A Community Based Approach to Promoting Change in Community Policy and Practice in Appalachian Tennessee Counties

Tennessee’s prevalence of death from cardiovascular and cancer causes, high infant mortality, high incidence of complications from diabetes, obesity and tobacco use has identified the state as one of the least healthy in the nation.  These health conditions degrade the quality of life and lessen the economic viability of many counties especially those in eastern Tennessee classified as Appalachian. Because the roots of many of these conditions depend on individual behaviors and personal choice, providing the mechanisms for communities to address these health disparities in ways that are most meaningful was the thrust of the “Roadmap for a Healthier Appalachian Tennessee,” a grant-funded program of the Tennessee Institute of Public Health (TNIPH) in 2014.  TNIPH used small grant funding approach to encourage 20 counties/communities to systematically implement health and disease prevention strategies to promote positive health behaviors in response to local health conditions.  By aggressively engaging diverse local partnerships to collectively encourage community-driven health promotion, these 20 communities were able to meet local needs within the boundaries of the overall program goals while reaching locally determined objectives and measures.  Additionally each community organization targeted different populations (e.g., school-aged youth, women, senior citizens, etc. in their project designs and involved new health partners and new economic partners by the end of the grant year to alter their communities’ health profile.  We will discuss and compare various health promotion methodologies used by these Appalachian communities to change fundamental health behaviors and to establish new directions for local health policies.