Greetings from VA’s Eastern Shore
March 10, 2020
The beauty of VA’s Eastern Shore is matched only by the generous spirit of its residents who volunteer to remove barriers to well-being as they see them. Eastern Shore Healthy Communities (ESHC), a collective impact effort to create well-being, provides the vessel in which organizations collaborate on this shared vision: all residents will report a growing, positive sense of health, well-being, and self-empowerment.
ESHC convened ten years ago over a shared vision to reduce and prevent obesity. At the time, the health district had VA’s greatest adult rate of overweight and obesity. We convened stakeholders from a variety of sectors and organizations, including medical, mental and public health, education, social services, county and town administrators, cooperative extension, business, faith communities, and the YMCA to address the root causes of overweight and obesity.
While we have made tremendous success, the latest data replicates that dubious status. In responses, we have now changed our focus to adopt a broader lens of well-being rather than just obesity. It is a more complete and connected vision. We have added work groups on diversity, equity and inclusion; trauma; and poverty – each of which connects with obesity in unique ways.
Dr. James Felitti, Chief of Kaiser Permanente’s Department of Preventive Medicine in San Diego, one of the now-famous authors of the Adverse Childhood Experiences Study, found that for some people, obesity can be protective. He explained that for those who had experienced a trauma, especially sexual abuse, eating soothed their anxiety, fear, anger or depression. It worked like alcohol, tobacco or methamphetamines. Not eating increased their anxiety, depression, and fear to intolerable levels. While not all people with obesity have been sexually assaulted or experienced a trauma, it is important to consider those who have when communities consider how they will address obesity on the population level.
Working with town and county administrators, the Accomack-Northampton Planning District Commission, public health, and other interested private citizens, ESHC has developed walking trails and coupled that effort with a strong social media campaign to urge citizens to “Walk the Shore.” We have branded a “Healthy Options Restaurants” initiative to insure those eating out have healthy menu options. We have supported our schools in their efforts to adopt Grab and Go Breakfasts and the Community Eligibility Provision (CEP) to provide free meals for all students.
Most recently, however, we have added a Resilient and Trauma-Informed Communities Work Group and our vision is to have all community employers eventually adopt trauma-informed practices and policies.
So far, we have held trauma trainings for these sectors: the courts, social services, clergy, medical, public health, mental health and education. We provided training to all Accomack County Public School teachers, counselors, principals and central office leadership in trauma, held a community screening of the movie, “Paper Tigers.” We hold monthly telephonic meetings to provide support to and answer questions from those who have taken the training. We want to move our community from trauma aware to trauma sensitive, responsive and informed – the point at which organizations implement resilient and trauma informed policy changes with an ongoing process of continuous improvement and monitoring.
The Action Plan for a Healthy Virginia asks us to consider multiple approaches in our communities when we address obesity, among those it asks us to consider adverse childhood experiences as a possible contributor. ESHC is doing just that with an amazing group of 47 organizations and 99 individual partners. We optimistically expect great things while realistically understanding that culture change takes years. We work towards our vision as if our lives depend on it because for many of us, it does. We look forward to hearing stories from other communities across VA and welcome opportunities to exchange strategies, success and challenges.
Patti
Kiger
Eastern Virginia Medical School