The "Story Behind the Curve" helps us understand why the data on servings of fruits and vegetables is the way that it is in our community. When we understand the root causes of our community problems, we have a better chance of finding the right solutions, together.

What's Helping? These are the positive forces at work in our community and beyond that influence this issue in our community.

• Community gardening
• School nutrition guidelines
• Free-or-reduced lunches
• Jackson County Farmers Market
• The Whee Market
• MANNA Foodbank
• The Community Table
• Farm-to-Table Restaurants

What's Hurting? These are the negative forces at work in our community and beyond that influence this issue in our community.

• Inflation causing high food and gas prices
• Affordability and accessibility of fast food
• Lack of education on preparing meals
• Lack of time to prepare nutritious meals
• Culture of eating out, fast food, etc

Partners in our Community Health Improvement Process:  

• Area Ageny on Aging
• Jackson County Department of Public Health
• Safe Kids Jackson County
• Region A Partnership For Children
• Smart Start
• HIGHTS
• Great Smokies Health Foundation 
• Center for Domestic Peace
• Jackson County Parks and Recreation Department
• Western Carolina University
• Harris Paramedicine & EMS
• Harris Regional Hospital
• Jackson County Public Library
• Nurse-Family Partnership
• Jackson County Public Schools
• WNC Healthy Impact

Partners with a Role in Helping Our Community Do Better on This Issue: 

• Jackson County Farmers Market
• The Whee Market
• Sylva Community Garden
• Cullowhee Community Garden
• Southwestern Planning Commission
• Southwestern Child Development
• Jackson County Transit
• Parents
• Jackson County Department on Aging
• MANNA
• WRGC
• County Manager Don Adams
• Jackson County Commissioners
• Town of Sylva Commissioners
• Local Churches
• Department of Social Services
• Southwestern Community College
• Local grocery stores
• Pediatricians
• Medical Professionals
• Lactation Consultants

The following actions have been identified by our Healthy for Life Action Team, community members and stakeholders as ideas for what can work for our community to make a difference on healthy living. 

Actions and Approaches Identified by Our Partners These are actions and approaches that our partners think can make a difference on healthy living. 

• Elevate 828 - community-wide and public school wellness program
• Healthy Snack Master Competition
• Implementing Community Walking Trails
• Breastfeeding Friendly Worksites and Businesses

What is Currently Working in Our Community These are actions and approaches that are currently in place in our community to make a difference on healthy living.

• Jackson County Dept of Public Health WIC, Diabetes Education, Medical Nutrition Therapy
• Jackson County Dept of Public Health - Health Education section
• School Nutrition
• Farmers Markets
• MANNA
• Community Table
• Community Gardens
• Elevate 828 wellness program
• Worksite wellness programs

Evidence-Based Strategies These are actions and approaches that have been shown to make a difference on healthy living. 

What Community Members Most Affected Say 

• Healthy foods are harder to afford and to access
• Healthy eating takes more time (meal planning, grocery shopping, preparation time)
• My family is less likely to eat what I prepare

Process for Selecting Priority Strategies

We used the following criteria to identify significant health issues:

● Data is related to past health priorities

● Data reflects a concerning trend related to size or severity

● Significant disparities exist

● Issue surfaced as a topic of high community concern

● County data deviates notably from the region, state or benchmark

Once our team made sense of the data, they considered the severity of the issue, the relevancy of the issue, and the feasibility in improving the issue. We presented key health issues to a wide range of partners and community members. The participants used the information we presented to review each issue, and then agreed on their top areas of concern. This process, often called health issue prioritization, is an opportunity for various community stakeholders, such the hospital, health department, public school system, parks and recreation, and more to agree on which health issues and results we can all contribute to, which increases the likelihood that we will make a difference in the lives of people in our community.

During the above process, the group identified the following health issues:

 Lack of Healthy Eating: Few residents are consuming the recommended servings of fruits/vegetables.

 Lack of Physical Activity: Few residents are meeting physical activity recommendations.

 Chronic Disease Rates: Chronic disease rates are high, especially diabetes. 

During our group process, the following criteria were applied to the issues listed above to select priority health issues of focus for our community over the next three years:

● Criteria 1 – Relevant – How important is this issue? (Size of the problem; Severity of problem; Focus on equity; Aligned with HNC 2030; Urgency to solve problem; Linked to other important issues)

● Criteria 2 – Impactful – What will we get out of addressing this issue? (Availability of solutions/proven strategies; Builds on or enhances current work; Significant consequences of not addressing issue now)

● Criteria 3 – Feasible – Can we adequately address this issue? (Availability of resources (staff, community partners, time, money, equipment) to address the issue; Political capacity/will; Community/social acceptability; Appropriate socio-culturally; Can identify easy, short-term wins) Participants used an open discussion to rate the priorities using the criteria listed above.

The following priority health issues are the final community-wide priorities for our county that were selected through the process described above:

 Healthy Eating & Physical Activity: Originally, obesity prevention through eating healthy and being physically active, emerged as health priorities during the 2011 CHA process. While much effort has occurred to positively increase healthy eating and physical activity, there is still much to be done. We are concerned by the low percentage of residents eating the recommended servings of fruits/vegetables and who are inactive. In addition, chronic disease rates such as diabetes are high. 

The group then completed a Whole Distance Exercise to determine strategies for the Healthy Living priority. These community members and professionals worked together to go through a desired result, experience, etc until the finally had strategy options listed. They voted on the strategies that met our criteria above for feasibility, interest, etc.