Description

Monett, Missouri is in an area of Barry County that is considered a food desert, meaning residents have limited access to fresh food on a regular basis. The county's access to exercise opportunities is lower than the state average, while obesity rates are higher. Deteriorating downtown infrastructure left little opportunity for walking, biking, and hosting community events.

In an effort to offer healthy options to residents and to revitalize the infrastructure and the experience of downtown Monett, CoxHealth Monett applied for planning assistance through the Healthy Places for Healthy People (HP2) program. Located just 5 blocks from downtown Monett, the Critical Access Hospital (CAH), also wanted to create attractive opportunities for the town's workforce, half of whom are commuters from outside areas.

In 2017, CoxHealth Monett received planning assistance services from HP2, which is operated by the United States Environmental Protection Agency (EPA) in partnership with Appalachian Regional Commission and other federal agencies. Monett is one of 16 communities selected for HP2 assistance. HP2 supports efforts led by healthcare facilities to address social determinants of health, protect the environment, and spur economic growth and downtown revitalization.

CoxHealth Monett created a coalition to manage HP2 efforts that includes the following partners:

• City of Monett
• Monett R-1 School District
• Drury University
• Monett Main Street
• Missouri Foundation for Health
• Barry County Health Department
• Monett YMCA
• Clark Community Mental Health Center
• Tyson Foods
• Jack Henry & Associates

HP2 Monett is an extension of the 5-year Healthy Schools, Healthy Communities project that improves the town's sidewalks, bike paths, and parks. It started community gardens, cooking classes, and health-related events to reach the town's Hispanic population.

Services offered

Monett received the following help from EPA's Healthy Places for Healthy People program:

• Planning assistance through a 2-day community workshop
• An action plan developed in partnership with community stakeholders
• Planning assistance
• Surveys to evaluate the effectiveness of EPA's engagement immediately following the workshop
• Community tours for vision-casting
• Continued assistance via meetings and conference calls

Results

HP2 Monett's Action Plan & Goals:

• GOAL 1: Create opportunities for physical activity in everyday life.

  • In March 2018, Monett passed a Complete Streets ordinance, requiring that future infrastructure enhancements, developments, and repairs must contain sidewalks, bike lanes, and accommodate pedestrians.
  • Installed "Walk your City" signs that include the amount of time it takes and the distance to walk to key destinations (grocery store, park, school, et cetera).
    • Acute myocardial infarction and congestive heart failure readmissions decreased from 2016 to 2017, a direct result from the workgroups implementing quality improvements.

• GOAL 2: Lay the groundwork for a green and beautiful downtown Monett and surrounding neighborhoods.

  • Monett Main Street is utilizing the HP2 plan as the guide for 2018-2019 for all beautification processes.

• GOAL 3: Create programming in downtown spaces that incorporate and encourage health and wellness.

  • Completion of the Monett Community Pavilion, which houses the Monett Area Farmers Market, "First Friday Downtown Events," and "Monett on the Move."
  • The Monett Area Farmer's Market is held every Saturday morning and is continuing to grow in numbers of both patrons and vendors.

• GOAL 4: Broaden community engagement.

  • Creation of the non-profit coalition Southwest Missouri Initiative to Change Health (MO SWITCH).
    • Created to focus on continuing community engagement and population health efforts within the service area.

• GOAL 5: Provide housing & downtown amenities to attract more workers to live in Monett.

As part of the HP2 initiative, CoxHealth Monett, in partnership with Clark Community Mental Health Center, applied for the Community Foundation of the Ozarks Rural Health Initiative grant. Funds will be used to assist in mental health efforts for patients admitted to their emergency department due to a substance use disorder or mental health related issues.

The City of Monett, in conjunction with the HP2 steering committee and CoxHealth Monett, received a grant from the Missouri Department of Transportation to conduct a transportation and highway revitalization study. With the funds, the committee will also create bike lanes and improve sidewalks for pedestrian safety.

MO SWITCH is collaborating with the University of Missouri to conduct a food insecurity study for the county. This will provide insight into the resources that are necessary. The coalition also aims to create a food hub partnership, engaging county food pantries.

Barriers

Challenges HP2 Monett faced when implementing their project included:

• Initial buy-in – The large scope of HP2 was initially overwhelming to the community. The most common questions asked were, "What is this going to cost?" and "What will you expect me to do?" Communicating the scope and potential outcome of the project was a hard sell. Encouraging influential partners to attend and provide input was crucial to ensure the report was reflective of the community's future aspirations.
• Initial goals – It became clear that the initial goals for HP2 Monett benefited bigger businesses in town but didn't prioritize the town's immigrant population, 18% of whom were uninsured. In response, the HP2 steering committee adjusted their goals to provide healthcare and educational services to the Hispanic population. Developing a timeline and requirements with small goals for each project was beneficial.
• Publicity – In order to engage all audiences around HP2 Monett, the message and communication methods had to be considered. Taking time to craft the goals, reasons behind them, and timeline was important for community receptivity. Engaging with partners like the school district, health department, city leaders, and universities helped to distribute the information to households on a mass scale.

Replication

The focus of HP2 Monett was to coordinate population health and economic efforts in order to maintain sustainability. Through HP2, CoxHealth Monett was able to partner with stakeholders to promote healthy, environmental, and economic goals. Creating a fruitful partnership between healthcare, government, businesses, and the school system helped multiply the message, momentum, and funding.

Contact Information

Shawn Hayden, MS, Project Coordinator II
CoxHealth Population Health Department
Healthy Places for Healthy People
417.236.2593
Shawn.Hayden@coxhealth.com