We explored rural older adults perceptions of health to inform health promotion program development, using social marketing as our framework. Participants in seven focus groups viewed independence and holistic health as indicators of health and identified healthful eating and physical activity as actions to promote health. Barriers to these actions included physical limitations, social factors, financial considerations, motivation issues, and information confusion. Participants desired education that improves knowledge and skills, provides socialization opportunities, and occurs in familiar, affordable locations. Our findings can be useful to others developing health programming for rural-residing older adults. Also, we show that applying social marketing principles during formative assessment can be helpful in tailoring programs to audience interests and concerns.