ANDERSON — Madison County’s well-documented problems with health outcomes and overall quality of life include indicators of an issue for which there are few easy solutions.

The county’s overall obesity rate, according to the recently issued Robert Wood Johnson Foundation report, is 37%. According to information from the Centers for Disease Control and Prevention, 34.6% of all adults in Indiana’s rural areas are considered obese.

Although the Johnson Foundation report didn’t include specific numbers for those living in unincorporated areas, county health officials believe the area’s rural obesity rate is even higher.

“If Indiana is the 10th most obese state (according to the report) and Madison County is even more obese than the state, that’s alarming,” said Stephenie Grimes, administrator with the Madison County Health Department. “We still have places where we should be better at providing access to healthy food.”

In many instances, poor food choices and economic insecurity go hand in hand. According to the Johnson Foundation’s County Health Rankings and Road Maps, 10% of individuals who are considered low income do not live near a grocery store.

“You only buy what you can afford,” says Alexa Farrar, a clinical dietitian at St. Vincent Anderson Hospital. “I think we’re set up, we’re hard-wired as humans to go toward those unhealthy options.”

Farrar generally works with patients who have already been diagnosed with diabetes, heart disease and other conditions connected to obesity. At that point, she says, the options become more reactive — mitigating the effects of obesity, rather than preventing it.

“I think a lot of it comes back to education,” she said. “We’ve got to get some of these individuals connected to sources that will provide them with healthier choices. There are food pantries that are open at different times, different days of the month. We’ve got to supply them with those fresh fruits and vegetables that they need.”

Jam-packed schedules also frequently contribute to decisions to forgo healthier, home-cooked meals as well.

“We’re just so much busier these days, and it can be easier to grab something from McDonald’s,” said Elizabeth Hart, coordinator of volunteer and mission services at St. Vincent.

Farrar said practical ideas like getting food in “to-go” boxes, or ordering smaller-sized french fries and drinks, are ways people can reduce their calorie intake if they choose to eat out.

But a lack of good food choices is only one part of the problem, officials say. Residents who live in the country often may not get enough exercise due to a lack of sidewalks and access to hiking and biking trails. Statewide, 25% of adults aged 20 and older reported no leisure-time physical activity, according to the Johnson Foundation’s County Health Rankings. In Madison County, that figure is 29%.

“Definitely a lack of physical activity plays a big role in the obesity problem,” said Jenny Martin, a nutrition care coordinator at Community Hospital Anderson. “There is a lack of parks in most rural areas. Screen time is also an issue. Overall, physical activity has taken a back seat for people and is not considered a priority for many.”

The nature of work for many rural residents — especially farmers — has also evolved. Advances in technology have automated many chores, meaning even jobs commonly thought of as labor intensive may not be providing people with ample exercise. But officials point to solutions like online workout guides and other resources as ways to overcome inactivity.

“We try to encourage people that there are exercises you can do around the house, in the yard,” Farrar said. “Depending on where you are, running is a very cost effective way to exercise as well. All you need is a decent pair of sneakers and you can do it just about anywhere.”

Efforts are also being made to improve low-income residents’ access to healthier foods. Community Hospital’s Community Farm, for example, is developing partnerships with several local organizations, including Second Harvest Food Bank of East Central Indiana, to make fruits and vegetables more readily available.

“Some of our goals are to improve access to food and to provide education to the community on how to grow and use fresh produce,” said farm project coordinator Christine Davies.

The county this week launched a health assessment survey aimed at collecting and analyzing data from patients at local hospitals. Grimes said officials intend to compile the data into a comprehensive plan that will involve several entities — hospitals, qualified health centers and the health department itself — in crafting or adjusting programs to address food choices and physical activity options, among other issues.

“It’s not really the typical assessment where we’re asking what’s wrong with our community,” Grimes said. “We know what’s wrong. I know we might get some feedback that’s hard to swallow, but we need to hear it in order to know how to help.”

Follow Andy Knight on Twitter @Andrew_J_Knight, or call 765-640-4809.

By the numbers

37: Percentage of adults in Madison County who are considered obese, according to the 2016 Community Health Needs Assessment compiled by St. Vincent Anderson Regional Hospital. The statewide average is 33%.

29: Percentage of adults in Madison County who are considered “physically inactive,” according to figures from the Madison County Health Department. The statewide average is 25%.

69: Percentage of Madison County adults reporting adequate access to locations for physical activity. The statewide average is 75%.

7.1: Madison County’s food index, a 0-10 scale that measures factors contributing to a healthy food environment. The statewide average is 7.5, with most counties falling between 6.9 and 8.2.

Area food pantries

The following food pantries offer groceries and other healthy food options to those who meet certain income guidelines:

Second Harvest Food Bank of East Central Indiana

Tailgate Food Pantry

Where: Old Kmart parking lot, 2811 Nichol Ave., Anderson

When: Monthly, noon to 2 p.m. while supplies last.

Intake: Drive up.

What to bring: Nothing.

Cost: None.

Eligibility: Open (limit three families per vehicle)

Information: 765-287-8698.

Carrie Mae Hyatt Westside Community Food Pantry

Provides fresh, frozen and nonperishable food for people in need. Clients make their own selections from available items.

Where: New Hope United Methodist Church, 2215 Fulton St., Anderson

When: Office open Monday, Wednesday, Friday 1 to 5 p.m.; Pantry: Tuesday, 4 to 6 p.m.

Intake: Walk in through rear door near parking lot.

What to bring: Photo identification with Madison County address, proof of address (such as utility bill) if address differs from photo ID.

Eligibility: Madison County residents; limit two visits per month.

Information: 765-649-1892.

