What Would Get Rural Men Moving? 447 Men on Barriers and What They Want

Rural men in the United States have a 19 percent higher age-adjusted death rate than urban men and a 39 percent higher rate than rural women, along with more heart disease, diabetes, cancer and obesity. Fewer of them meet physical activity guidelines than urban men — yet they are underrepresented in the programs designed to get people moving. So researchers at the University of Iowa asked 447 of them what such a program should look like.

Interested, but not reached

Knowing is not the problem. About 94 percent of Americans know the health benefits of regular physical activity, yet more than 75 percent do not get the recommended amount — which suggests that information alone does not change behavior.

Among the rural men surveyed:

• 97.7 percent rated physical activity at least somewhat important to their health, and 40.3 percent very important;
• 83.9 percent were at least somewhat interested in a program to help them be more active;
• the more important a man thought exercise was, the more interested he was — each step up in importance came with 1.38 times the odds of greater interest.

What stops them

On a scale from 1 (not a barrier) to 5 (very much a barrier), the top barriers were motivation (3.4), cold weather (3.4) and tiredness (3.3). A lack of facilities was not among the top barriers, unlike in earlier studies of rural populations. Barriers varied by region: men in the West rated fear of COVID-19 exposure, short winter days and a lack of indoor places to exercise as bigger barriers than men elsewhere.

What they want

Features rural men preferred or required in a physical activity program. Credit: CDC, Preventing Chronic Disease.

These men also had the means: 86.1 percent used smartphones and 77.6 percent had broadband. More than half had used exercise apps (60.1 percent) or workout videos (52.2 percent).

How this differs from rural women

An earlier mail survey of rural women in Wisconsin found they most wanted better health, weight loss and more energy — and preferred in-person meetings. The men chose fitness and energy over weight loss, and remote delivery over meeting in person. The authors suggest recruiting men by emphasizing fitness and energy rather than weight loss. The difference in delivery may reflect a wish for privacy, the online versus mail survey, or the pandemic, during which this study was done.

Caveats

The men were recruited through Amazon's Mechanical Turk and paid $2.00, so they may be more tech-savvy than rural men in general — and they were far more educated: 79.3 percent had a college degree, against a national average for rural men of about 20 percent. Most were White (85.5 percent) and married (72.5 percent). A study advertised as being about physical activity may also have attracted men already interested in it. The authors call for testing programs built on these preferences, and for studying men of color and men with less education.

Sources

Based on "Physical Activity Among Rural Men: Barriers and Preferences," by Jacob Gallagher, Emine O. Bayman, Lisa A. Cadmus-Bertram, Nathaniel D.M. Jenkins, Amy Pearlman, Kara M. Whitaker and Lucas J. Carr, Preventing Chronic Disease (2023), Centers for Disease Control and Prevention; a work of the United States government in the public domain. "Rural" followed the U.S. Department of Agriculture's definition: a town of fewer than 2,500 people, or an area outside a town.