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.
Similar content being viewed by others
References
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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/.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Physical Activity Guidelines Advisory Committee. (2008). Physical activity guidelines advisory committee report, 2008. Washington, DC: US Department of Health and Human Services.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
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.
Rights and permissions
About this article
Cite this article
Bernhart, J.A., La Valley, E.A., Kaczynski, A.T. et al. Investigating Socioeconomic Disparities in the Potential Healthy Eating and Physical Activity Environments of Churches. J Relig Health 59, 1065–1079 (2020). https://doi.org/10.1007/s10943-018-0687-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10943-018-0687-y