Alice Ammerman: Inspiring heart health in the ‘stroke belt’

July 17, 2014

This article by Courtney Mitchell first appeared in the July 15, 2014, University Gazette, a publication of The University of North Carolina at Chapel Hill.

Alice Ammerman is co-creator of Heart Healthy Lenoir, a project that helps encourage healthy living in Lenoir County, N.C.

comms_heart-healthy-lenoir-logoLenoir County is tucked into the eastern part of the state, about 75 miles east of Raleigh, with a population of around 57,000. If you’re headed to the coast, you’re likely to pass through.

“We welcome everybody with open arms,” said Laura Lee Sylvester, the president of the Kinston-Lenoir County Chamber of Commerce. “That’s what makes us stand out – we really take care of each other, no matter who you are or where you live.”

The tight-knit community is also facing a health crisis. Located in what is recognized as the “stroke belt,” its residents experience significantly higher rates of cardiovascular disease, stroke and obesity rates compared to other parts of the state and nation.

Alice Ammerman,  professor of nutrition at UNC’s Gillings School of Global Public Health and director of the UNC Center for Health Promotion and Disease Prevention (HPDP), took notice. She and her colleagues reached out to county health officials to learn more about the county’s specific needs and the initiatives already in place, and for nearly five years now, this community has been the focus of Heart Healthy Lenoir.

The National Institutes of Health-funded project is a community-based partnership of UNC’s HPDP, the county and East Carolina University. It includes multiple initiatives to help Lenoir County residents live healthier lives and researchers collect the kinds of information that could affect change statewide.

“The people of Lenoir County have such a commitment to improving health, and they also approach things with a spirit of collaboration and partnership that’s helped accomplish many goals,” said Ammerman. “We’ve tried to help create a healthier environment rather than imposing restrictions, so that the healthy choice is the easy choice.”

Collaboration, not imposition

The HPDP, which has projects in nearly all 100 counties across the state, takes a community-based approach to making a difference, one that works within the context of local culture to inspire lasting change.

Dr. Alice Ammerman selects peppers at the Kinston, N.C., Farmers Market. Ammerman won a prize for heart-healthy hushpuppies at the Kinston barbeque festival this year. Photo still courtesy of HPDP video.

Dr. Alice Ammerman selects peppers at the Kinston, N.C., Farmers Market. Ammerman’s heart-healthy hushpuppies won second prize at the Kinston barbeque festival this year. Photo still courtesy of HPDP video.

Finding the most effective ways to tackle Lenoir County’s cardiovascular disease problem was a process of inclusion. A local advisory committee of health professionals, researchers, residents and other community partners, including Sylvester, convened to guide the process.

“I call them ‘The Dream Team,’” Ammerman said. “We needed to figure out how to do this in a way that would fit the community culture, designing programs and strategies that would be long-term, rather than making a big splash that can’t be sustained.”

Three interrelated studies with more than 650 participants emerged — a lifestyle intervention initiative to reduce heart disease risk and disparities in risk; a practice-based, enhanced-care intervention for hypertension that works with both patients and health professionals; and a genetic predispositions and genomic signatures study.

Preliminary data have shown positive results. Blood pressure is, by and large, on the decline, and so is weight. Changes – measurable and immeasurable – have been felt throughout the county, said Sylvester, who participated in some of the lifestyle change sessions offered by Heart Healthy Lenoir.

She considers it the chamber’s role to advocate for not only strong local businesses, but also a strong, healthy community.

“We’ve got problems here with childhood obesity, stroke and hypertension, the kinds of things that are going on in other parts of North Carolina, too,” said Sylvester. “Part of our mission at the chamber is to make sure we’ve got healthy citizens, because we know that healthy citizens bring economic development, and it makes for a better community.”

Read more about Heart Healthy Lenoir on The University Gazette website.

See Ammerman’s recipe for heart-healthy hushpuppies, which won second place this year in the Kinston, N.C., Barbecue Festival.

Gillings School of Global Public Health contact: David Pesci, director of communications, (919) 962-2600 or