Date of Award

Summer 8-15-2021

Author's School

Graduate School of Arts and Sciences

Author's Department

Public Health

Degree Name

Doctor of Philosophy (PhD)

Degree Type



The benefits of physical activity for health are far reaching, including the reduced risk of several chronic diseases. However, only about 24% of US adults meet recommended guidelines of physical activity, with traditionally disadvantaged populations such as rural residents and persons of color facing even lower rates. Ecological models of health behavior help to understand correlates of physical activity that impact population health, but may not be as useful in disadvantaged populations where the evidence base is either lacking or not as rigorous. Furthermore, measures and methods may be underdeveloped in disadvantaged populations and there is a lack of understanding of context (social-cultural, political, economic) in these settings. A health equity lens is needed to address some of these barriers and help equalize opportunities to be active and healthy. The present study seeks to contribute to health equity and the evidence base by addressing three aims in key disadvantaged populations: 1) Examine sub-population differences in the relationship between the perceived built environment and rural residents’ objectively assessed physical activity; 2) Assess how community development strategies influence the built and social-cultural environment to promote physical activity; and 3) Describe the impacts (benefits and consequences) of community development strategies for health promoting environments. Rural midwestern adults, particularly women, have disproportionately lower levels of physical activity, but there is evidence to suggest that increased self-efficacy for physical activity and recreational access (including walking trails) may help to promote physical activity in this group. However, a lack of clear associations between perceived environmental factors and physical activity, suggests the importance of gender in driving physical activity behaviors. Community development strategies that have traditionally focused on social and economic benefits for disadvantaged communities, may also benefit the health of communities by provding infrastructure and opportunities to be physically active. Neighborhood improvements such as the implementation of smart growth strategies and complete streets are shown to influence physical activity behaviors. However, successful community development that benefits all community members should also focus on capacity building for key stakeholders in the community (e.g., community members, public health practitioners, advocates) and community engagement. Public health practitioners and advocates should engage with community members, but also across sectors.


English (en)

Chair and Committee

Ross C. Brownson

Committee Members

Amy A. Eyler, Rodrigo Reis, Deborah Salvo, Joseph T. Steensma,