Whitley County Health Department
Community Health Assessment &
Improvement Plan
June 28, 2014
Whitley County Community Health Improvement Plan - MAPP
Page 1
Table of Contents
Community Partners……………………………………………………… 3
Introduction …………………………………………………………………. 4
Essential Public Health Services…………………………………………….. 5
Mobilizing for Action through Planning and Partnerships (MAPP)….. ……..5
Community Health Assessment:
Community Health Status Assessment……………………………………… 7
Community Themes and Strengths………………….………………………15
Forces of Change ………………………………………………………….. 17
Local Public Health Assessment…………………………………………… 18
Strategic Planning Priorities………………………………………………... 24
Community Health Improvement Plan:
Strategies…………………………………………………………………… 28
Whitley County Community Health Improvement Plan - MAPP
Page 2
Whitley County Community Partners
Whitley County Healthy Community Coalition
Haley Bargo
Keith Barnett
Sherry Blaylock
Melissa Bond
Teresa Bunch
Jennifer Canada
Margie Centers
Stephanie Davis
Marian Collette
Sherry Paul Cooper
Kathleen Croley
Mattie Daniels
Beverly Faulkner
Jamie Freeman
Debbie Hardin
Debbie Harp
Peggy Henderson
Willard McBurney
Elizabeth Neal
Tamara Phelps
Rich Prewitt
Sharon King
Donna Lang
Katharine Lay
Jayma Moore
Jamie Moses
Cheryl Owens
Judy Petrey
Leigh Powell
Lee Richardson
Kristen Smith
George Paul Rains
John Taylor
Shannon Thacker
Gail Timperio
Patricia Turner
Cecelia White
Baptist Health
Whitley County Adult Education
Women’s Health Associates
Whitley County Extension Office
Whitley County Health Department
Whitley County Health Department HANDS
Whitley County High School YRC
Corbin United Effort
Independence Place of the Cumberland
Whitley North Family Resource Center
HANDS Program
Whitley County Extension Office
Corbin Senior Citizens
Whitley County Home Health
Baptist Health, Corbin Kentucky
University of the Cumberland
Healthy Start and HANDS Supervisor
Mayor of Corbin Kentucky
HANDS Program Supervisor
Whitley County Health Department
Cumberland Valley Rural Electric
HANDS
UNITE
Whitley County Health Department
Firestone Industrial Products
Healthy Start
Whitley County Extension Office
Whitley County Middle School YRC
Cumberland Valley Area Development District
Baptist Health
Whitley County Extension Office
Whitley County Board of Health
Corbin United Effort
Cumberland River Clinic (Daysprings)
Whitley County Health Department Director
Independence Place of the Cumberland
Cumberland River Rape Crisis Center
Whitley County Community Health Improvement Plan - MAPP
Page 3
Introduction
Our local public health system faces challenges because of rising health care costs, managed
care, and shrinking funding and resources. The Whitley County Healthy Community Coalition
has become more devoted than ever to identify and address health issues in our community. We
are proud to present our MAPP & Community Health Improvement Plan (CHIP), a combined
effort from committed community partners (Whitley County Healthy Community Coalition), and
the Whitley County Health Department.
With continued collaboration with our community partners we are working diligently on goals
and objectives from this Community Health Assessment and Community Health Improvement
Plan. This will be our first step to mobilize community partnerships to improve the health status
of people in Whitley County. The action taken on these plans will result in a local public health
system working together to deliver the 10 Essential Public Health Services. The 10 Essential
Public Health Services are: 1. Monitor Health Status, 2. Diagnose and Investigate Health
Problems, 3. Inform, Educate, and Empower People about Health Issues, 4. Mobilize
Community Partnerships to Identify and Solve Health Problems, 5. Develop Policies and Plans
that Support Health Efforts, 6. Enforce Laws and Regulations that Protect Health, 7. Link People
to Health Services and Assure the Provision of Healthcare, 8. Assure a Competent Public Health
and Personal Healthcare Workforce, 9. Evaluate Health Services,10. Research for Innovative
Solutions to Health Problems.
The Community Health Assessment and Community Health Improvement Plan would not be
possible without the hard work and dedication of our 37 community partners that participated in
visioning and planning sessions to develop the framework of the Community Health Assessment
and Community Health Improvement Plan. In addition, total of 1500 citizens of Whitley County
participated in surveys for the Community Health Assessment.
If you have any questions about our Community Health Assessment or Community Health
Improvement Plan visit us at www.whitleycountyhealthdepartment.com , also look for updates
on how we are changing our community for a healthier Whitley County Kentucky.
Whitley County Community Health Improvement Plan - MAPP
Page 4
STRATEGIC PLAN FOR COMMUNITY HEALTH IMPROVEMENT
The Whitley County Healthy Community (MAPP) Coalition was formed on October 6, 2010.
The coalition used the community health improvement planning model known as Mobilizing for
Action through Planning and Partnership (MAPP). This model was developed by the National
Association of County and City Health Officials in cooperation with the Centers for Disease
Control and Prevention. The Whitley County Healthy Community Coalition used the framework
to assess the strengths and needs of Whitley County and then formulated a plan to address
identified needs.
The figure below shows how the data is collected during the MAPP assessments. This model
provided the necessary information for the entire process of creating a plan. The four
assessments were: Community Themes and Strengths Assessment, Local Public Health System
Assessment, Community Health Status Assessment, and Forces of Change Assessment. The
Whitley County Healthy Community Coalition analyzed the assessment data, identified priority
health issues and created this plan specifying program, policy, systems and environmental
change strategies to improve the health of Whitley County.
