Connecting farm viability and community vitality

Gleaning cropped

Connecting farm viability and community vitality

Northwestern Medical Center - Vermont
Community benefit investment strategy couples farm viability and access to locally grown food with engagement campaign to promote healthy lifestyle choices and strengthen regional food system.
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  • Community benefit investments address increasing access to healthy food and supporting healthy behaviors, exemplifying making the healthy choice the easy choice.
  • Strategies combine promoting community health, local economic development, and farm viability.
    • Healthy Roots Collaborative: In 2016, Healthy Roots reached 3,100 individuals through 16 community events, assisted 28 schools with farm-to-school efforts, and collected 10,600 pounds of fresh, local produce for distribution to food pantries. The collaborative works with 150 farms and food producers.
    • RiseVT: Since its launch in 2015, Rise-VT has experienced successes including:
      • 56 businesses engaged in worksite wellness efforts.
      • 18 school participants; 15 have implemented safe routes to school.
      • 11 municipalities have instituted wellness programs and policies to support community changes.
      • 3,416 individuals have participated by signing the pledge or completing health assessments and 1,832 individuals have used the online portal, website dashboard, and health coaching.
  • Hospital name: Northwestern Medical Center
  • Hospital type: Private, nonprofit
  • Hospital size: Small (70 beds)
  • Geographic area: Urban 
  • System/Network: Independent 
  • Network coverage: Northwestern Vermont (Franklin and Grand Isle Counties)
  • White, non-Hispanic: 94% (Franklin), 93.3% (Grand Isle)
  • Hispanic: 1.6% (Franklin), 2.1% (Grand Isle)
  • Black, non-Hispanic: 0.7% (Franklin), 0.6% (Grand Isle)
  • Asian/Pacific Islander: 0.7% (Franklin), 0.5% (Grand Isle)
  • Other: 3% (Franklin), 3.5% (Grand Isle)
  • Community health needs assessment region: Franklin and Grand Isle Counties (predominantly rural area in the northwestern corner of Vermont)
  • Population: 55,810
Health indicators
  • Obesity (adult): 32% Franklin County, 27%Grand Isle County 
  • Diabetes: 12% Franklin County, 10.8% Grand Isle County

Like many hospitals across the country, Northwestern Medical Center serves a community struggling with obesity and poor health behaviors. While the hospital’s location is considered urban/metro due to its vicinity to Burlington, the area is largely rural, encompassing Franklin and Grand Isle counties in the northwest corner of Vermont.1 Food insecurity affects more than 10 percent of the population (11 percent in Grand Isle and 12 percent in Franklin), and data indicate an increasing prevalence of obesity in both counties. 

Community health needs assessment: Priorities and process

  • Food and diet-related disease priorities:
    • 2013 CHNA-Obesity 
    • 2016 CHNA -Obesity
  • Participation from food-related organizations in CHNA process: 
    • Vermont Agency of Human Services, Martha’s Kitchen (regional soup kitchen), Vermont Department of Health
  • How/why did obesity (food issues) emerge as a priority:
    • A 2012 CHNA community survey identified obesity as a “top resident concern,” and secondary data analysis found rates of morbid obesity exceeded U.S. average by five percent while healthy eating lagged U.S. average by ten percent. In 2016, an online survey of 29 local expert advisors found 72 percent supported retaining obesity as a health priority.
  • Key community indicators:
    •  32.4 percent of Franklin County population is characterized as BMI-Morbid/Obese, which exceeds national average by 5.8 percent. 
    • 27.3 percent of Grand Isle population is characterized as BMI-Morbid/Obesity 

Full Assessment: Northwestern Medical Center 2016 Community Health Needs Assessment

Assessing health needs — and how to meet them

Community health needs assessment process

Northwestern Medical Center has a long history of working with community partners to address health needs. As part of its organizational structure, the hospital has a board of 150 incorporators, local residents that “serve as a formal connection between the hospital and the community.” These individuals are responsible for electing the hospital’s board of directors and acting as ambassadors and advocates of the hospital. Prior to the federal community health needs assessment (CHNA) requirement, the hospital collaborated with Franklin Grand Isle United Way (now part of the United Way of Northwest Vermont) and Franklin-Grand Isle Community Partnership to determine how to effectively use their collective resources to address community health needs. 

Jonathan Billings, vice president of planning and community relations directs Northwestern Medical Center’s community benefit reporting and community health needs assessment process. The hospital’s lifestyle medicine department carries out the community benefit activities focused on primary and secondary prevention efforts. Lifestyle medicine staff members include physicians, nurses, dietitians, diabetes management educators, health coaches, and food system specialists. According to Billings, the CHNA process plays a valuable role in shaping both community benefit initiatives and the hospital’s overall strategic direction, and also functions as a blueprint for community groups who “take it and run with it in their own action plans.”

Adrienne harvesting sage as a part of the Healthy Roots Collaborative programming in rural Vermont (Northwestern Medical Center).
Adrienne harvesting sage as a part of the Healthy Roots Collaborative programming in rural Vermont (Northwestern Medical Center).


Investing in solutions

Implementation strategy 

Northwestern Medical Center’s leadership recognizes that access to affordable, high quality, nutritious, food is fundamental to good health. The hospital’s strategy to address obesity and diet-related health issues combines community and clinical components with long-term investments focused on increasing access to healthy, local food. 

Hospital leadership understands the role of agricultural activity plays in its community’s economic health and how a strong agricultural economy supports its work around food access and healthy eating. Community partners have echoed the importance of farm-to-table as a strategy to address community health needs that would benefit individuals and organizations across Franklin and Grand Isle counties.

The obesity-prevention strategy developed by Northwestern Medical Center connects community engagement, local food system development, and education. The hospital also plays a role in efforts to improve health through policy and systems change. Northwestern Medical Center has actively advocated for a tax on sugar-sweetened beverages as part of its obesity-prevention efforts and is active in the Vermont Blueprint for Health implementation for its region. 

Healthy Roots Collaborative in Vermont worked with ten farms and gleaned over 10,600 pounds of produce
In 2016, the Healthy Roots Collaborative in Vermont worked with ten farms and gleaned over 10,600 pounds of produce, which was distributed to 18 area food pantries and meal programs (Northwestern Medical Center).


“Making the connection between eating healthy and the long-term consequences is hard. Take, for example, a patient who has a bad surgical outcome because they’ve had high cholesterol and bad blood sugar, and they’re morbidly obese and as a result, they end up having a longer health care stay. It hard for people to see that important link— that if 15 years ago this person had a healthier diet and had been eating well for 15 years, we would never have this terrible health condition right now.”

— Jonathan Billings, Northwestern Medical Center vice president of planning and community relations
End Notes

1. Grand Isle, which is made up of the islands in Lake Champlain, is classified as 100 percent rural, while Franklin County is 71 percent rural

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