Need: Monett, Missouri's high tobacco use rates, lack of access to fresh foods, limited walkability and bikeability, and aging downtown infrastructure were all affecting residents' health.
Intervention: With planning assistance from Healthy Places for Healthy People, CoxHealth Monett led a coalition to revitalize downtown infrastructure and create opportunities for healthy living.
Results: Changes have helped to improve patient health, increase exercise opportunities, enhance downtown, and engage Monett's Hispanic population.
Monett, Missouri is in an area of Barry County that is
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
In an effort to offer healthy options to residents and to
revitalize the infrastructure and the experience of
CoxHealth Monett applied for planning assistance
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:
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
Monett received the following help from EPA's Healthy
Places for Healthy People program:
Planning assistance through a 2-day community
An action plan developed in partnership with
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
HP2 Monett's Action Plan & Goals:
GOAL 1: Create opportunities for physical activity in
In March 2018, Monett passed a
Complete Streets ordinance, requiring that future
infrastructure enhancements, developments, and
repairs must contain sidewalks, bike lanes, and
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). As a result from the workgroups implementing
quality improvements, acute myocardial infarction and
congestive heart failure readmissions decreased from
2016 to 2017.
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
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.
In conjunction with the CDC
Health in All Policies initiative, a clean air
policy passed in 2019, restricting locations for
Established First on Front, a concert series in
the park that unites art and music and encourages
local entertainment options.
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.
Challenges HP2 Monett faced when implementing their
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
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
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.
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.
Please contact the models and innovations contact directly for the most complete and current information
about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The
programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
community should consider whether a particular project or approach is a good match for their community’s
needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.