Addressing Food Insecurity in Rural Tennessee

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Tom Haederle
When a community health needs assessment was conducted in Hardeman County, Tennessee, it confirmed what most people already knew. Not only was obesity a serious health threat for adults and youth alike, but accessing food at all was a real problem for many county residents who lacked transportation and lived miles from a convenient grocery store. Fortunately for the people of Hardeman County, their local hospitals decided to take action.

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Tom Haederle
Welcome to “Community Cornerstones: Conversations with Rural Hospitals in America.” A new series from the American Hospital Association. I'm Tom Haederle with AHA Communications. As part of its mission to advance the health of the community it serves, Bolivar General Hospital led the fight against food insecurity in Hardeman County, Tennessee. What they did, how they did it and what was the result is the subject of this podcast.

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Tom Haederle
Their story is a window into the lives of leaders who took the necessary steps to improve the health of their community.

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John Supplitt
Good day. I'm John Supplitt senior director of AHA Rural Health Services, and with me is Ruby Kirby, CEO of two critical access hospitals for west Tennessee health care, Bolivar and Camden Hospitals, and she's the recipient of the AHA Rural Hospital Leadership Team Award. Welcome, Ruby.

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Ruby Kirby
Good morning.

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John Supplitt
We are here to discuss how the team at Bolivar General Hospital collaborates with stakeholders across Hardeman County to feed their residents. Ruby, what is the origin behind the effort of a healthier Hardeman County?

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Ruby Kirby
John, originally this initiative came from the results of our community health needs assessment and some of the CDC data. We actually have three entities in Hardeman County that does health needs assessment. We have FQAC, of course, a health department, and the hospital. And we bring all this data back to what we call now our health council, and we were looking at that and some of the things that jumped out at us quickly was our obesity rates for youth, which was like 44% higher than state average. Adults, was 40%, which our state was at 32 at that time.

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Ruby Kirby
But interesting from our survey, 58% of the residents said they were either overweight or obese. So, you know, 14% said they didn't have healthy foods and 21% said they had to travel more than five miles to access food. And in a community like ours, where transportation is the issue, that was how we decided how to address these.

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John Supplitt
So you gathered a lot of data over the course of your community health needs assessment, and then you tried to put them into action. You defined the need and had a strategy, but how did you put it into action?

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Ruby Kirby
Well, we had the health council, and when we looked at the composition of the health council, we knew we didn't have the people we needed at the table. So we got some additional people to the table. And the first step that we decided was to address access to healthy food. So we was fortunate that we were able to collaborate with the University of Tennessee Agri-Stension Agency.

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Ruby Kirby
And through the CDC, a $500,000 grant, cooperative grant that we could use on this program. So we established the “Healthy Hardeman County for Healthy Weight” or we finally call it the “H2O Initiative.” We identified food deserts in the county, and we work with our local farmers and farmers markets to set up produce bins all through the county. So they would distribute food in these bins,

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Ruby Kirby
and it was open to anybody that needed to come in or anybody in the community could contribute. We had the Power Produce Club, which we called a Pops Club. We would give youth their own funding so they could go to the farmers market and pick out their vegetables and fruit. So that was really fun. We worked with the USDA Food Box program to create the Hungry Health and Hope Foodbank, and now we're off and running.

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John Supplitt
And exercise is a part of this experience too, was it not?

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Ruby Kirby
Yep. A lot of the community did not think they had anywhere safe to do the exercise. So what we did was start looking at how to increase the physical activities. People would come out with ideas. We got other entities involved. We built walking trails and walking paths. Additionally, we had new parks, crosswalks, bicycle safety programs and many of the neighbors just took part in what we call “Walk Across Tennessee” challenges.

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Ruby Kirby
So we're still working on that.

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John Supplitt
So it clearly would not have been possible without the strong commitment from your community leaders. So what are the results? What are the outcomes from the experience?

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Ruby Kirby
So we have improved food security. They've had 18 food distribution through the county. 27,000 boxes plus of food has went into the community. The obesity rate in Hardeman County has dropped. It was 40% when we started. We were down to like 35% within two years, and that was the adults. Amongst students it was 46% and now it's like 44%.

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John Supplitt
So as a result of these efforts, you are recognized as a healthier Tennessee community by the governor. So tell us what's next for Bolivar Hospital, the Council and H2O?

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Ruby Kirby
We are still adding individuals . Our work continues. Next step is to work with local industry. We are trying to engage them and their employees in eating healthy and exercising. We plan to engage the schools by visiting classroom, teaching children about healthy food choices and the importance of regular mobility and exercise. The Council and the H2O are working to raise awareness.

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Ruby Kirby
That's, you know, the biggest thing in a community is people to be aware. So we're looking at having a poverty simulator that we would invite 50 community leaders so that they would understand what it's like to live in poverty and be able to stretch your dollars.

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John Supplitt
Yeah. It's great to see you continue this very important work in your community. So thank you, Ruby. Your leadership is inspiring and the award is well-deserved. I look forward to learning more about the success you have improving your community’s health through healthy foods and physical activity. Your team has gone above and beyond providing inpatient care to improve the health of Hardeman County, Tennessee.

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John Supplitt
I'm John Supplitt, senior director of AHA Rural Health Services. Thank you for listening.