Mobilizing for Action through Planning and Partnerships (MAPP)
Whitley County Community Health Improvement Plan - MAPP
Page 5
Mission and Vision
In the beginning of our coalition development a meeting was called with
community members on October 6, 2010. The Whitley County Community
Coalition discussed and brainstormed what would be included in our mission and
vision and statement. This mission and vision included creating a healthier
Whitley County Kentucky that included a comprehensive smoke-free policy
prohibiting smoking in public, and all workplaces that protect non-smokers from
the harms of secondhand smoke. The benefit would be that smoking rates will
start to decline and fewer adolescents and young adults will start or use tobacco.
Our vision includes healthier foods served in all of our schools and increased
physical activity for all students throughout our county with at least 30 minutes
every day dedicated to engaging students in real physical fitness activities. It also
includes a community where individuals can walk, run, bicycle and engage in
physical fitness activities. It includes having a community with good access to
nutritious foods such as fruits and vegetables. Whitley County Healthy
Community Coalition’s primary focus is to create policy and environmental
changes that will improve the health of places where we live, work, learn, and
play. We hope to build lasting partnerships in the community to address obesity
and other chronic diseases through a variety of nutrition, physical activity and
smoke-free strategies that will improve the quality of life for all Whitley
Countians.
Whitley County Community Health Improvement Plan - MAPP
Page 6
COMMUNITY ASSESSMENTS
Four assessments were completed prior to the strategic planning phase. The four assessments
included: Community Health Status Assessment, Community Themes and Strengths Assessment,
Local Public Health System Assessment, and the Forces of Change Assessment. A total of 10
meetings were held to develop these four assessments and analyze information.
Community Health Status Assessment:
Demographics (2010-2013)
Population
Persons under 18 years old
Persons 65 years and older
White persons
Black persons
American Indian and Alaska
Native persons
Asian persons
Persons reporting 2 or more
races
Persons of Hispanic or
Latino origin
Table 1:
Whitley County
35,766
23.8%
14.4% (2012)
97.3% (2012)
0.8% (2012)
0.3% (2012)
Kentucky
4,395,295
23.2%
14.0%
88.6%
8.1%
0.3%
0.4% (2012)
1.2% (2012)
1.3%
1.6%
1.0% (2012)
3.2%
U.S. Census Bureau, 2010-2013
Demographics
The Whitley County community covers 437.83 square miles containing two cities of
Williamsburg and Corbin Kentucky. Whitley County has the population of 35,766 with 8l.4
persons within each square mile, and borders the state line of Tennessee. Whitley County is the
home for University of the Cumberlands, which brings new students to our community of
different race and ethnic groups. The community’s diversity (see table 1 above) includes African
American, Asian, American Indian and Alaska native persons, and has a predominately White
population. 23.8% of residents are under the age of 18 and 14.4% of residents are 65 years of
age or older (U.S. Census Bureau, 2012). The two area hospitals are Baptist Health located in
the north end of the county (Corbin), and Jellico Community Hospital located over the Kentucky
and Tennessee state line. Both hospitals provide medical services to our community.
Socioeconomic Characteristics
Whitley County has 37% of children living below poverty level compared to the 27% in
Kentucky. The median household income (2011) was $29,876, lower than the state at $42,610
and significantly lower than the national median of $50,502 (U.S. Census Bureau, 2012). Socio
Whitley County Community Health Improvement Plan - MAPP
Page 7
economic characteristics, such as, unemployment rates, insurance coverage and education level
have been a very important determinate for health status in a community.
The United States Department of Labor (2011) data revealed unemployment rates of 10.8% for
Whitley County, 9.5% for Kentucky. The most recent health insurance estimates showed an
uninsured rate of 18% for Whitley County equal to 18% for state of Kentucky. The graduation
rate of 81% for all Whitley county high schools was higher than the state of Kentucky percentage
of 78%. On the flip side of these statistics Whitley County residents with some college showed a
lower rate of 42% compared to Kentucky average of 56% (2013 County Health Rankings &
Roadmaps).
Social and Behavior Indicators: Adults 2011
Indicator
Obesity +
Lack of Physical Activity
+
Prevalence of
Overweight (percent of
adults)
Whitley
Kentucky
37%
27%
39%
31%
66%
64%
Data Source
BRFSS Kentucky Health
Rankings 2013
BRFSS Kentucky Health
Rankings 2013
BRFSS Kentucky Health
Rankings 2013
Maternal & Child Health
Indicator
Teen Birth Rate (ages 1519 per 1000) (1)
Adequate Prenatal Care
(2)
Number of reported
Child Abuse Cases
(2010) (3)
Low Birth weight (4)
Births to mothers who
smoked during
pregnancy (5)
Early Childhood Obesity
(age 2-4) (5)
Data Source:
1.
2.
3.
4.
5.
Whitley
Kentucky
U.S.
61
50
21
81%
85%
75%
348
33,353
-
9.8%
36%
9.0%
24%
8.2%
-
24.2%
15.6%
12.1%
2005-2011 National Center for Health Statistics
1999-2003 Kentucky Health Profiles
2011 KIDS Count Data
2004-2010 National Center for Health Statistics
2010 Kentucky Youth Advocates
Whitley County Community Health Improvement Plan - MAPP
Page 8
Indicators
Primary Care Physicians (per 1000)
Whitley
1.3
Kentucky
1.0
US
_
Immunization Coverage
(ages 19-35 months)
% of Uninsured Adults
(under 65 years)
% of Uninsured Children (under 19
years)
Poor mental health days
(average/month?
