Nurse Melanie Hernandez measures Yazmine Euceda, 11, during a checkup at Lake County’s school-based health center. The four-year-old clinic, located at the high school, provides medical, dental, and mental health services to students, teachers, and families. No one is turned away for an inability to pay. (Photo courtesy of the Robert Wood Johnson Foundation)

When officials in Lake County saw the results of the 2010 Healthy Kids Colorado survey, they knew they had to do something.

Substance abuse and school absences were up. Academic performance was down.

In response, leaders organized a community-wide effort to improve the lives of students in the rural Colorado county, situated along the crest of the Rocky Mountains.

The effort has started to pay off, said Brayhan Reveles, the Healthy Eating and Active Living coordinator for Lake County.

“We’re working on improved access for youth opportunities, from volunteer opportunities, to internships, to career paths that start in school, as well as getting students outdoors and being more active,” Reveles said.

“From my perspective, there was a good shift from the youth seeing their community wasn’t really invested in them to seeing that their community was invested in their development.”

Jackie Radilla and Cisco Tharp of Get Outdoors Leadville! organize camping gear at the community gear library. (Photo courtesy of the Robert Wood Johnson Foundation)

Lake County’s turn-around was one of the reasons the Robert Wood Johnson Foundation awarded the rural community a Culture of Health Prize. The annual award recognizes communities that are “working at the forefront of advancing health, opportunity, and equity for all,” according to the foundation.

Two other rural communities also received one of the five awards given this year: Sitka, Alaska, a town of about 9,000 on the remote southern coast of the state near Juneau; and Gonzales, California, a town of 7,500 located in the Salinas Valley of Monterey County (Monterey is a metropolitan county because of the city of Salinas, population 156,000, located about 20 minutes away from Gonzales).

“This award is for all of the Lake County community members, partners, and leaders who continue to show up and shape our community,” said Colleen Nielsen, director of the Lake County Public Health Agency. “It recognizes that Lake County is headed in the right direction to ensure that our community is a place where all residents can achieve their greatest health, regardless of neighborhood, ethnicity, or income.”

The Sitka boat harbor. (Photo courtesy of the Robert Wood Johnson Foundation)

In Sitka, change started when the two hospitals in the town came together to do a community health summit, said Doug Osborne, health educator at the SouthEast Alaska Regional Health Consortium and a member of the Sitka Health Summit Coalition. Started in 2006, the summit gathered community members to identify health issues they wanted to tackle each year. Some activities spurred by the effort have included building a park that meets requirements of the Americans with Disabilities Act, opening a farmers’ market, and building a racial reconciliation project. Other actions involved changing city ordinances.

“Sitka was the first community in the state to raise the age to buy cigarettes to 21,” Osborne said. “And our voters passed a tobacco tax increase which made it more difficult for young adults to afford” cigarettes.

The community focused on being more bike and walking friendly, he said, as well as focusing on distracted driving with cell phones.

The community measured impact with publicly available data. And where there was no data, they improvised.

“There [with distracted driving] we just did observations to see the impact,” he said. “Just watching traffic to see how many drivers were distracted by their cell phones prior to the effort and after, we were able to see the incidence go from about 20 percent of all drivers and get it all the way down to 4 percent. In small places and rural places, you don’t necessary have the same resources as a larger place… but there are ways to measure your impact.”

Making the commitment to improving health meant setting priorities, he said.

“I think every community would say that doing health work is important,” he said. “But are you willing to do the work, that’s another story. As a country, we’re number one in what we’re spending on healthcare, but not in what we’re willing to do to be healthier. We had to make choices… on the tobacco age, our local polling showed that 70 percent of the people were for it. Still that meant that 30 percent said no they didn’t want us prioritizing [children’s] health at the expense of tobacco sellers, but it’s something we decided needed to be done.”

In Gonzales, California, community efforts have focused on economic development, opportunities for youth, and environmental sustainability. About 94 percent of the community is Latino, and one third of residents are younger than 18. The community passed a half-cent sales tax in 2014 to support youth activities, improvements in parks and recreation activities, and career training.

The Culture of Health Prize rewards community that “define health in the broadest possible terms, create conditions that give everyone a fair and just opportunity to reach their best possible health, harness all aspects of the community, and show measurable results,” according to the foundation.

Communities win a $25,000 prize and join a network of other prize-winning communities.

Disclosure: The Center for Rural Strategies, which publishes the Daily Yonder, receives financial support from the Robert Wood Johnson Foundation.

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