November 29, 2010

Elementary school kids in Seattle enjoy a snack provided by the local Healthy Eating by Design program. Photo courtesy of Active Living By Design.

Elementary school kids in Seattle enjoy a snack provided by the local Healthy Eating by Design program. Photo courtesy of Active Living By Design.

In the mid-2000s, Lynda Kinnane – and others in the beautiful mountain town of Burnsville, N.C. – had a major concern. “We were seeing a lot of children who were overweight,” Kinnane recalls.

But now, thanks to a Fit Community grant administered by UNC Gillings School of Global Public Health’s Active Living By Design (ALBD), the Yancey County community is turning the tide.

Using the $60,000 grant as seed money, the community partnership, known as “Healthy Yancey,” renovated a previously closed gymnasium, bought park playground equipment for young children, added a sidewalk to connect a local swimming pool to Ray-Cort Park and hired a director to oversee the projects.

The technical assistance Healthy Yancey received from ALBD was as critical as the seed money.

“The five Ps they stress – Preparation, Promotion, Programs, Policy and Physical Projects – helped us tremendously,” says Kinnane, who wrote the grant application. “They make you think things through. Because of that, I feel like we’ve been successful.”

Although there is no hard data yet on youth weight loss or maintenance, it appears Healthy Yancey is making a difference. “Changes like this take a long time; the problem is so multifactorial,” says Kinnane, director of the Toe River Health District, which covers Yancey, Avery and Mitchell counties.

“I believe our community is more fit. Our gym is busy all the time; the park is busy, too. All of these things are helping.”

Funded by the North Carolina Health and Wellness Trust Fund, Fit Community is one of many grant programs administered by ALBD, an organization based in the School’s North Carolina Institute for Public Health.

What all ALBD programs have in common is a focus on supporting community partnerships to create environments that foster good health. “We are taking public health to the streets,” says ALBD director of communications Mark Dessauer.

ALBD was one of the first organizations in the country to zero in on the importance of the built environment and its potential impact on health. “Our relationship with the Robert Wood Johnson Foundation and the focus of our first initiative together was innovative,” says ALBD director Sarah Strunk, MHA. “We were early adopters that helped communities translate a growing area of research into practice. We looked at how we could increase physical activity through community design.”

With an initial foundation investment of $15.5 million in 2001, ALBD selected partnerships of key players within communities to solve infrastructure challenges around physical activity and, later, healthy eating.

“We wanted neighborhood and grassroots groups determining what their communities needed and working with others, including local government entities such as public health, transportation, and parks and recreation, to make it happen,” Dessauer says. The approach struck a chord. “We expected 300 to 350 to apply, but we had 966. The response broke all foundation records,” he says.

The first 25 community grantees received technical assistance and $40,000 annually for five years. The money seeded partnerships that leveraged nearly $260 million in additional community investments.

“The lesson we learned was that with a small amount of money, these partnerships can accomplish something significant,” Dessauer says. “It gave them an opportunity to pause and think about community health and how they could work together.”

South Bronx (N.Y.) youth celebrate their borough's newest park. The ALBD grantee engaged local young people to clean up trash in the park and make landscaping changes. Photo courtesy of Active Living By Design.

South Bronx (N.Y.) youth celebrate their borough’s newest park. The ALBD grantee engaged local young people to clean up trash in the park and make landscaping changes. Photo courtesy of Active Living By Design.

With such success, the N.C. Health and Wellness Trust Fund, Kellogg Foundation, Blue Cross Blue Shield of Minnesota and other groups soon engaged ALBD to work with their grants programs.

In 2008, the Robert Wood Johnson Foundation made an even bigger commitment to ALBD, asking it to lead the new $33 million Healthy Kids, Healthy Communities program – the foundation’s largest investment in community-based change related to childhood obesity, Dessauer says.

Among the 50 Healthy Kids, Healthy Communities grants made so far, one for $400,000 in Baldwin Park, Calif., continues to fuel a childhood obesity fight launched more than a decade ago.

The largely Latino suburb of Los Angeles has seen children lose weight and increase test scores as the community has instituted salad bars and mandatory physical education levels in schools, increased fresh produce in stores, banned drive-through windows at new fast-food restaurants and launched a website called, created by and targeted to young people.

The grant is helping the partnership implement “People on the Move,” focused on decreasing unhealthy food marketing and advertising, increasing access to healthy foods in corner groceries near schools and boosting “walkability” and green space in the downtown area.

In Somerville, Mass., ALBD also is advancing a longtime initiative. Since the early 2000s, “Shape up Somerville” has spurred new parks, walking paths, recreational facilities, community gardens, low-fat menu options at restaurants and education of parents about healthy eating.

A $400,000 Healthy Kids, Healthy Communities’ commitment is helping the town make changes in public policy to sustain health over time – a major ALBD emphasis. “To truly reverse the epidemic of childhood obesity, we need to address policies, environments and systems, not just individual behavior,” says ALBD director Strunk. “This means working to create community-level changes that can be sustained for generations to come.”

Susan Shackelford

Carolina Public Health is a publication of the University of North Carolina at Chapel Hill Gillings School of Global Public Health. To view previous issues, please visit

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