76%
80%
81%
18%
18%
11%
7%
7%
-
5.7
4.3
2.3
Data Source
2008-2010 Kentucky Board of Medical
Licensure
1999-2003 Kentucky Health ProfilesKentucky Institute of Medicine
2010 Small Area Health Insurance
Estimates
2010 Small Area Health Insurance
Estimates
2005-2011 BRFSS
Cancers
Indicators
Cancer deaths (per 100,000)
Lung and Bronchus Cancer
deaths (rate per 100,000)
Colorectal Cancer Deaths (rate
per 100,000)
Prostate Cancer Deaths (rate
per 100,000)
Breast Cancer Deaths (rate per
100,000)
Whitley
244.33
102.73
Kentucky
222.85
79.00
US
--
Data Source
2006-2010 Kentucky Cancer Registry
2006-2010 Kentucky Cancer Registry
21.66
20.37
--
2006-2010 Kentucky Cancer Registry
19.43
18.45
--
2006-2010 Kentucky Cancer Registry
11.11
13.95
--
2006-2010 Kentucky Cancer Registry
Heart Disease
Per 100,000 population
Heart Disease Deaths
Whitley
287.2
Kentucky
224.0
Stroke Deaths
37.6
47.0
Data Source
Kentucky State Data Center-Vital
Statistics
Kentucky State Data Center-Vital
Statistics
Prevalence of Asthma (percent adults)
Per 100,000 population
County data
Whitley
15%
Kentucky
13%
Data Source
BRFSS
Prevalence of Hypertension (percent adults)
Percent of adults who report they have told
the health care professional they have
hypertension or high blood pressure
Whitley
Whitley County Community Health Improvement Plan - MAPP
Data Source
Page 9
County
34.9%
BRFSS
Cancer
Cancer Deaths (age –adjusted rate per
100,000 population)
All cancers
Lung and Bronchus
Colorectal
Breast
Prostrate
Whitley
Kentucky
203
90
19
19
212
75
20
23
25
Data
Source
BRFSS
“
“
“
“
Diabetes
Diabetes per 100,000 population
Whitley
Kentucky
Percentage of population with Diabetes
14%
12%
Diabetes screenings (Medicare
enrollees that receive screening)
83%
84%
Data Source
2010 Dartmouth Atlas of
Health Care
2009 National Center for
Chronic Disease Prevention
and Health Promotion
Stroke
Stroke Deaths (per 100,000 population)
Age adjusted rate of deaths (due to stroke)
per year
Whitley
37.6
Kentucky
47.0
Data Source
Kentucky State Data
Center – Vital Statistics
Tobacco Use
Adults
Prevalence of Youth Smoking
Whitley
31%
25%
Kentucky
26%
25%
Whitley County Community Health Improvement Plan - MAPP
Kentucky Health Rankings
Youth Tobacco Survey and Youth
Risk Behavior Survey
Page 10
Social and Mental Health
Social and mental health factors can influence directly or indirectly the overall health status of an
individual and the community quality of life. Mental health can be affected by substance abuse
and violence factors. Looking at mental health; Kentucky Health Facts uses the BRFSS source
to show data that residents of Whitley County reported having an average of 8 mentally
unhealthy days per month compared to the average for Kentucky, of 4.0. The BRFSS data
revealed social and mental health indicators, which included depression, stress, and problems
with emotions within an individual’s daily life. The Kentucky BRFSS 2005-2011 also reported
that the percentage of adults who report fair or poor health for Whitley County was 28%
compared to Kentucky’s percentage of 22%.
The safety of a child to grow and develop into adults is also an important determinate of mental
and physical health. According to Kentucky Kids Count county data the number of child victims
with substantiated abuse in 2012 was 174.
County Health Rankings 2014
The health of a community depends on many different factors, including environment, access to
quality of health care, high school graduation rates, unemployment, physical inactivity, smoking,
access to healthy foods, and much more. The University of Wisconsin Population Health
Institute study was funded by Robert Woods Foundation. It ranks all 120 counties of Kentucky
with 1 being the healthiest to 120 being the unhealthiest. Whitley County ranks 94 in health
outcomes or “today’s health” or the length of life which tells if people are dying too early; and
quality of life which tells how well people feel while living. Health factors are “tomorrow’s
health” which measures health behaviors, clinical care, socio-economic and physical
environment. Health factor measures behaviors such as tobacco use, diet and exercise, alcohol
use, and sexual activity. Whitley County ranks 75 out of 120 counties. The county rankings are a
snapshot of our community that shows where we live matters to our health.
Health Outcomes Rank
County
Whitley
Rank
94
Health Factors Rank
County
Whitley
Rank
75
Whitley County Community Health Improvement Plan - MAPP
Page 11
Source: Kentucky County Health Rankings 2014
Community Health Assessment
A total of 1506 surveys were completed by the citizens of Whitley County either online by
Survey Monkey or through paper survey. The survey asked questions regarding health and
safety issues within the community. The questions asked and the results of the survey are
reflected in the following table:
Question
Answers
(Top 3 if applicable)
Percent of
Respondents
1. In the list below, what do you think are the 3
most important areas we need to improve upon?
Good Jobs
Low crime/safe neighborhoods
Healthy behaviors and Lifestyles
52.8%
33.1%
32/3%
2. In the list below, what do you think are the 3
biggest health problems in our community?
Cancer
Diabetes
No Health Insurance
Drug Abuse
Meth Labs
Alcohol Abuse
40.7%
37.9%
29.5%
59.5%
53.2%
38.6%
4. For survey purposes, please click the color
RED.
RED (1,502 respondents)
99.7%
5. Are you for or against a smoke free policy in
all public places?
For
Against
77.9%
27.1%
6. Are you for or against alcohol sales in our
community?
For
Against
47.8%
52.2%
7. Do you feel that breast feeding is important
for infant health?
Yes
No
86.4%
13.6%
8. Do you know what the EPSDT (Early
Periodic Screening, Diagnosis, and Treatment)
Program is for kids aged birth to 21 years?
Yes
No
46.1%
53.9%
9. How would you rate our community overall
as a “Healthy Community?”
