• Mark P Doescher, Chanam Lee, Ethan M Berke, Anna M Adachi-Mejia, Chun-Kuen Lee, Orion Stewart, Davis G Patterson, Philip M Hurvitz, Heather A Carlos, Glen E Duncan, and Anne Vernez Moudon.
• Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Electronic address: mark-doescher@ouhsc.edu.
• Prev Med. 2014 Dec 1; 69: 808680-6.

ObjectivesThe role of the built environment on walking in rural United States (U.S.) locations is not well characterized. We examined self-reported and measured built environment correlates of walking for utilitarian purposes among adult residents of small rural towns.MethodsIn 2011-12, we collected telephone survey and geographic data from 2152 adults in 9 small towns from three U.S. regions. We performed mixed-effects logistic regression modeling to examine relationships between built environment measures and utilitarian walking ("any" versus "none"; "high" [≥150min per week] versus "low" [<150min per week]) to retail, employment and public transit destinations.ResultsWalking levels were lower than those reported for populations living in larger metropolitan areas. Environmental factors significantly (p<0.05) associated with higher odds of utilitarian walking in both models included self-reported presence of crosswalks and pedestrian signals and availability of park/natural recreational areas in the neighborhood, and also objectively measured manufacturing land use.ConclusionsEnvironmental factors associated with utilitarian walking in cities and suburbs were important in small rural towns. Moreover, manufacturing land use was associated with utilitarian walking. Modifying the built environment of small towns could lead to increased walking in a sizeable segment of the U.S. population.Copyright © 2014 Elsevier Inc. All rights reserved.

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