This greater demand to provide and manage care for the obese will come as healthcare reform turns towards reimbursement models that reward quality outcomes and prevention over fee for service. Rural healthcare providers must get on the front end of this epidemic and emphasize prevention. Unfortunately there doesn't seem to be much coordination for this in any broad fashion.
"I don't think there is any single entity that will be able to turn the tide on this epidemic of obesity both in the nation and specifically in rural areas. It is going to have to be a convergence of many factors coming together," says Perri, who is also a professor and dean of the UF College of Public Health and Health Professions.
He believes the most cost-effective route may be to use existing infrastructures to provide nutrition and health education to rural families.
"One thing that jumps out is cooperative extension services in almost every county throughout the country. Part of their mission is nutritional education," Perri says. "In rural areas the extension office is highly valued as a place to go and get assistance. Often the extension offices are the places to go for the WIC (Women, Infants and Children) Program. We can teach family and consumer science agents in the offices how to do weight management programs targeting children and adults and families."