Very Unhealthy
Somewhat Unhealthy
Very Unhealthy
Somewhat Healthy
20.4%
52.2%
4.8%
22.6%
3. In the list below what do you think are the 3
most “Risky Behaviors” in our community?
Those behaviors that have the greatest impact on
overall community health.
Whitley County Community Health Improvement Plan - MAPP
Page 12
10. How would you rate your own personal
health?
Very Unhealthy
Somewhat Unhealthy
Very Healthy
Somewhat Healthy
3.7%
22.0%
28.5%
45.8%
11. What is your postal zip code?
40769
40701
40759
53.7%
38.5%
2.9%
12. Sex?
Male
Female
26.5%
73.5%
13. Marital Status?
Single
Married
53.8%
46.2%
14. Age? Top 3
19-25
26-39
40-54
25.4%
24.7%
23.4%
15. Work Status?
Full Time
Unemployed
Part Time
Work at Home
44.3%
34.5%
18.5%
2.6%
16. Household Income
Less than $10,000
$10,000 to 19,999
Over $50,000
28.9%
15.7%
26.6%
17. How do you pay for your Health Care?
Health Insurance (e.g. Private
Insurance, Blue Shield, HMO)
Pay Cash (No Insurance)
Medicare
Medicaid Kentucky Spirit
Medicaid Well Care
Medicaid Coventry
White/Caucasian
African American/Black
Hispanic/Latino
57.9%
16.4%
9.9%
6.7%
5.4%
3.2%
94.8%
2.4%
1.1%
19. Education?
High School Diploma or GED
College Degree or Higher
Less than High School
45.8%
41.5%
12.7%
20. Where/how you got this survey?
Workplace
Personal Contact
Health Department
26.0%
21.7%
19.2%
18. Ethnic Group?
Whitley County Community Health Improvement Plan - MAPP
Page 13
Whitley County Health Synopsis
Whitley County has good rankings in two areas: physical activity rates among adults and primary
care physician to population ratio. Its challenges are high rates of smoking, obesity, diabetes,
motor vehicle accident deaths, and infant mortality. Whitley County has among the worst health
indicators in poor oral health, occupational fatalities, cardiovascular disease, lung, colorectal and
prostate cancer deaths. Improved nutrition, increased exercise, and smoking reduction can
reduce the risk for heart disease, stroke, and diabetes. Smoke-free policies and smoking
cessation can help reduce lung cancer deaths and improve respiratory health. Early detection
through regular screenings and treatment can reduce colorectal, prostate, and other cancer deaths.
In the future more Community Health Assessments and statistical information will be gathered to
give the Whitley County Healthy Community Coalition a better picture on how the Affordable
Care Act has impacted health needs in our Whitley County community.
Whitley County Community Health Improvement Plan - MAPP
Page 14
Community Themes and Strengths
Whitley County Healthy Community Coalition
What are the themes that come from the data? A meeting was held August 27, 2013 and
coalition members were asked to identify themes from the county data which were positive
and concerning. Information was collected from the coalition members and is reflected
below in the table.
Positive County Themes
Data Source
Population Growth
U.S Census Bureau projected a slow
population growth for Whitley County
Kentucky. The estimated population
growth from 2010 was (35,637), compared
to 2013, which is (35,637).
2010 BRFSS reveals that Whitley County
Kentucky rates 8% compared to the State
of Kentucky, 12%.
2010-2011 Kentucky Department of
Education data shows 81% for Whitley
County, and the State of Kentucky.
2009-2011 Kentucky Youth Advocates.
Data was compared from Whitley County
showing 15 compared to the State of
Kentucky’s 22.
2008-2010 Kentucky Board of Medical
Licensure: Whitley County 1.3 compared
to the State of Kentucky 1.0. Two
hospitals service Whitley County, Baptist
Health and Jellico Community Hospital.
2006-2010 Kentucky Cancer Registry:
Whitley County, 11.11 compared to State
of Kentucky, 13.95.
Low excessive drinking rate
High School graduation rates
Asthma Hospitalizations 2009-2011 (per 10,000)
Primary Care Physicians (per 1,000)
Breast Cancer Deaths (rate per 100,000)
Concerning County Themes
Children in poverty
Teen Birth Rate (ages 15-19 per 1,000)
Data Source
2010 Small Area Income and Poverty
Estimates. Whitley County poverty level is
37% compared to Kentucky, 27% and US,
14%.
2005-2011 National Center for Health
Statistics. Whitley County 61, compared to
Whitley County Community Health Improvement Plan - MAPP
Page 15
Early Childhood Obesity (2-4 yrs.)
Births to mothers who smoked during pregnancy
Cancers deaths (per 100,000)
Number of recreational facilities (per 100,000)
Poor Mental Health (average/month)
Lack of Physical Activity (% of adults 20 and older
reporting no leisure time physical activity)
Tooth Loss (percent of adults missing 6 or more
teeth)
Immunization Coverage (ages19-35 months)
Adult Smoking
Sexually Transmitted Infection (Chlamydia rate per
100,000)
Kentucky 50, and US, 21.
2010 Kentucky Youth Advocates. Whitley
County, 24.2% compared to Kentucky
15.6%, and US, 12.1%.
2009 Kentucky Youth Advocates: Whitley
County, 36% compared to Kentucky, 24%.
