Healthy Monadnock Alliance

Description

The Healthy Monadnock Alliance (HMA) is a partnership of community leaders from different public health sectors across the Greater Monadnock region of southwestern New Hampshire. The HMA serves as the regional public health network with the goal to create and foster local initiatives to achieve better health and wellness for all. Its organizational body tells the ongoing story of the health and well-being of the 130,000+ people who live, work, and play in the Monadnock region. The region includes all of Cheshire County (which, according to the latest County Health Rankings data, ranks above the national average for health and well-being factors) and the ten westernmost towns of Hillsborough County (see map).

Members are guided in the mission by the Healthy Monadnock Alliance Executive Committee, with direct input from the community and the support of Cheshire Medical Center's Center for Population Health. HMA membership spans all sectors, including local municipalities, schools, businesses, healthcare organizations, and faith and civic groups.

The members of the HMA share a belief that together they can work towards creating better health and well-being for everyone living in the Monadnock region. They believe this is accomplished through shared goals, cross-community connection, and collaboration to execute their Community Health Improvement Plan (CHIP). The work is informed by an understanding that trauma, education, income, and other factors pose challenges to an individual's ability to thrive, and that together they can address these challenges head-on. Membership in the HMA is open to any organization interested in helping advance this work.

Services offered

The HMA engages in multiple projects and public service offerings, guided by community health needs assessment data which set strategic priority areas for action. Currently the HMA engages in work in the following areas:

• Improving behavioral health outcomes through increasing mental and emotional health resources and community acceptance
• Ensuring communities are ready to face any emergency through personal and community emergency preparedness activities
• Providing resources and connections to community supports to improve food access across the region
• Providing resources and connections to community supports to encourage engagement with outdoor recreation as a means of promoting active living and healthy lifestyles
• Working to ensure easier access to healthcare for all, which includes the ability to access appropriate services and pay for those services
• Creating a healthy environment for young people to thrive through increased understanding of protective and risk factors in our communities

Some examples of community programs that support these strategies include:

• Gear Library and Outdoor Recreation Resource Maps: In partnership with the Keene Public Library, the Monadnock Outdoors workgroup has established a Gear Library that allows Cheshire County residents to check out / borrow common outdoor recreational equipment at no cost. They also provide a digital map to help community members locate and access public recreational offerings such as hiking trailheads, public parks, handicap accessible parking, etc.
• NARCAN Trainings: More than 1,000 people in the region have been trained to recognize the need for and administer NARCAN to prevent opioid overdose deaths in the region.
• CPR and Emergency Animal Shelter Trainings: Through partnerships with Cheshire Medical Center, the Greater Monadnock Disaster Animal Response Team, and the New Hampshire Disaster Animal Response team, HMA offers various workshops and trainings for community members and organizations to teach participants actions to prepare and respond to life-threatening emergencies for themselves, their families, and their pets.
• Mobile Food Pantry program: The Community Kitchen provides a mobile food pantry program which distributes locally produced fresh food to families across the region in towns where no other food pantry currently exists.
• Breast and Cervical Cancer Screenings: The New Hampshire Healthy Lives Breast and Cervical Cancer Program aims to reduce mortality rates through early detection of cancer by providing free or reduced cost screening and diagnostic services through healthcare providers in the region including Cheshire Medical Center and Monadnock Community Hospital.
• Youth Mental Health First Aid Training: Designed to teach parents, family members, caregivers, teachers, school staff, peers, neighbors, and other community members how to help an adolescent who may be experiencing a mental health crisis or addiction challenge.

Results

Work in each of the HMA's priority areas is supported by a workgroup made up of community experts, service organizations, and volunteers who come together to prioritize work and set measurable goals for community improvements through a framework of objectives and key results (OKRs). The OKRs for each workgroup are set for a two-year period and include an overarching community objective with three to five measurable key results to track progress. Current OKRs can be viewed on the HMA website.

In order to better understand the impact of their work in the community, the HMA also partners with Cheshire Medical Center to collect and analyze a wider range of regional health and wellness data related to their programs and initiatives, including a periodic Monadnock Community Health Survey.

Challenges

There were many barriers noted by the Council at the start and continuation of the Healthy Monadnock Alliance. Below are some challenges and how they have been addressed:

• There was an initial misperception among member organizations that, in order to start an initiative for the Alliance, Cheshire Medical Center Dartmouth-Hitchcock needed to lead it. At the same time, the medical center was hoping other members would start to take initiative. Through redirecting and strategies, the Healthy Monadnock Alliance has become an effort of the whole community, not solely led by the medical center.
• Because environmental change often starts with public policy, Council members have put more effort into changing policy and environmental regulations in order to carry out Health Monadnock Alliance initiatives.
• Traditionally, healthcare is often thought of as confined within the walls of a clinic or hospital. Since conversations around Healthy Monadnock Alliance started, the perception that health and well-being extends to all areas of life has become more widely accepted across businesses and individuals.
• The availability of affordable healthy food has been a challenge for the Monadnock Region. The Council has been working with the Cheshire County Conservation District to connect local producers to distributors in order to improve food access on an institutional level.

Replication

Resources and efforts that may help communities implement similar programs include:

• The Community Health Improvement Plan (CHIP) created by the Leadership Council for a Healthy Monadnock to guide the public health work in the region through the Healthy Monadnock Alliance (a five-year plan last updated in 2020)
• Cheshire Medical Center Community Health Needs Assessments and accompanying implementation plans (a three-year plan last updated in 2025), which summarize the work of Cheshire Medical Center and the Leadership Council for a Healthy Monadnock through collaborative efforts to assess regional health-related needs
• A Partnerships, Programs, Policy, System, and Environmental Change (PPPSE) model has informed Healthy Monadnock Alliance's approach to creating large-scale, sustainable change
• When creating community-wide action plans, it is crucial to recognize that not all communities require and receive support equally. This realization led the HMA to develop the Community Well-Being Impact Guide, and the "High-Impact Town" model. The purpose of this work was to enhance existing community initiatives across the region and to focus the efforts of the HMA workgroups to create the most significant community impact.

Contact Information

Topics
Access · Community engagement and volunteerism · Food security and nutrition · Health disparities · Hospitals · Networking and collaboration · Physical activity · Population health · Social determinants of health · Trauma-informed care · Wellness, health promotion, and disease prevention

States served
New Hampshire

Date added
December 31, 2019

Suggested citation: Rural Health Information Hub, 2025 . Healthy Monadnock Alliance [online]. Rural Health Information Hub. Available at: https://www.ruralhealthinfo.org/project-examples/1079 [Accessed 20 November 2025]