WED-097 - Beyond the Pavement: Advancing Rural Health Equity Through Walkability and Infrastructure in Montana
Wednesday, April 22, 2026
6:00 PM - 7:00 PM PST
Location: Plaza Foyer, Plaza Level
Area of Responsibility: Area I: Assessment of Needs and Capacity Keywords: Health Equity@@@Physical Activity@@@Rural Health, Subcompetencies: 1.1.3 Identify existing and available resources, policies, programs, practices, and interventions., 1.2 Obtain primary data, secondary data, and other evidence-informed sources. Research or Practice: Research
Student Montana State University Bozeman, Montana, United States
Learning Objectives:
At the end of this session, participants will be able to:
Learn how to assess built environment barriers and facilitators to physical activity in rural communities using community-based data collection methods.
Learn how to utilize walk audits as a needs assessment tool to improve the built environment for physical activity.
Apply walkability assessment findings to inform equity-centered planning strategies that promote physical activity and improve rural health outcomes.
Brief Abstract Summary: Learn how rural infrastructure affects everyday health and equity through findings from a mixed-methods study in Choteau, Montana. Residents identified cracked sidewalks, missing crosswalks, and seasonal hazards as key barriers to walking and biking, yet expressed strong interest in safer, more walkable routes. This session shares both quantitative and qualitative results and highlights practical, equity-focused strategies, such as adding signage, benches, and bike racks, that communities can realistically implement. Attendees will also see how health communication and resident engagement can reframe infrastructure challenges as public health opportunities to support active living and well-being in rural settings.
Detailed abstract description: Background Rural communities face persistent health inequities often tied to infrastructure and policy. In Choteau, Montana, a rural town of 1,700 residents, aging sidewalks, limited crosswalks, and seasonal hazards restrict safe walking and biking, especially for older adults and families. We examined how the built environment influences physical activity in order to make recommendations to increase physical activity, thereby improving various facets of physical and mental health for community members.
Methods We used a convergent mixed-methods design guided by the Social Ecological Model. Surveys (n=67) measured physical activity, perceptions of infrastructure, and safety. Semi-structured interviews (n=7) captured residents’ perspectives on barriers and opportunities for change.
Results Survey respondents overwhelmingly identified environmental barriers: 99% cited cracked sidewalks, 67% reported missing crosswalks, and 58% pointed to winter conditions. Interviews reinforced these findings as residents described inequities in sidewalk maintenance, limited signage, and unsafe intersections. Participants also noted seasonal challenges and gaps in infrastructure that restricted active living. Despite these barriers, 70% rated walkable routes as “very important,” reflecting strong community interest in built environment improvements as a means to increase walkability and bikeability for all ages and abilities.
Conclusions Infrastructure, such as sidewalks, bike lanes, and safe crossings, functions as a public health intervention by promoting physical activity and reducing injury risks. By advancing equity-focused planning, implementing low-cost improvements (e.g., signage, benches, bike racks), and promoting policy advocacy, communities can foster activity-friendly, health-promoting rural environments. Centering resident voices demonstrates the urgency of addressing infrastructure inequities and offers actionable strategies to promote rural health equity and physical activity.
