What information led to the selection of this health issue and related result? 

Obesity was selected as a top health priority in the 2012 and 2015 CHAs. In the 2018 CHA, the priority was instead renamed to physical activity and nutrition. Evidence shows that physical activity and making good nutritional choices can have a positive impact on obesity and on many of the chronic diseases that obesity contributes to. What we have always talked about when working on “obesity” as a priority was physical activity and nutrition.  As depicted to the right, four of the top five leading causes of death in Henderson County have physical activity and nutrition as a risk factor. Further, various disparities are observed within each of these leading causes of death. Equitable actions to address physical activity and nutrition could have a postive impact on disease outcomes and disproportionally affected groups.

In 2021, about 21% of adults in Henderson County reported participating in no leisure-time physical activity in the past month. Just over 26% of survey respondents self-reported meeting the physical activity recommendations of greater than or equal to 150 minutes of moderate-aerobic physical activity per week. Only 4.6% of adults in Henderson County reported consuming the recommended amounts (five or more 1-cup servings) of fruits/vegetables per day. 

Overall, 17.2% of adults in Henderson County are food insecure, meaning they ran out of food in the past year and/or worried about running out of food in the past year. When disaggregated by race and ethnicity, 41.5% of Hispanic adults were classified as food insecure, as compared to 18.9% of non-Hispanic, Black adults and 14.9% of non-Hispanic, White adults.

The Henderson County Committee for Action and Nutrition is the action team responsible for addressing healthy eating and active living in our community. The organizations and individuals that make up the Henderson County Partnership for Health and the Henderson County Committee for Activity and Nutrition will address this priority collectively. These partners include:

• AdventHealth Hendersonville
• Bearwallow Valley Farms
• Blue Ridge Bicycle Club
• Blue Ridge Community Health Services
• Blue Ridge Humane Society
• Caja Solideria
• Children and Family Resource Center
• City of Hendersonville
• Conserving Carolina
• Council on Aging
• Friends of Ecusta Trail
• Friends of Oklawaha
• Henderson County Cooperative Extension
• Henderson County Department of Public Health
• Henderson County Parks & Recreation
• Henderson County Public Schools
• Henderson County Department of Social Services
• Hendersonville Farmers Market
• Hendersonville Family YMCA
• Interfaith Assistance Ministries
• MANNA
• Mills River Farmer's Market
• Pardee UNC Health Care
• Safelight
• Smart Start Partnership for Children
• Tierra Fertil Co-op
• The Free Clinics
• United Way of Henderson County
• WNC Source

Additionally, through a participatory budgeting process, community members with lived experience were invited to join CAN as Delegates. The Delegates are important partners in identifying what works to do better in Henderson County. 

Physical Activity & Nutrition and the related result, "Healthy eating and safe, active living are the norm for everyone in Henderson County", are aligned with the following Healthy NC 2030 health indicators and desired results:

• Access to Exercise Opportunities- Increase physical activity
• Limited Access to Healthy Food- Improve access to healthy food

The Committee for Activity and Nutrition (CAN) is the action team responsible for addressing physical activity and nutrition, as a Community Health Assessment prioirty, in Henderson County. The group is lead by a Coordinator (supported by the Healthy People Healthy Carolinas grant) who convenes stakeholders to identify gaps and strategies. The partners that make up CAN meet quarterly, with workgroups to address identified strategies meeting monthly.

In September 2022, CAN met to collectively identify actions that may improve opportunities for physical activity and access to healthy foods in our community. The group walked through a root cause analysis using SHOWeD to develop their understanding of the indicators, and propose strategies for changing policies, systems, and environments that impact nutrition and health. These identifed strateigies are listed in section A below.

The following actions have been identified by CAN as ideas for what can work for our community to make a difference on physical activity and nutrition.

(A) Actions and approaches identified by our partners. These are actions and approaches that we think can make a difference for physical activity and nutrition.

• Community block parties
• "Pop-up" shop with healthy foods or cooking utensils
• Promote EFNEP cooking classes and meals
• Community Resource Board 
• Culturally diverse activities related to physical activity and nutrition
• Shared funding and resources
• Family Greenway walks
• Buddy system for exercise
• Education on staying active in the home
• Shared family meals
• Community Dinners in trusted community centers

(B) What is currently working in our community. These are actions and approaches that are currently in place in our community to make a difference on physical activity and nutrition.

• Equitable community engagement
• Participatory budgeting
• Healthy food prescriptions
• Doubling SNAP at Farmers Markets
• Cooperative food purchasing
• Nutrition Education
• Cooking Demonstrations
• MANNA Mobile Markets
• Kids in Parks/Track Trails
• Implementing the Greenway Master Plan
• Support for gardening/active recess in classrooms
• Bike helmet initiative

(C) Evidence-based strategies. These are actions and approaches that have been shown to make a difference on physical activity and nutrition.

• Active recess/physically active classrooms
• Community gardens
• Complete streets and streetscape design
• EBT at Farmers Markets
• Food Buying Clubs & Co-ops
• Fruit and vegetable gleaning
• Mobile produce markets
• Nutrition prescriptions
• Safe Routes to Schools
• Bike & Pedestrian Master Plans

(D) What community members most affected say. These are the actions and approaches recommended by members of our community who are most affected by access to opportunities for physical activity and healthy foods.

• Community Dinners
• Youth Cooking Demonstrations
• BIPOC/Free Farmers Market model
• Multi-cultural events at Farmers Markets

The Committee for Activity and Nutrition (CAN) continued to meet throughout 2023 and worked on the strategies and programs.  In addition to these strategies, Henderson County had several new and continuing initiaitives that have a focus on physical activity and nutrition.  Jackson Park, an inclusive playground, was completed and open to the public in 2023. The Children and Family Resource Center continued the GLO Mobile. 

New for 2023: 

• Sesame Street in Communities - Eating Well Toolkit 
  Smart Start Partnership for Children Henderson County and Henderson County Department of Public Health partnered to distribute 75 English and 55 Spanish toolkits.  This initiative also included Emotional Toolkit and Resilience Toolkit. 
• Seed Library
  NC Cooperative Extension Henderson County and Henderson County Public Library distributed 977 seed packets.  Program will continue in 2024
• Ecusta Trail Phase 1 Completed
• Farmer's Market Passport
  For more information on Henderson County's Farmer's Markets click HERE.
• Senior Farm Market Nutrition Program @ Mills River Farmers Market
• View From Here Social Media Campaign

ViewFromHereWNC View From Here - Henderson County Social Media Campaign (Facebook & Instagram) August 7, 2023—September 29, 2023
In 2023, Henderson County joined the #ViewFromHereWNC social media campaign led by the WNC Health Communicators Collaborative. The ad campaign addresses several health priorities in Henderson County, including mental health, substance misuse, and physical activity/nutrition. Geo-targeted ads, which featured Western North Carolina residents, garnered 60,600 impressions, 1,549 ad clicks, 44,659 video plays, and 21,568 engagements in Henderson County’s first cycle. Initial online survey results showed 62% of respondents found the ads helpful and 72% sought more information on the health topics. The next campaign cycle starts in spring 2024.
Healthy Eating & Active Living:
One of Isabel’s favorite childhood memories was watching her mother cook. Do you crave fresh, delicious meals? Nourish yourself with local food at your neighborhood farmer’s market in Henderson County. #ViewFromHereWNC
Reach: 8,724
Clicks: 549
Impressions: 20,232
Video Plays: 16,167
Post Engagements: 7,423