2006-2010 Kentucky Cancer Registry:
Whitley County 244.33 compared to
Kentucky, 222.85
2010 County Business Patterns: Whitley
County, 3 compared to Kentucky, 8 and
US, 16
2005-2011 BRFSS: Whitley County, 5.7
days compared to Kentucky, 4.3 and US,
2.3
2009 National Center for Chronic Disease
Prevention and Health Promotion: Whitley
County 35% compared to Kentucky, 31%
and US, 21%
2008-2010 BRFSS: Whitley County, 33%
1999-2003 Kentucky Health Profiles—
Kentucky Institute of Medicine: Whitley
County, 76% compared to Kentucky, 80%
and US, 81%
2008-2010 Kentucky Youth Advocates:
Whitley County, 31% compared to
Kentucky, 26% and US, 13%
2010 National Center for HIV/AIDS, Viral
Hepatitis, STD, and TB Prevention:
Whitley County, 160 compared to
Kentucky, 377 and US, 92
Whitley County Community Health Improvement Plan - MAPP
Page 16
FORCES OF CHANGE ASSESSMENT:
(Whitley County Healthy Community Coalition)
On August 27, 2013 a discussion was led by Angela Carman with the Community partners of the
Whitley County Healthy Community Coalition to identify forces, trends, factors or events that
are or will be influencing the health and quality of life of the community and the work of the
local public health system. A brainstorming session was held and answers were recorded and
placed in specific forces of change categories as follows:
Social Forces of Change


Substance Abuse
Mental health issues
Legal/Ethical Forces of Change:



Alcohol Sales increase health problems
2 cities of Whitley County became Smoke-free
Alcohol sales brings in money
Economic Forces of Change:




Funding Sources diminishing
Losing school nurses in schools
Lost 650 jobs from companies closing
CSC Government agency closed in Williamsburg
Political Forces of Change:



Affordable Care Act
Legislation/program cuts
New Judicial Center built
Environmental Forces of Change:


Garbage disposal
Recycling
Scientific Forces of Change:
Whitley County Community Health Improvement Plan - MAPP
Page 17



Growing number of obese children
Children with chronic health problems
Overuse/Over prescribing of pain medications
Technological Forces of Change:


Electronic Medical Records
Everything is going to computer systems
Local Public Health System Assessment:
The Whitley County public health system was assessed by organizations and agencies that serve
Whitley County and part of the Whitley County Healthy Community Coalition on August 27,
2013. The purpose of this assessment was to identify our public health system’s strengths and
weaknesses by using the 10 Essential Core Functions of Public Health Services and then decide
upon opportunities for continuous improvement. Whitley County Health Department is only one
of many partners in Whitley County’s public health system. The public health system includes
governmental agencies, healthcare providers, human service organizations, school, and
universities, faith institutions, youth development organizations, economic and philanthropic
organizations.
Essential Public Health Service (EPHS) #1: Monitor Health Status
Whitley County Health Department- Monitor health status to identify and solve community
health problems; Community Health Assessment; Applying for Grants; Starting Programs
looking on policy changes in health; Health Risk Assessment; Home Visits-monitor prenatal,
postpartum care; In-home depression, screening, domestic violence screen; Monitor statistics (all
sources).
Baptist Health Center and Baptist Health Systems, Inc. The hospital is located centrally
among the three counties of Knox, Whitley and Laurel. Baptist Health completed a hospital
community health assessment to identify health needs in the community. Baptist Health
provides many educational programs throughout the community on cardiovascular disease,
stroke, hypertension and CHF, diabetes, obesity, teen births, cancer and uninsured/forego care
due to cost, that includes depression, bone density, cholesterol, glucose, blood pressure and PSA
blood test screening for our community.
Whitley County Community Health Improvement Plan - MAPP
Page 18
Whitley County Cooperative Extension Service through EFNEP program- Through EFNEP
program and our NEERS federal reporting # 1 is covered partially through partner in the
Diabetes Coalition and the Whitley County Healthy Community Coalition; Whitley County
Extension provides educational classes to the community on gardening, baking, budgeting,
nutrition, 4-H programs for children and teenagers in the schools, and etc.
Jellico Community Hospital located on the Kentucky and Tennessee state line, provides
educational programs in the community on many health topics.
Women’s Health Associates- Sexually Transmitted disease reporting;
EPHS #2: Diagnose and Investigate Health Problems
Whitley County Health Department- Investigate diseases; Environmental Health Services
School/restaurant/ other facility inspections; Epidemiology-Infectious Disease Control&
reporting; Lead Program, Food safety; Pool Safety; Flu Outbreak; Food borne illness;
Baptist Health Hospital- The hospital and physician offices ensures infection and disease
control practices are followed and reporting to diagnose and investigate health problems.
Whitley County Cooperative Extension Service through EFNEP program- Work in
Substance Abuse rehab to better educate; Example- Pregnant mom’s coming off substances to
take proper care and have a healthier infant. Also through various Advisory Councils; Advisory
Council assesses community needs for education on a yearly basis. The council is made up of
many in the community;
Jellico Community Hospital- Infection and Disease Control practices are implemented by the
hospital and physicians’ offices, reporting to diagnose and investigate health problems.
Cumberland Valley Electric- Investigate and correct health safety hazards in the community on
a regular basis- stoplights-security lights-road light poles;
EPHS #3: Inform, Educate, and Empower People about Health Issues
Whitley County Health Department- Tobacco Prevention & Control; WIC counseling;
Postponing Sexual Involvement and Reducing the Risk in the schools; Food Service Handler
classes; Home Visiting (pregnant women & infant children) offering education and information;
Diabetes Self-Management classes; Healthy Start/HANDS; Medical Nutrition Therapy; Counsel
patients on health and educate them on how to help themselves; Work in community, schools
and other organizations to educate on health issues; .
Baptist Health Systems provide many educational programs throughout the community on
cardiovascular disease, stroke, hypertension and CHF, diabetes, obesity, teen births, cancer and
uninsured/forego care due to cost that includes depression, bone density, cholesterol, glucose,
blood pressure and PSA blood test screening for our community. Psychiatry, chemical
Whitley County Community Health Improvement Plan - MAPP
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dependency programs, and rehabilitation are among the many services the hospital provides in
the community.
