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Objective To determine if: (1) differences exist for body mass index (BMI) and moderate-to-vigorous physical activity (MVPA) between rural and urban youth, and (2) perceived and objective measures of environmental supports for physical activity differentially correlate with BMI and MVPA in middle school rural and urban youth. Method Cross-sectional analyses were performed in spring 2012 on data collected from December 2008 until May 2010 for 284 middle school youth from a rural county and an adjacent urbanized area. Multivariable linear models estimated associations between BMI/MVPA and perceived environmental barriers/supports for physical activity and objectively measured neighborhood spatial variables. Results Mean MVPA was significantly lower for rural youth (15.9 minutes/day) compared to urban youth (19.2 minutes/day). No differences were observed between rural and urban youth for BMI or BMI percentile. Significant differences in both perceived and objective correlates for MVPA and BMI percentile were found in multivariable models between rural and urban youth. Conclusion Differences observed for correlates of MVPA and BMI across the settings suggest that rurality should be considered when identifying targets for intervention to promote MVPA and prevent adiposity in youth.

Objective We examined associations between access to food venues (farmers’ markets and supermarkets), shopping patterns, fruit and vegetable consumption and health indicators among women of reproductive age in eastern North Carolina, USA. Design Access to food venues was measured using a Geographic Information System incorporating distance, seasonality and business hours, to quantify access to farmers’ markets. Produce consumption was assessed by self-report of eating five or more fruits and vegetables daily. BMI and blood pressure were assessed by clinical measurements. Poisson regression with robust variance was used for dichotomous outcomes and multiple linear regression was used for continuous outcomes. As the study occurred in a university town and university students are likely to have different shopping patterns from non-students, we stratified analyses by student status. Setting Eastern North Carolina. Subjects Low-income women of reproductive age (18–44 years) with valid address information accessing family planning services at a local health department (n 400). Results Over a quarter reported ever shopping at farmers’ markets (114/400). A larger percentage of women who shopped at farmers’ markets consumed five or more fruits and vegetables daily (42·1%) than those who did not (24·0%; P<0·001). The mean objectively measured distance to men reported shopping was 11·4 (SD 9·0) km (7·1 (SD 5·6) miles), while the mean distance to the farmers’ market closest to the residence was 4·0 (SD 3·7) km (2·5 (SD 2·3) miles). Conclusions Among non-students, those who shopped at farmers’ markets were more likely to consume five or more servings of fruits and vegetables daily. Future research should further explore potential health benefits of farmers’ markets.

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Greater accessibility to geospatial technologies has led to a surge of spatialized public health research, much of which has focused on food environments. The purpose of this study was to analyze differing spatial measures of exposure to supermarkets and farmers’ markets among women of reproductive age in eastern North Carolina. Exposure measures were derived using participant-defined neighborhoods, investigator-defined road network neighborhoods, and activity spaces incorporating participants’ time space behaviors. Results showed that mean area for participant-defined neighborhoods (0.04 sq. miles) was much smaller than 2.0 mile road network neighborhoods (3.11 sq. miles) and activity spaces (26.36 sq. miles), and that activity spaces provided the greatest market exposure. The traditional residential neighborhood concept may not be particularly relevant for all places. Time-space approaches capturing activity space may be more relevant, particularly if integrated with mixed methods strategies.