Building Roadmaps to Better Health in Tennessee
Since its inception in 2011, the CHR&R coaching program has partnered with individuals and teams in nearly every state across the United States to help them identify and work toward their health and equity goals. Over the next five months, we'll be speaking with five CHR&R Action Learning Coaches and the communities they've coached to learn more about how they worked together to move with data to action.
Nestled in the northeastern tip of Tennessee is East Tennessee State University’s College of Public Health, home of the Tennessee Institute of Public Health. Ginny Kidwell, a northeast Tennessee native with a background in government and education policy, has served as the Executive Director of the institute since 2010. As Kidwell recalls a decade ago, “Nobody was talking about health as an equal partner at the table.” Kidwell, together with dean of the College of Public Health Dr. Randy Wykoff, anchored the principles of the Tennessee Institute of Public Health around a deep understanding of the social and economic factors that influence health outcomes; “We focused around the three-legged stool: economic development, education and health,” shared Kidwell.
Kidwell and Wykoff used County Health Rankings data as the guiding framework for their statewide outreach. They engaged local policymakers, providing them with resources such as the County Health Rankings & Roadmaps state reports and their county’s Rankings data as tools to take action. Kidwell remembers how these reports sparked conversations among legislators when the data were presented at an annual gathering: “People wondered, ‘Why is my county number 82, and this guy right next to me is number 12?’” The Rankings were created to spark these types of questions and ignite action in communities.
This data-guided approach to community change further came into play in 2015, when the Institute was funded by the Appalachian Regional Commission and Blue Cross Blue Shield of Tennessee to develop the Regional Roadmaps Project. The five-year long project focused on rural areas in the state with limited access to economic opportunities, which affect health outcomes. As Kidwell explained: “The further you get off Interstate 40, the harder it is to recruit industry, for a community to grow.” To address these challenges, the Regional Roadmaps Project encouraged local communities to form multi-sector partnerships and work together to improve health outcomes, with projects ranging from community gardens to after school programs to workforce development projects.
Kidwell invited County Health Rankings & Roadmaps Action Learning Coach Aliana Havrilla to speak at one of the Regional Roadmaps Project community forums in 2015, where Havrilla facilitated a discussion. Kidwell immediately recognized the value of having a coach work with communities on their goals: “It was very helpful to have that follow up piece and be confident that it was going to be done in a professional and helpful way.” Their partnership thrived through their shared work on the Regional Roadmaps Project and in 2019, CHR&R convened the Appalachian Communities Addressing Opioids Learning Cohort with the assistance of the Tennessee Public Health Institute. Communities from across the Appalachian region came together to learn about each other’s responses to the urgency of the opioid crisis. Havrilla, along with other coaches from CHR&R, used the opportunity to help participants plan how to bring together networks of community members and organizations to shape solutions and facilitate learning from their collective experiences.
Building on the data-to-action community coaching Havrilla provided, Kidwell led the way for further success with the Correctional Career Pathways program, a workforce development initiative that provides education and job skills to individuals incarcerated in county jails. Due to this connection and cross-state network available through the Regional Roadmap Project, the program was able to flourish. The program was later reproduced in six additional Appalachian region counties, with the added peer-to-peer recovery piece to counteract recidivism. Kidwell shared how the program’s model was not only successful, but sustainable: “ [People formerly incarcerated] can be released from jail not only debt free, but have a savings account, buy school supplies and Christmas gifts, and put money back into the local economy.”
After five years and continued support from Havrilla and CHR&R, Kidwell has helped the Regional Roadmaps Project spread across the state, sponsoring a network of projects in 87 of Tennessee’s 95 counties, directly impacting over 7,000 people and indirectly impacting many others. Havrilla recalled how the focus on asset growth and cross-sector collaboration was key to its success. “We help communities see where they intersect so there’s that opportunity to gain momentum and build momentum…that was always at the heart of the workshops and the work,” recounted Havrilla.
Kidwell’s continued plan to expand collaborative, community health improvement projects throughout the state, like the Correctional Career Pathways program, have not been dampened by the COVID-19 pandemic, and at the beginning of 2021 she keeps her focus on the future: “Everything’s going to be different. We're going to have a paradigm shift, and we need to be prepared for it, because we’re not going to be able to go back to what we were doing before.”
Kidwell’s optimism was shared by Havrilla, who likewise expressed hope for the future of the Tennessee Institute of Public Health’s work: “I like the idea of a paradigm shift and the opportunities that creates for us, and thinking about what that means in creating communities that are infused with health and equity.”