District Health Department #10 builds healthier communities in 10 Michigan counties

This article is part of Stories of Change, a series of inspirational articles of the people who deliver evidence-based programs and strategies that empower communities to eat healthy and move more. It is made possible with funding from Michigan Fitness Foundation.

Spanning 10 counties, District Health Department #10 (DHD#10) is the largest health department in Michigan by geographical service area and the 10th largest by population served. While the area encompasses regions known for farms, orchards, forests, rivers, and a variety of recreational assets, residents still experience food insecurity and difficulty accessing places to be physically active.

Working to address these issues by helping children, families, and older adults build their health, DHD#10 uses a variety of evidence-based programs and approaches to create a broader culture of health through their policies, systems, and environmental change (PSE) work. And they are seeing encouraging results.
Signage promoting physical activity in Manistee County is the result of DHD#10's SNAP-Ed work.
"As public health professionals, we can engage in meaningful ways across our communities and actually see our PSE projects from start to finish, from assessment to planning to implementation to follow-up evaluation. It really gives us a good circular view of what public health is here," says Katie Miller, DHD#10 community health supervisor. "We are seeing the visibility of our work, seeing it start to come to life."

Their work is made possible in part through Michigan Fitness Foundation (MFF) Supplemental Nutrition Assistance Program Education (SNAP-Ed) funding. MFF is a State Implementing Agency of the Michigan Department of Health and Human Services for the education component of the Supplemental Nutrition Assistance Program. SNAP-Ed is an education program of the U.S. Department of Agriculture that teaches people eligible for SNAP how to live healthier lives. MFF offers grants to conduct SNAP-Ed programming throughout the state of Michigan.

"Our SNAP-Ed PSE work allows us to engage and work within the pockets of our community that are not otherwise touched," Miller says. "For example, in Mason County's fourth ward, there isn't a lot of infrastructure. A lot of community members are passionate to make their neighborhoods walkable, safer, and healthier places to live."

To address these types of issues, as part of their SNAP-Ed work, DHD#10 used the Promoting Active Communities (PAC) online assessment, engaging residents in examining the physical activity infrastructure needs in the community. Residents took stock of their neighborhoods, and shared their concerns about uneven sidewalks, crosswalks that needed better markings, and the need for improvements that would better facilitate walking and biking. From this input, partnerships were created with area stakeholders to help DHD#10 push their work forward. One of the first actions was to install temporary walking loops with new wayfinding signs in the Baldwin community. The goal of that signage was to define safe places to walk and nudge residents to get outside and move more.

By something seemingly as simple as installing signs, they filled a gap and had impact because they promoted physical activity that was accessible and close to home for residents who otherwise would have had difficulty being active.

They also learned through their PAC work that each community has different needs.

In Mason County, a group of DHD#10’s partners took part in the PAC assessment while others completed the on-the-ground walking audits. Their partners represented city government, health coalitions, community members, and local public health professionals. Because of the positive experience using the PAC in 2021, their partners are ready and willing to jump on board to continue their collective work in 2022.

"We found it was about strengthening our relationships across Mason County. We had some great partners step up to be champions for our projects," says Kaitlyn Haner, DHD#10 public health educator. "We're being mindful to look beyond our day-to-day work to see where partnerships and alliances could naturally fall with our PSE work."

Using the PAC to examine the policies, programs, and built environment in Mecosta County to help create more vibrant places, they were able to identify and address concerns that surfaced across the community.

“In Mecosta, pedestrian safety issues were revealed,” says Miller. “We've been approved to have the crosswalks re-painted this year based on information provided by the PAC Neighborhood assessment.”

In Manistee County, DHD#10 Public Health Educator Holly Joseph likes to lead by example as well as by profession. In the food space, she works as an MFF Farmers Market Food Navigator at the Big Rapids Farmers Market and Manistee Farmers Market to help shoppers using food assistance benefits understand how the farmers market works, and how to plan and cook healthy, affordable meals using fresh, locally grown fruits and vegetables.

Holly Joseph.
“I enjoy sharing my passion for locally grown vegetables, how good they are for you and all the wonderful ways they can be prepared,” Joseph says. “I have learned that if you show people genuine love of eating healthy and share your own journey and challenges, people are more likely to open up about their challenges to healthy eating and work towards trying small changes.”

In addition to her food-focused public health work, Joseph also works on physical activity initiatives with the DHD#10 SNAP-Ed team. Using the PAC, they helped facilitate new signage in Manistee County’s Sands Park.
Signage promoting physical activity in Manistee County.
“Our PAC walking audits acted as an underpinning for discussions that led to the LiveWell Manistee Coalition developing plans for vibrant signage to encourage physical activity,” Joseph explains. "The community had a seat at the table to say what kind of signage they wanted to see at the park. It's a huge space for people to play, with a lot of people from the community using it in a lot of different ways. The goal is to help direct everyone to the amenities available in the park.”

This work exemplifies how using the PAC can act as a catalyst for communities to identify needs, find solutions, and empower residents to effect positive change in their community. The improvements at the park were completed in fall of 2021. To evaluate the impact of the signage, DHD#10 is compiling data from community feedback gathered via QR codes placed on the new signage.

“I can say that there have been positive comments, thus far, about people enjoying the park,” Joseph says. “I walk in the park often, and the signage really helps brighten up the space too.”

Joseph has advice for other agencies seeking to make their communities healthier places to live.

"Make sure that what you do extends past your work time," Joseph says. "Be active in your community. Get outside, go to your farmers market."

Farmers Market Food Navigators offer information on how to use fresh vegetables.
Miller adds that it's important to "seek out partnerships and opportunities for collaborations."

"There are always going to be other efforts that are similar to or align with yours in regard to PSE work, health, and things like that," she says. "It’s important to have partners and allies, then build on those relationships, set goals, and work together to serve the greater good."
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