By Liora Engel-Smith

School children carrying backpacks walk in line on a highway. There is a house and an empty field in the background ahead of them.
Willis Hare Elementary school student participate in a walk to school celebration in Pendleton. Source: NC State University.

For many years, Clark Memorial Park in Tarboro had been crumbling. The community of roughly 10,000 boasts one of the oldest town commons in the country, yet the recreation area just blocks away from the county manager’s office was far from charming.

Floods from two hurricanes — Floyd in 1999 and Matthew in 2016 — damaged the equipment at the recreation area on the east side of town, and general decay during years of economic hardship in Edgecombe County didn’t help.

Money for the park’s rehabilitation in 2017 came from an unlikely source. A Centers for Disease Control and Prevention grant funded a partnership between North Carolina State University, N.C. State Extension and the community made a $12,000-facelift to the park possible. The Tarboro Department of Parks and Recreation contributed roughly $4,500 in materials and personnel, installing the new playground equipment, swing set, signage and more.

The program, dubbed Health Matters, worked on dozens of similar initiatives across four North Carolina counties, creating environments that promote physical activity, healthy eating and recreation, with the goal of eventually decreasing obesity rates, said co-leader Annie Hardison-Moody, assistant professor and extension specialist at the N.C. State’s Department of Agricultural and Human Sciences.

Three other counties where obesity rates top 40 percent, also participated: Lee, Halifax and Northampton.

The 79 projects the grant funded ran the gamut from creating a utensil and small appliance lending library to promote home cooking and healthy eating to installing bike racks in a community.

Though the grant expired last December, Hardison Moody said, the work — in these counties and beyond — is far from over.

Stringing pearls

Edgecombe County Manager Eric Evans has come to call the Health Matters projects — like the park renovation in Tarboro — pearls. And real change, he added, comes from stringing them together.

“We’ve got a high rate of chronic disease, high obesity rates, all the things you expect in a county in Eastern North Carolina,” he said. “So to have these opportunities (for physical activity) and to see people make use of it is very exciting. … It’s not something that would turn the page for the county overnight, but it’s pointing us in a better direction.”

Evans isn’t far off. Over the past two decades or so, the public health community has established that the causes of obesity are multifaceted and involve, among other things, cues from the environment. So when a nearby park isn’t safe, accessible or inviting to play on, the research says, children and their parents are likely to avoid it. And if no other recreation options are available in an area, families may become more sedentary, putting them at risk for obesity and associated conditions, such as Type 2 diabetes and heart disease.

An African-American Woman and an white man pose near a sign that says "Clark Memorial Park" behind them is a newly renovated playground and trees. The renocation is part of their obesity prevention plan.
Yvonne Murphy of Edgecombe County Extension and Travis Stigge, the Tarboro Parks and Recreation director pose in front of the newly renovated Clark Memorial Park in east Tarboro. The park renovation was one of 79 projects in four N.C. Counties funded by a CDC grant designed to create healthy environments that promote obesity prevention. Source: courtesy of Annie Hardison-Moody

The opposite is also true, researchers discovered: the right environmental cues — lush, inviting parks, walking tracks and well-maintained sidewalks — can be a powerful ally in mitigating obesity.

Health Matters created or laid the groundwork for many such changes in Edgecombe County, Evans said. It also fostered opportunities for counties to learn from one another. For example, Evans learned of a Halifax County program that gives out small grants to promote recreation and physical activity. Over the last couple of years, Evans said, his county followed suit, creating a similar initiative. Thus far, Edgecombe supported a wide array of activities through grants of up to $2,000 from teaching children to play tennis to creating a music therapy program for seniors.

And Evans wants to expand the government’s role in creating an environment of wellness in Edgecombe. He wants to establish a county parks and recreation department that would coordinate future initiatives. The effort is likely to take time, he said, but he hopes for a department that will be up and running in the next three years.

“That recreation mini-grant is just another one of those pearls,” he added. “It’s small, but we’re stringing together collectively these things and it’s shaping up to be a more organized recreation effort from the county.”

Walking the walk

Health Matters didn’t just put new resources in place, N.C. State’s Hardison-Moody said. It also helped communities identify and make better use of facilities they already had by removing obstacles to access when needed.

“Especially rural counties that don’t have the financial resources that more urban counties have, they do have these incredible assets whether it’s through schools or faith communities or other assets that are local to their communities and by thinking about what they have, they were able to be very creative (with solutions),” Hardison-Moody said.

A man in a bright yellow vest stands on the edge of a highway, inspecting a hole on the ground as cars drive in the background
Seaboard Commissioner George Jerman, Sr., inspects a hole at the edge of Highway 186 during a walk audit to a local park last summer. Courtesy: NC State University.

Sometimes, those barriers can be trash cans, said Extension associate Lauren Morris, who works in Northampton and Halifax County.

Last summer, Morris led a walk to a newly installed local park in Seaboard along with lawmakers, county commissioners, the mayor and community members. It was during that walk they noticed trash cans left out for collectors in the middle of the sidewalk made it difficult to access a street en route to the park.

“(We) found that all the trash cans were right on the sidewalk after it was picked up,” she said. “ … So we had to move all of them (to walk there during trash day).”

One solution the group explored was to ask the contractors who pick the trash to place the empty cans away from the sidewalk, Morris added.

Morris has since taught others to take stock of walkability on their own. Staff has been exploring an option to write a manual that would train other extension agents to audit their own communities in a similar way.

Increasingly, extension staff are looking for ways to share what they’ve learned with others, Hardison-Moody said. These skills may be valuable to many counties in the state, as North Carolina’s adult obesity rates more than doubled in recent decades, surging from 12.3 percent in 1990 to 32.1 percent in 2017.

“There’s so many opportunities that it’s almost like an endless list of things that could be done,” Morris said. “I never thought that being a Health Matters associate that I would be trying to help a community to put a playground. It never even crossed my mind.”

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Liora Engel-Smith joined NC Health News in July 2019 and covers policies, programs and issues that affect rural areas. She has previously worked for the The Keene Sentinel in New Hampshire and the Muscatine...