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Note: This article is cross-posted on APHA’s Healthiest Cities and Counties Challenge Communities4Health blog and Healthy Places by Design’s blog.

One year ago, the Aetna Foundation, the American Public Health Association (APHA), the National Association of Counties (NACO), and Healthy Places by Design (HPBD) collectively launched the Healthiest Cities & Counties Challenge (HCCC) grant initiative. Today, 20 cities and counties across the nation are midway into their inspiring initiatives — improving access to food and health services — by changing systems and policies through diverse partnerships and the engagement of motivated resident leaders.

To date, HCCC’s 20 project teams have had a range of opportunities to learn through interactive webinars, skill-building workshops, virtual peer exchange sessions, and one-on-one coaching. The Challenge team, composed of APHA, NACo, Aetna, and HPbD, has coordinated this support.

Throughout the past year, the HCCC peer network has centered learning opportunities on themes that are important to improving equitable access to food and health services: community engagement, health and racial equity, food policy, and other essential topics. As a result of the network, HCCC project leaders have begun to prioritize and self-organize around common strategies, including youth leadership and enhancing nutrition security with charitable food agencies. In addition, food policy council coordinators in some Challenge communities are starting to organize (with support from the planning team) and are bringing new organizations with food policy council expertise into their conversations.

The peer learning network has also paved the way for Challenge grantees to adopt frameworks and best practices from the Challenge team itself. For example, after the Challenge team hosted a workshop on developing 15% solutions, the Wheeling, West Virginia project team incorporated the framework into their steering committee meetings, enhancing decision-making roles among partners and residents to reduce the burden of health challenges in their community.

While achieving lasting public health and equity outcomes is a big task, HCCC project teams have achieved plenty in their communities so far. Collaboration with old and new partners — and with community members — during an unprecedented time in our nation has prompted a number of local changes. Among them:

• In Perry County, Kentucky focus groups and interviews with community members highlighted critical food access needs and surfaced themes related to generational poverty and social stigma that keeps many from using food pantries. The Perry County team is using this information in a social media campaign to inform the community about food availability and preparation ideas.
• HCCC leaders in Greenbrier County, West Virginia are engaging their community through an Ambassador mini-grant program, which will enlist resident leaders to address social determinants and health inequities. These ambassadors will now also have the option to help lead chronic pain management workshops for residents within the community.
• To expand equitable access to dental services, the Kerrville, Texas team helped a community clinic shift resources. Kerrville project collaborators also formalized a partnership with the San Antonio Food Bank to start a new food pantry and, as a result, the team encouraged the food bank to also enact a policy change allowing for at-home food deliveries.
• In Rochester, New York, the city council recently adopted a request from HCCC organizers to formalize the city’s first Food Policy Council. The HCCC initiative enabled health advocates and community partners to focus purposely on creating the council, which the city had de-prioritized.
• Since the start of their Challenge project, the Cambria County team has expanded the population their community health workers are serving to include pregnant women and their families as well as at-risk students.

Ultimately, food and health systems must change from within each community to improve equity. Their success will depend on the quality of relationships among community organizations and other collaborators; an understanding of residents’ priorities, levels of trust, and power dynamics; and a willingness to confront the longstanding inequities that lead to poor health. Health and social inequities will take years to overcome, and we hope that the HCCC initiative will initiate and accelerate community change in important ways.

Learn more about all of the HCCC communities here and updates of their work through the Communities4Health Blog.