A change is gonna come: Creating a healthier Mississippi one community at a time! through evidence and practice-based policy, environmental, programmatic, and infrastructure interventions

Background: Residents in Mississippi brunt the greatest burden of cardiovascular disease outcomes (incidence, morbidity and mortality) and related risk factors (hypertension, diabetes, obesity, poor nutrition and tobacco use). Consequently, the continuance of these trends undermines national public health prevention strategies - the overarching objective of Healthy People 2020 (HP2020) is to understand and reduce inequalities in health. Methods: Project CHANGE is a novel statewide initiative funded by the Prevention and Public Health Fund 2012: Community Transformation Grants. This initiative utilizes a comprehensive set of evidence and practice-based policy, environmental, programmatic, and infrastructure interventions in strategic areas that align with HP2020 performance measures. Strategic areas include: Tobacco Free Living; Active Living & Healthy Eating; High Impact Quality Clinical and Other Preventive Services; Social and Emotional Wellness; and, Healthy & Safe Physical Environment. Performance measures, as outlined in the Affordable Care Act, include: changes in: weight, proper nutrition, physical activity, tobacco use prevalence, and emotional well-being and overall mental health. We assessed the progress of our community capacity building efforts, implementation of pilot interventions, and other program-related achievements. Results: As of February 2013, the following (though not an exhaustive list) gains have been made: (1) an annual statewide capacity building training conference, (2) 28 community health fairs and forums, (3) Telling Your Story documentary highlighting the deplorable conditions in many underserved communities, (4) 18 event partnerships, (5) passage of comprehensive smoke-free ordinances in 27 local municipalities, and (6) state-level legislation (e.g., bills) that supports joint use agreements, safe-routes-to-schools, city/county farmers markets, and healthy food retail stores. Conclusions: Full implementation of the proposed interventions across Mississippi will be the catalyst to the needed “Cultural Revolution of Health,” where the shared knowledge, beliefs, and behaviors of healthy lifestyle choices and supportive environments to make these choices will extend life expectancy in Mississippi and globally.