Salvation Army Anderson

Provides food monthly to people in need. Limited service area.

Where: 1615 Meridian St., Anderson

When: Monthly; last Tuesday, 9-11:30 a.m. and 1-2:30 p.m.

Intake: Walk in.

What to bring: Current photo identification; proof of address.

Cost: None.

Eligibility: Madison County residents.

Information: 765-644-2538.

Lapel Community Food Pantry

Provides perishable and nonperishable food for people in need.

Where: 1321 N. Main St., Lapel

When: Saturday, 9 a.m. to noon. Second and fourth Friday; 9 a.m. to noon.

Intake: Walk in.

What to bring: State-issued photo identification. Proof of current address if different from photo ID.

Cost: None.

Eligibility: Residents of Green, Jackson and Stoney Creek townships, Madison County. Limit of one visit per month.

Information: 765-534-3314.

Park Place Church Of God Food Pantry

Where: 802 E. Fifth St., Anderson

When: Monday, Tuesday and Friday, 12:30 to 2 p.m.; Thursday, 12:30 to 2 p.m. and 6:30 to 7:30 p.m.

Intake: Walk in; use entrance from parking lot off Cottage Avenue.

What to bring: Photo identification and proof of address.

Cost: None.

Eligibility: Madison County residents; limit of one visit every other week.

Information: 765-374-4663.

Client Choice Food Pantry

Operation Love Ministries

Where: 620 E. 21st St., Anderson

When: Wednesday, 9-11:30 a.m. and 1-3:30 p.m.

Intake: Walk in.

What to bring: Proof of address, proof of each household member. Photo identification for all adults; Social Security card, birth certificate, insurance card, or school records for all children.

Cost: None.

Eligibility: One visit per month

Information: 765-644-2121.

Saint John's Evangelical Lutheran Church

Provides food twice monthly to persons in need.

Where: 310 E. 53rd St., Anderson

When: Check in 2 p.m. first and third Monday; food pickup from 6 to 7:30 p.m.

Intake: Arrive during check-in to receive a number; return same day during pickup hours to receive food.

What to bring: Photo identification, and (first visit only) two proofs of address.

Eligibility: Open.

Cost: None.

Information: 765-644-6020.

East Lynn Christian Church

Where: 522 E. 53rd St., Anderson

When: Check-in: Wednesday 10 a.m.; food pickup Wednesday, noon to 2 p.m.

Intake: Use east entrance to church.

What to bring: Photo identification and proof of current address.

Cost: None.

Eligibility: Madison County residents; can only use pantry once per month.

Information: 765-643-7415.

Frankton Christian Church

Where: 201 Church St., Frankton.

When: Tuesday, 10 a.m. to noon.

Intake: Walk in.

What to bring: Photo identification; recent utility bill; address must match photo ID.

Cost: None.

Eligibility: Patrons must live within the school district boundaries of Frankton Elementary and Frankton Junior/Senior High School; may only use pantry once every 30 days.

Information: 765-754-8660.

Chesterfield Community Food Pantry

Where: 202 Federal Drive, Chesterfield

When: Town Hall, Monday through Friday, 8 a.m. to 4 p.m. Pantry: Tuesday, 5 to 7 p.m.

Intake: Walk in, or call town hall for information.

What to bring: Photo identification and proof of address, recent mail, utility bill, lease.

Cost: None.

Eligibility: Patrons must live in Union Township. Limit: Two visits per month.

Information: 765-378-3331.

Read 'N' Feed

Pendleton Community Public Library

Where: Pendleton First United Methodist Church, 225 W. State St., Pendleton; First United Methodist Church, 301 N. Alfonte St., Ingalls; and Markleville East Christian Church, 124 E. Main St., Markleville.

When: Thursday, 7 p.m., Ingalls; 5 p.m., Markleville, and 6 p.m., Pendleton.

Intake: Call or visit library website to confirm bookmobile schedule. Clients should be prepared to provide name, address, phone number, and the number of people in their household before receiving food.

What to bring: Nothing is needed for food pantry. To apply for library card, state-issued photo identification and proof of address.

Cost: None.

Eligibility: For food or resident library card, patrons must live in Pendleton, or Fall Creek, Green or Adams townships.

Information: 765-778-7527.

Pete's Pantry

Provides perishable and nonperishable food, including butter and eggs, to people in need. Clients make their own selection from available items on a shopping list. Limited service area.

Where: 309 W. Washington St., Alexandria

When: Monday, Wednesday, and Friday, 9:30 to 10:50 a.m.

Intake: Walk in; pantry is in church basement.

What to bring: Photo identification; proof of address if different.

Cost: None.

Eligibility: Residents of Alexandria, Orestes, or Summitville in Madison County. Limit of three visits per month.

Information: 765-724-7566.

Daleville United Methodist Church

Where: 8104 S. Hickory Lane, Daleville.

When: First Monday of the month, 9 a.m. to noon; first Wednesday of the month, 4 to 6 p.m.

Intake: Walk in.

What to bring: Photo Identification, proof of address.

Cost: None.

Eligibility: Patrons must live in Salem Township in Delaware County.

Information: 765-378-3000.

Elwood Community Food Pantry

Where: 208 S. Anderson St., Elwood.

When: Monday, 6 to 7:30 p.m.; Wednesday and Thursday, 10 a.m. to noon.

Intake: Walk in.

What to bring: Photo identification, proof of address, Social Security cards for all adult household members; Social Security cards or birth certificates for all children in household; proof of household income and or government benefits.

Cost: None.

Eligibility: Patrons limited to one visit per month.

Information: 765-552-5570.

*Source: United Way of Madison County. This list may not be complete.