Comp Care- Provide mental health & substance abuse treatment to children and adults; provide
training on suicide prevention to schools and community groups;
Jellico Community Hospital provides educational programs in the community on different
health topics. Health screening services are provided at community events, health fairs in
Whitley County and surrounding areas.
Whitley County Cooperative Extension Service through EFNEP- Inform and educate
through various classes taught; Nutrition Education Program and March of Dimes; Education
about- nutrition, budgeting, aging, agriculture, arts, horticulture, 4h;
Whitley and Corbin Senior Citizens- Monthly nutrition education; Health issues educationheart, diabetes, hearing, falls prevention, elder abuse; Utilize Baptist Health and Health
Departments;
Women’s Health Associates- Educate patients on importance of preventive care; Partner with
AHEC to educate pregnant patients;
Cumberland Valley Electric- School electrical safety classes; Volunteer fire department safety
training;
Independence Place- Women obtaining treatment for alcohol and drug addictions;
EPHS #4: Mobilize Community Partnerships to Identify and Solve
Health Problems
Whitley County Health Department- Diabetes coalition, Whitley County Healthy Community
coalition; Healthy Start coalition; Dental Health coalition; Home Health advisory; Board of
Health actions; Medical Reserve Corps; Consortia; Local Health System Health Plan;
Baptist Health Hospital – The hospital partners with health organizations throughout the tricounty area to identify and solve health problems. Baptist Health is on many planning
committees and coalitions. The hospital on going provides health screenings at many health fairs
and special events in the community.
Whitley County Cooperative Extension Service through EFNEP program- Work with the
Housing authority groups; Comp Care TSR clients; Diabetes coalition group; Whitley County
Healthy Community Coalition; Family Resource Centers and their advisory council groups;
Rehab’s – substance abuse;
Comp Care- Collaborate with OCBS, Schools & Court system; Sit on domestic violence
councils and elder abuse councils;
Whitley County Community Health Improvement Plan - MAPP
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Cumberland Valley Electric- Maintains community partnerships through financial assistance to
nonprofit entities;
Jellico Community Hospital – Ongoing partners with many community organizations to
provide screening for cholesterol, blood glucose, and blood pressure and the hospital partners
with health coalitions throughout Whitley County to identify and solve health problems.
Corbin Senior Citizens- Elder Abuse Council;
Independence Place- women that are in rehabilitation for alcohol and drug dependency;
Bell Whitley Community Action – heating and electric assistance to residents in the
community, and early head start program for children in Whitley County.
Firestone Industrial Products – partners with different health coalitions in Whitley and
provides small grant assistance for health and community activities. Firestone takes the lead
with ongoing fundraising events that supports cancer projects in the tri-county area and
employees.
EPHS #5: Develop Policies and Plans that Support Health Efforts
Whitley County Health Department- Board of Health actions/policies; Smoke-free policies;
Disaster preparedness meets with Local Emergency Planning Committee quarterly, stakeholders
include emergency manager for Whitley County, police, fire, Red Cross, University of the
Cumberland, Baptist Health, and Firestone Industrial Products representatives.
EPHS #6: Enforce Laws and Regulations that Protect Health
Whitley County Health Department- Environmental services and safe food and water;
Environmentalist; Environmental policies and regulations; Board of Health; Investigate
reportable diseases- infectious disease control; Immunizations; STD/TB; Disaster preparedness
practices for the community.
Whitley County Cooperative Extension Services through EFNEP program- Teach food
safety and March of Dimes curriculum; Promotion of healthy eating;
Women’s Health Associates- Monitor monthly reports to assure patient care provided and does
not fall through cracks – (pap smear follow);
Firestone- OSHA practices for employees’ safety
EPHS #7: Link People to Health Services and Assure the Provision of
Healthcare
Whitley County Health Department- Tri-County cancer coalitions; Healthy Communities
coalition; Health start consortium; School advisory councils; HANDS; Home health services;
Whitley County Community Health Improvement Plan - MAPP
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Contract with other providers for clinical services; outside referrals to needed resources and
health providers, medical providers, etc;
Whitley County Cooperative Extension Service through EFNEP program- Being part of
different councils and collaboration efforts with various agencies; promote and let clients know
about additional resources;
Jellico Community Hospital – refers patients to specialists and area community organizations
for additional resources.
Comp Care- Refer to hospitals, private physicians, health department, domestic violence
advocate, etc.; Provides mental health and substance abuse counseling to the community.
Cumberland Valley Electric- Maintain data base of essential lifesaving equipment in residents
to prioritize our work during an outage;
Corbin& Whitley Senior Citizens Centers- Referrals to physicians, dieticians, and health
departments for diabetes education; Referrals for community resources- Food pantries; Meals on
Wheels for elderly that doesn’t have transportation and provides lunch for seniors at both
locations.
Baptist Health provides hospital referrals to specialists and other community organizations.
Women’s Health Associates- Referral to patients to needed health care or Health Departments;
Family Resource and Youth Resource Centers- The three school system provide health
screenings for students and works with families to obtain additional resources by making
referrals.
Firestone Industries- provides in house nurse for employees’ health issues and refers
employees’ to additional resources in the community.
EPHS #8: Assure a Competent Public Health and Personal Healthcare
Workforce
Whitley County Health Department- Internal quality assurance; employee training; Training
and education for staff-clinical providers; Junior Achievement and Southern Kentucky Chamber;
Success skills in schools for job empowerment; Drug screens for employees;
Baptist Health Hospital- The hospital provides employees with many employee training and
education opportunities and, internal quality assurance procedures.
