Comprehensive Obesity Prevention Efforts in a Rural Setting
Shelby is a rural town in eastern Montana with a population of approximately 3,000. Mayor Larry Bonderud has held his position for 18 years. After several years of attending conferences and reading about the environment and its effects on public health, Mayor Bonderud was inspired to make some significant city-wide changes. Like most rural towns, Shelby does not have a large public health budget. However, with the leadership of the mayor, the community has been able to initiate and implement a number of obesity prevention strategies:
After surveying residents in the city newsletter, the mayor concluded that a fitness center was the first logical step for obesity prevention in Shelby. In partnership with a local hospital, he spearheaded an effort to install a fitness center in the local civic center and to hire a trainer. Memberships help sustain the center. The mayor and his community partners convinced major local employers to subsidize fitness center memberships for employees.
The mayor and his committee of stakeholders planned a 6-mile paved walking trail that links the business district, residential neighborhoods, the Civic Center, the hospital, and schools to public lands. The trail was financed by the City of Shelby; the Community Transportation Enhancement Program; the Montana Fish, Wildlife and Parks Urban Recreational Trails Program; the Shelby Theme Committee; and in-kind contributions of labor and materials. Social marketing campaigns are being used to promote the trail.
In partnership with others, the local health department developed a low-cost surveillance system to collect baseline data on breastfeeding rates in Shelby because of the strong association between breastfeeding and prevention of obesity later in life. The county public health nurse calls each new mother to see whether she needs information or resources. The nurse also asks if the mother is still breastfeeding, if she is feeding her child other foods, and if there are any factors that make it difficult to continue breastfeeding. The nurse repeats her calls quarterly. The county uses this information to help health care providers learn what interventions might increase breastfeeding initiation and duration.
After surveying all Shelby households, Mayor Bonderud found that residents were overwhelmingly in favor of improving access to healthy foods in restaurants. He is working with Shelby restaurant managers and major food distributors to place healthier items on the menu. Once such items are in place, he hopes to conduct a promotional campaign aimed at encouraging residents to support those restaurants offering healthy food and to order the healthier items off the menu.
SOURCE: Baehr, 2008.