The "Story Behind the Curve" helps us understand why the data on adult obesity 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? 

Community members who participated in the planning meetings reported the following positive forces that influence this issue in a positive way in Transylvania County:

• Free programs and resources available in the county
• Access to abundant outdoor resources such as the state and national parks, greenways
• Opportunities for fun physical activity (e.g. bowling)
• Social groups around physical activity (e.g. hiking groups, biking groups)
• Outdoor volunteerism
• Silver Sneakers program to provide affordable access to physical activity for older adults
• Senior Games provides social interaction and encourages physical activity among older adults
• Special Olympics provides social interaction and encourages physical activity among special-needs populations
• Community events (e.g. 5Ks, biking events)
• Kids running programs (e.g. Girls on the Run, SMART kids)
• Muddy Sneakers provides access to the outdoors for elementary students
• Comprehensive outdoor focus offered in some schools and programs
• Worksite wellness programs (city, county, private employers)
• Senior centers at Silvermont and Quebec Community Center
• Discounted fitness center rates for certain groups
• Hospital offers fitness program on a sliding scale fee
• Diabetes Prevention Programs at Transylvania Regional Hospital and Transylvania Public Health
• Nutritionist at Blue Ridge Health Center, Transylvania Regional Hospital, WIC
• Community gardens in neighborhoods and at churches
• Access to options for healthy foods in grocery stores and restaurants
• Few food deserts
• School meals provide exposure to fruits and vegetables
• Cooperative Extension classes and programs (e.g. 4-H)
• Sharing House classes for low-resource neighbors
• Good weather for being outdoors most of the year

What's Hurting? 

Community members who participated in the planning meetings reported the following forces that influence this issue in a negative way in Transylvania County:

• Low walkability in many areas of the county
• Students not getting recommended PE and recess time at school
• Limited access to swimming pools and other recreation facilities
• Perception that healthy food is more expensive
• Cost of living and affordable housing results in less money available for food
• Low wages results in less money available for food
• Access to and marketing of fast food
• Prevalence of sweetened drinks (e.g. sweet tea, sodas, juice, sugary coffee drinks)
• Culturally favorite foods are often fried and sugary
• Food as emotional comfort and to relieve stress
• Food as a centrally-important part of social events
• Lack of knowledge about cooking
• Underuse/low desire to take home economics classes
• Limited prep time to cook healthy food (or to cook at all)
• No elective time for self-care
• Electronics usage takes available time that could be used for physical activity or food preparation
• Lack of sleep contributes to weight gain, exhaustion, stress
• Exhaustion and stress leads to not having physical or mental energy to spend on food choices or physical activity
• Some areas of the county are food deserts, especially when driving distances (rather than just radius distances) are taken into account
• School meals don't always offer healthy choices that students want to consume; limited by regulations and student purchasing habits

Partners in our Community Health Improvement Process: 

The following individuals and agencies were represented in the planning process related to adult obesity:

• Blue Ridge Health Center
• Brevard City Council
• Hunger Coalition of Transylvania County
• NAACP Health Committee
• Pisgah Forest Rotary
• Sharing House
• Transylvania County Government
• Transylvania County Library
• Transylvania County Parks and Recreation
• Transylvania Public Health
• Transylvania Regional Hospital
• TRAIN (Transylvania Resource Access and Information Network)

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

The following organizations were identified as potential partners on strategies that were considered during the planning process

Government

Actions and Approaches Discussed by Our Partners

Our community partners considered ideas of what works to do better, what is currently working in our community, what people most affected by the issue think will work, evidence-based strategies from sources such as the CDC, County Health Rankings, and Healthy People 2020. The following actions were identified by community members as ideas for what can work in Transylvania County to make a difference on reducing adult obesity:

• Organization of available resources to increase awareness/visibility, especially for at-risk populations
• Moai (social engagement/exercise groups)
• Cooking education
• Pop-up shopping nutrition education
• Diabetes Prevention Programs
• Worksite wellness programs
• Faith-based wellness programs
• Screenings and interventions to prevent falls
• Silver Sneakers physical activity program for older adults
• NC CARE 360 care management system
• Double-up food bucks to lower cost of fresh produce
• SNAP at Farmer’s Market
• Living wage
• Rails to Trails programs
• Bike lane requests to DOT
• Sidewalk policy within City of Brevard jurisdiction

Evidence-Based Strategies 

In addition, the following evidence-based strategies are actions and approaches have been shown to make a difference on reducing emergency department visits for mental health concerns, from resources such as the CDC's Community Health Improvement Navigator, the CDC's The Community Guide, County Health Rankings, and Healthy People 2020.