Comp Care- Train new staff, train schools, train ER staff;
Women’s Health Associates- Competence check lists for employees;
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Jellico Community Hospital- The hospital ensures staff is given opportunity to obtain training
and education.
EPHS #9: Evaluate Health Services
Whitley County Health Department- State reports on effectiveness on sexual abstinence and
tobacco programs; Grant reporting; Quality assurance; Works with community agencies to
develop Community Health Assessments.
Whitley County Cooperative Extension Services through the EFNEP program- Our
reporting systems helps with evaluations, etc;
Baptist Health- Quality Assurance measures and works on Community Health Assessments.
Jellico Community Hospital- Internal quality Assurance measures within the hospital.
EPHS #10: Research for Innovative Solutions to Health Problems
Whitley County Health Department- State trainings on new renovating programs on health
that other states use and work; work with CDC, universities, participate in research activities;
Comp Care- Provide evidence based treatment (trauma focused-cognitive behavior therapytrauma informed care-education programs);
Baptist Health and Jellico Community hospitals research for innovative solutions to health
problems by renovating and expanding patient’s services and buying state of the art equipment.
Both hospitals opened urgent care clinics in Williamsburg and Corbin area.
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I. Strategic Plan Process
Data was shared with the Whitley County Healthy Community Coalition group from objective
statistics (data perspective), community forums (organizational perspective) and community
surveys (individual perspective).
Small workgroups were formed and each group was provided with handouts which contained
information from the Three Perspectives on Community Health (data perspective, organizational
perspective, and individual perspective). Each workgroup reviewed the Three Perspectives on
Community Health and discussed which areas of focus they felt would have the most impact on
the health of Whitley County. The workgroup process resulted in the following potential focus
areas identified (numbers indicate the number of workgroup suggestions for that topic to become
a strategic initiative):





Substance Abuse – including alcohol and all drugs
Chronic Disease – including prevention awareness, obesity, physical
inactivity, cancer due to environment, unhealthy lifestyles/behaviors/diets due
to cost and accessibility issues
Economy/Unemployment
Teen Pregnancy
Transportation
Workgroups were directed back to the Three Perspectives on Community Health handouts. In
addition, workgroups were given a copy of the Local Public Health System Assessment
(LPHSA) completed in the first forum. This information was used for workgroup discussions on
the resources currently present in Whitley County to work on potential focus areas for
improvement of Whitley County health.
After reviewing the list of resources currently present in Whitley County, participants
determined the following strategic initiatives were supported by the Three Perspectives on
Community Health and by the resources available.
Strategic Initiative #1: Substance Abuse (which includes alcohol; all prescription and
illegal drugs)
Strategic Initiative #2: Chronic Disease (with emphasis on unhealthy lifestyles/behaviors)
In an effort to assure on-going progress toward the strategic initiatives community partners
formed two volunteer workgroups to develop strategic initiatives in substance abuse and
chronic diseases. The substance abuse workgroup met on January 15, 2014, and the Chronic
Whitley County Community Health Improvement Plan - MAPP
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Disease workgroup met on January 22, 2014. These two workgroups will report back to the
Whitley County Healthy Coalition with information from these meetings.
Healthy Communities
Chronic Disease
Workgroup
Substance Abuse
Workgroup
Owner: Whitley County
Health Department,
Kathy Lay
Owner: UNITE - Carl
Varney
II: Methodology of the Workgroups
The two workgroups set meeting dates: Substance Abuse workgroup, January 15, 2014 and
Chronic Disease workgroup, January 22, 2014. The two columns below identified which
community partners volunteered to meet and what workgroup. The workgroup responsibility was
to develop goals and objectives for the strategic initiative of substance abuse and chronic disease
and report back to the Whitley County Community Coalition.
Substance Abuse
Cecilia White
Melissa Bond
Debbie Harp
Gail Timperio
Jamie Moses
Elizabeth Neal
Jennifer Canada
Patricia Turner
Debbie Harden
Cheryl Owens
Kathy Lay
Carl Varney (UNITE )
Chronic Disease
Haley Bargo
Teresa Bunch
Kathleen Croley
Sherry Paul Cooper
Jamie Moses
Elizabeth Neal
Jennifer Canada
Jamie Freeman
Debbie Harden
Marian Colette
Mattie Daniels
Cheryl Owens and Kathy Lay
Substance Abuse (Strategic Initiative 1):
The substance abuse workgroup met on January 15, 2014, the five whys were discussed for the
reasons substance abuse is a problem in Whitley County. The workgroup brainstormed the
following ideas and these were recorded: Poverty, lack of education, lack of immediate
resources, lack of treatment money, teens/kids taking prescription drugs from home, lack of jobs,
Whitley County Community Health Improvement Plan - MAPP
Page 25
mental health issues untreated, behaviors passed down through generations, lack of youth
activities/recreation, transportation, rural areas, doctors prescribing pain medications, pain
clinics, qualify less for social assistance with food stamps and social programs when they go to
work, never ending cycle for drug users for relapsing, and parents who use substances.
Specific, Measurable, Attainable, Realistic, and Timely, (SMART) Goals were discussed and
decided on by coalition members. The items of discussion were, Pill Dragon from UNITE,
National Drug Take Back Days, Statewide Smoke-free Initiative editorials for paper and
supporting this issue, Drug mobile Unit owned by UNITE, KYASAP assistance for activities.
