Partners With A Role to Play

• North Carolina Department of Health & Human Services: Healthy Communities funding 
• CHIP Advisory Council members and organizations

• * To be further defined - this is still in planning phases

Process for Selecting Priority Program/ Strategies

The overall approach used was a modified Results-Based Accountability process. A community input process was facilitated using the RBA Whole Distance Exercise framework with multiple events held in partnership with community providers to listen to community voices. These input sessions included over 75 individuals including those with lived experience, health care providers, social service agencies, advocacy organizations and local non-profits. The professionals participating included those working in the health field as well as those working to address many of the social and economic factors that impact health.

The following actions have been identified by our CHIP Advisory and Leadership team and community members as ideas for what can work for our community to make a difference on chronic disease.

Actions and Approaches Identified by Our Partners 

These are actions and approaches that our partners think can make a difference:

• Gentrification, systemic racism/land taken (eliminating places to exercise and be outside safely)
• Lifestyle education – process for making changes in behaviors
• "There are not enough greenways, bike lanes, sidewalks, dense development. We are still reliant on the car. People need to move more and the attachment to our long-held values of cars, busy streets that are unsafe for walking/biking. We need a community design that is people centric." 
• "Lack of greenways and other physical activity outlets in rural areas of the County."

What is Currently Working in Our Community 

These are actions and approaches that are currently in place in our community to make a difference:

• Community Health Workers - linking to resources and eduction on healthy activities and movement
• Expansion of bicycle lanes and sidewalks (in some locations in the County)

What Community Members Most Affected by Chronic Disease (Heart Disease and Diabetes) Say 

These are the actions and approaches recommended by members of our community who are most affected by chronic disease conditions:

• Make public transportation accessible for ALL Buncombe County residents (particularly those who experience mobility issues with walking)
• Increasing access to healthcare advocates (community health workers) for better systems navigation and support with healthy activities and movement

Evidence-Based Strategies 

These are actions and approaches that have been shown to make a difference:

Studies have found that individuals living in less walkable neighborhoods have a higher risk for developing heart disease, high cholesterol, high blood pressure, and diabetes compared to indivuduals living in walkable neighborhoods.

Association Between Neighborhood Walkability and Predicted 10‐Year Cardiovascular Disease Risk: The CANHEART (Cardiovascular Health in Ambulatory Care Research Team) Cohort. Nicholas A. Howell, Jack V. Tu, Rahim Moineddin, Anna Chu and Gillian L. Booth Originally published31 Oct 2019https://doi.org/10.1161/JAHA.119.013146Journal of the American Heart Association. 2019;8:e013146

Walking (frequency and duration) is not only affected by objective elements, but also by the subjective quality of an area, and perceived suitability and ease for walking. In addition, aspects such as perceived safety and the atmosphere of an area may also have great influence on walking.

Jonas De Vos, Katrin Lättman, Anna-Lena van der Vlugt, Janina Welsch & Noriko Otsuka (2022) Determinants and effects of perceived walkability: a literature review, conceptual model and research agenda, Transport Reviews, DOI: 10.1080/01441647.2022.2101072