Healthiest Cities and Counties Challenge recap: Adapting, building from within, and just getting started

HCCC Recap

September 29, 2022

In July 2020, the Aetna Foundation (an independent charitable affiliate of CVS Health), the American Public Health Association, the National Association of Counties and Healthy Places by Design collectively launched the Healthiest Cities & Counties Challenge grant initiative, which sought to reduce disparities in food and health care access in communities across the nation. While the launch of the Challenge was an exciting opportunity to innovate creative community-led solutions, it coincided with the height of the COVID-19 pandemic as communities nationwide were experiencing unprecedented rates of food insecurity and worsening health disparities. 

With the pandemic vividly demonstrating the need for greater food security and health care access, the Aetna Foundation and its partners awarded 10 cities and 10 counties with $100,000 in grant funding over a two-year period. Funded agencies, including nonprofit organizations, academic institutions and local governments, used these funds to collaboratively work across disciplines and alongside residents and local leaders to address the systemic barriers to health and wellbeing in their communities.

In addition to the Aetna Foundation’s financial investment, the Challenge Team, composed of APHA, National Association of Counties, Aetna and Healthy Places by Design, coordinated peer support and learning opportunities through skill-building workshops, interactive webinars, virtual peer exchange sessions and one-on-one coaching. Project leaders also participated in national events led by APHA, including the Policy Action Institute, Annual Meeting and National Public Health Week, sharing their work and lessons learned. 

“During National Public Health Week 2022, project leads had an opportunity to interview a community member about their insights on building resilience,” said Amy Clark, Lead Director of Community Impact and Philanthropic Partnerships at CVS Health. “This encapsulated everything that I appreciate about the project. First, the public demonstration and affirmation that solutions and wisdom are abundant in communities. Second, the creativity of our [Challenge Team] in designing event formats that had value for our participants and embodied a respectful and humble stance respective to community voice.”

After two years of project planning and implementation, the grant period has come to an official end. While all groups experienced barriers and setbacks, grantee communities proved to be persistent and adaptable during such uncertain times. They leveraged new resources, developed diverse partnerships, engaged motivated resident leaders and influenced changes in policy and systems changes in local organizations. 

Success stories include:

  • The New Brunswick, New Jersey project team, led by Elijah’s Promise, launched the “Your Food, Your Choice” internship program to improve the food served in local public schools. The program was designed for New Brunswick High School students to learn about food systems within their community and encourage student feedback on school food. Students surveyed peers and their families about school food quality and worked with the school nutrition staff and other staff to create more culturally significant menu items, increase access to drinking water and develop school gardens.
  • In Cambria County, Pennsylvania, the 1889 Foundation and its partners developed a “HUB” model to better coordinate systems of care with social service and health care providers. Organizers dedicated their efforts to training and deploying community health workers to address both access to food and health services by connecting residents to community resources. To date, they’ve successfully trained multiple 1889 Jefferson Center for Population Health staff and residents to become community health worker certified trainers, expanding their reach and the HUB infrastructure within and outside of Cambria County.
  • In Cumberland County, North Carolina, the Department of Public Health and its partners sought to advance policy, systems and environmental change to decrease inequities in neighborhoods of color and among military soldiers and dependents within Fort Bragg. They centered their project around local residents to conduct a food system assessment and develop a joint county-military Fort Bragg and Cumberland County Food Policy Council. The council has established three ad-hoc committees that focus on expanding transportation to healthy food sources, improving communication of food resources to citizens, volunteers and food providers and expanding the use of WIC/EBT to farmer’s markets and other food markets.

“It is very exciting to see that so many projects are ending on a high note, whether it be receiving new grant funding, cementing a new partnership, or achieving a policy milestone,” Clark said. 

Despite the grant’s end, the work of the Aetna Foundation-funded partnerships endures. Clark offered advice to project teams as they continue their equity work: “Stay curious about how community change happens, and don’t be overwhelmed by all the work that you don’t control,” she said. “Focus on what you can influence today, and eventually you will see that your daily decisions have moved you into a space you could have never imagined a year ago.”