https://doi.org/10.1177/0890117116688107.PubMedCrossRefGoogle Scholar
  53. Turrell, G., Haynes, M., Wilson, L.-A., & Giles-Corti, B. (2013). Can the built environment reduce health inequalities? A study of neighbourhood socioeconomic disadvantage and walking for transport. Health & Place, 19, 89–98.  https://doi.org/10.1016/j.healthplace.2012.10.008.CrossRefGoogle Scholar
  54. U.S. Census Bureau. (2016). American Community Survey 5-year estimates. Retrieved November 4, 2018 from https://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml.
  55. Vaughan, K. B., Kaczynski, A. T., Stanis, W. A. S., Besenyi, G. M., Bergstrom, R., & Heinrich, K. M. (2013). Exploring the distribution of park availability, features, and quality across Kansas City, Missouri by income and race/ethnicity: An environmental justice investigation. Annals of Behavioral Medicine, 45(1), S28–S38.  https://doi.org/10.1007/s12160-012-9425-y.CrossRefPubMedGoogle Scholar
  56. Warburton, D. E. R., Nicol, C. W., & Bredin, S. S. D. (2006). Health benefits of physical activity: The evidence. CMAJ: Canadian Medical Association Journal, 174(6), 801–809.  https://doi.org/10.1503/cmaj.051351.CrossRefPubMedGoogle Scholar
  57. Wen, M., Zhang, X., Harris, C. D., Holt, J. B., & Croft, J. B. (2013). Spatial disparities in the distribution of Parks and Green Spaces in the USA. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 45(Suppl 1), 18–27.  https://doi.org/10.1007/s12160-012-9426-x.CrossRefGoogle Scholar
  58. Wilcox, S., Laken, M., Parrott, A. W., Condrasky, M., Saunders, R., Addy, C. L., et al. (2010). The faith, activity, and nutrition (FAN) program: Design of a participatory research intervention to increase physical activity and improve dietary habits in African American churches. Contemporary Clinical Trials, 31(4), 323–335.  https://doi.org/10.1016/j.cct.2010.03.011.CrossRefPubMedPubMedCentralGoogle Scholar
  59. Wilcox, S., Saunders, R. P., Kaczynski, A. T., Forthofer, M., Sharpe, P. A., Goodwin, C., et al. (2018). Faith, activity, and nutrition randomized dissemination and implementation study: Countywide adoption, reach, and effectiveness. American Journal of Preventive Medicine.  https://doi.org/10.1016/j.amepre.2018.02.018.PubMedCrossRefGoogle Scholar
  60. Williams, R. M., Glanz, K., Kegler, M. C., & Davis, E. (2012). A study of rural church health promotion environments: Leaders’ and members’ perspectives. Journal of Religion and Health, 51(1), 148–160.  https://doi.org/10.1007/s10943-009-9306-2.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • John A. Bernhart
    • 1
    • 2
  • Elizabeth A. La Valley
    • 1
    • 2
  • Andrew T. Kaczynski
    • 1
    • 3
  • Sara Wilcox
    • 1
    • 2
  • Danielle E. Jake-Schoffman
    • 4
  • Nathan Peters
    • 5
  • Caroline G. Dunn
    • 1
    • 3
  • Brent Hutto
    • 1
  1. 1.Prevention Research Center, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  2. 2.Department of Exercise Science, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  3. 3.Department of Health Promotion, Education, and Behavior, Arnold School of Public HealthUniversity of South CarolinaColumbiaUSA
  4. 4.Division of Preventive and Behavioral Medicine, Department of MedicineUniversity of Massachusetts Medical SchoolWorcesterUSA
  5. 5.School of Human Movement, Sport and Leisure StudiesBowling Green UniversityBowling GreenUSA

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