Process for Selecting Priority Strategies

Community members first identified several root causes or pieces of the "story" that they believed would be most important to address, from their own personal perspective or the perpective of their represented agency. They then identified up to two strategies (either discussed above or others that they had knowledge of) that would significantly impact that particular root cause.

They also indicated if they or their agency would be willing to lead, collaborate, or support each suggested strategy. Strategies with identified leadership are bolded below.

• Promote knowledge and use of existing free programs and resources
  • Campaigns/promotions to increase knowledge of existing programs to all age groups and interests
  • Group education
  • Incorporate health themes into regular programming (e.g. dancing at storytime)
  • Free exercise programs for beginners at library
• Education and support for diet and exercise
  • Diabetes Prevention Program
  • Faith-based programs
  • Worksite wellness: amplify, promote, educate smaller employers on available resources e.g. existing MountainWise programs, quick break workout cards, nutrition evaluation
  • Report successes in worksite wellness programs
  • Promote resources available to smaller employers
• Increase knowledge about cooking, meal planning, and healthy options
  • Group education such as cooking classes, cookbook clubs, food preservation (partner with Cooperative Extension) with cost/benefit information at Library, Sharing House, community centers
  • Grocery store tour for healthy options
  • “Advertise” healthy foods in schools to counter media advertising
  • Collaborate with afterschool programs to provide food education
  • Enhance and promote access to cooking and food-related books
  • Empower neighbors to teach neighbors – cooking healthy on a budget
• Access to healthy foods
  • Pisgah Health Foundation as leader in collaborative effort to transform county with options for low-resource residents to access healthy options/fresh produce at no cost with dignity
  • Encourage and support home gardening (those who grow food are more likely to cook and eat it)
  • Double-Up Food Bucks
  • Blue Zones approach to engage restaurants and grocery stores
  • Group education
  • Develop collections to assist with preparing healthy foods
  • Pop-up or mobile markets
  • Increase healthy food options in restaurants: collaborate with Transylvania Economic Authority to create financial incentives for restaurants to source local foods, offer stickers to indicate support of local farms
• Low walkability in outer parts of county
  • Expand sidewalks wherever possible for connectivity
  • Rails to Trails and Brevard urban trails expansion
• Outdoors as asset
  • Expand bike trails / Rails to Trails
  • Education about available options – especially for low income and Hispanic populations
• Social cohesion/activity groups
  • Include area resources in new employee orientation
  • Highlight existing groups – communicate in accessible way
  • Exercise programs: yoga, chair yoga, pilates, mediation
  • Bike programs: maintenance, safety
  • Collaborate with local businesses to create socioeconomically diverse groups around physical activity
• Encourage active lifestyle from organization leadership
  • Include active lifestyles in county strategic plan
  • Demonstrate cost savings when employing healthy employees by lower insurance claims
  • County commissioners lead by example with presence at wellness events
• Year-round access to safe, relaxing fitness options (e.g. pools, Rails to Trails)
  • Advocate for county support of Ecusta Trail
• Low-cost fitness options
  • Rail to Trails fitness
  • Worksite wellness
• Community events
  • Incentives
  • Group education
  • Campaigns/promotions
  • Incorporate physical activity into events at community centers
• Cost of living/poverty
  • Achieve Democratic majority in NC legislature
  • Advocate for Chamber of Commerce and Heart of Brevard support for living wage
• Affordable housing
  • Advocate for infrastructure that supports health in new developments (e.g. sidewalks, pedestrian-friendly, curb cuts)
  • Promote social gathering spots that support health (e.g. community gardens, conversation areas, walking paths)