Robeson County, population 134,000, is not only one of the largest rural counties in North Carolina but also tops the list as the biggest county within the state, BMI-wise. According to 2009 data from the CDC National Diabetes Surveillance System, nearly 40 percent of adult Robeson residents are obese compared with the national average of 25 percent.
Furthermore, Robeson is one of the few rural counties with big-city problems: 30 percent of residents living below the poverty line and one of the highest violent crime index rates in North Carolina.
Obesity researchers have found that there is a complex link between diet, physical activity and the environment. The environment is composed of social and physical elements such as safety, as well as the actual man-made structure and layout of buildings that comprise a town, city or community. Certain physical environmental designs, also known as the built environment, allow for and actually encourage physical activity by including wide sidewalks, bike paths, and pedestrian crosswalks in land development designs.
One of the first studies of its kind, conducted in 2003 for the Smart Growth America Surface Transportation Policy Project by Ewing and McCann, found that people who lived in more sprawling neighborhoods were more likely to have a higher BMI.
So what could be causing the staggering rates of obesity seen in Robeson County? Let’s turn a careful eye to the environmental factor. Many Robesonians, like many Americans, use a personal vehicle to get to desired destinations — the average Robesonian commute time is 27 minutes. The particularly high violent crime rates of the county also do not make it conducive for children to stay outside to play for longer periods or for adults to opt for walking or biking instead of taking their car.
In addition, the sprawl of Robeson County’s commercial-residential design creates yet another barrier for physical activity, since the distance between homes and points of interest such as the library, grocery store or shops can be fairly far from people’s homes.
How can we make opportunities for people to get active? The transportation infrastructure must first be in place and that can be achieved through a complete streets policy. A complete streets policy ensures that alternative forms of transportation, such as bicycling, walking and public transportation are considered wherever road infrastructure is being planned in new and existing communities. The desperate need for a complete streets policy is not only reflected in the obesity rates of Robeson County, but in the fact that only 16 percent of Robeson residents get the recommended amount of daily physical activity.
Furthermore, Robeson County is also the ninth-highest county for bicycle crashes and 11th-highest county for pedestrian crashes in North Carolina. To encourage physical activity and enhance safety, Robeson residents must have ample sidewalk and T-racked or median-protected bike lanes that allow for people to take alternative routes to their destinations.
Are our neighborhoods making us fat? The jury is still out as research is still forthcoming; however, the logic still stands: Safe communities with opportunities to commute by foot or bike encourage physical activity. With nearly half of Robeson County residents coping with obesity, a critical eye can easily be directed toward this county.
Robeson is not the only place in the nation that could benefit from a “built environment” re-haul. With 25 percent of American adults classified as obese, many communities across the nation should critically evaluate the built environment of their neighborhoods and consider a complete streets policy that would give their residents the opportunity to become more active.
Mieka Sanderson is a masters of Public Health candidate at University of North Carolina at Chapel Hill’s School of Public Health in the Health Behavior Department.