KYASAP for Bell, Knox and Whitley four goals in our community are: Tobacco prevention and
Cessation services, pregnant women smoking, METH, and Alcohol. KYASAP provides money
for science based school curriculum, for instance, Life skills. KYASAP will provide money for
media and promotion of drug prevention and awareness activities in Whitley County. Celebrate
Recovery Drug Support group was discussed for a possible activity to support and promote this
program. The Whitley County Healthy Community Substance Abuse Committee decided on a
goal for our substance abuse issue. Andy Croley Coroner of Whitley County has developed a
program called Win one Way that brings different celebrity/athlete speakers to the area schools
and talk about what drugs have done to their life and how they have recovered. The message
targets middle and high school teenagers to stay away from drugs and alcohol. Andy Croley is
currently seeking funding to provide drug kits to parents. Parents can obtain the drug kits at the
local health department, coroner’s office and organizations where parents feel comfortable
obtaining them.
Chronic Disease (Strategic Initiative 2):
The Chronic Disease workgroup met on January 22, 2014 at the Corbin Health Department. The
workgroup reviewed the October 21, 2013 meeting minutes along with KAPHTC Community
Physical Activity and Community Nutrition Interventions.
Specific, Measurable, Attainable, Realistic and Timely, (SMART) Goals were reviewed before
discussion began to create a strategic plan for Chronic Disease. The question was asked to the
workgroup to start off discussion, why do we have a problem with Chronic Disease in Whitley
County? This was an interactive discussion with members of this workgroup their answers were
reflected why there was a problem in our community that contributed too many chronic diseases.
The following answers were given and recorded:
Lack of Physical Activity: lack of affordable recreational centers, generational behaviors passed
down to children, lack of motivation, depression, not enough time to exercise, live in rural area,
transportation issues, lack of PE time in schools, more emphasis on core content in schools,
funding cuts in schools. Screen time, watching too much television, computer, IPad use,
children not in sports or physically active due to living in rural area, lack of transportation,
recreational facilities, and lack of parents modeling healthy behaviors themselves to their
children.
Whitley County Community Health Improvement Plan - MAPP
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Nutrition: Access to convenient foods, healthy foods are more expensive, fast food is cheap and
easy, new generations of people don’t know how to budget or cook food, lack knowledge on life
skills, fast food desert, lack of access to healthy foods, no gardening and food preparation skills,
model after parents with unhealthy eating behaviors, high consumption of sugary drinks, energy
drinks and mental health issues.
Tobacco Use: generational modeling from parents, parents buy tobacco products for kids, high
number of pregnant women that smoke, alcohol and drug use, and socially acceptable in public.
Screenings and Disease Management: Many people don’t get screened for health problems, noncompliant with medications needed for health problems, non-compliant with dietary plans, lack
of knowledge and disease information, doctors don’t talk to patient about disease and provide
resources from other organizations in the community to give education on chronic health issues,
disease management to learn new behavior skills in diet and promoting physical activity.
After the sub-committee looked into the 5 Whys, they further discussed what could be the main
goals and objectives were decided on for Chronic Disease in Whitley County.
After both of the meetings were held with workgroups goals and initiatives were developed to
address chronic disease and substance abuse. The workgroups reported back to the Whitley
County Healthy Community Coalition on March 18, 2014 to review the Goals and objectives of
each initiative and were approved by the coalition.
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GOAL: To promote education and awareness of healthy lifestyle behaviors in Whitley
County.
Objective#1: From February 2014-February 2017, create and maintain community
partnerships to increase the awareness of chronic health disease risks and prevention.
Strategies:
Cancer Awareness
Timeline:
Who: AHEC, Baptist
Dinner for cancer
Fall Annually
Health, Whitley
survivors and families
County Health
in Whitley County.
Department, TriCounty Cancer
In the Pink Cancer
Coalition, Whitley
Prevention
Fall Annually
County Healthy
Symposium
Community Coalition
Ladies in Red Women
Timeline:
Who: Southern
Cardiovascular
Spring Annually
Kentucky AHEC,
Dinner
Baptist Health,
Whitley County
Health Department,
and Whitley County
Healthy Community
Coalition.
Cardiovascular &
Timeline:
Who: Southern
Diabetes Symposium
Spring and Fall
Kentucky AHEC,
Annually
Baptist Health,
Whitley County
Health Department
Dare to Compare
Timeline:
Who: University of
Health Fair,
Spring and Fall
the Cumberland’s,
promoting the five
Annually
Whitley County
components of fitness.
Healthy Community
Coalition, area health
organizations, and
Whitley County
Microclinic Facilitator
Health Department.
Training and
Training March 25,
implementation of the
26th, and 27th 2014
program.
2 sessions June 2014
2 Microclinic Classes
in Corbin and
Williamsburg
May 2014
Ongoing
Whitley County
Health Department
Whitley County Community Health Improvement Plan - MAPP
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Objective#2: From February 2014-February 2017, promote and educate on programs and
initiatives that will increase awareness of prevention strategies for type 2 diabetes.
Strategies:
Diabetes education
Timeline
Who
self-management
Spring annually
Whitley County
classes.
Health Department
Taking Ownership of
Timeline:
Who:
Your Diabetes” Class
July-September
Whitley County
Series
Annually
Extension Office
5-2-1-0 Program
Timeline:
Who:
Microclinic Program
Ongoing
Whitley County
in Corbin and
Annually
Health Department
Williamsburg
Promote Choose My
Timeline:
Who:
Plate, USDA/CDC
Ongoing
Whitley County
Nutrition and Physical
Annually
Health Department
Activity Information
Whitley County
Extension Office
Diabetes Support
Timeline:
Who:
Group
Annually
Baptist Health
(Linda Mills)
Objective #3: From February 2014-February 2017, promotion of cessation programs that
can decrease the adult (31%) and pregnancy smoking rates (36%) and provide education
that can decrease the initiation of youth tobacco use (25%). (Baseline: Data Source BRFSS
2008-2010 and 2009 Youth Advocates).
Strategies:
Promote Quit Now
Timeline:
Who:
Kentucky quit line to
February 2014 and
Whitley County
patients.
ongoing
Health Department
Tobacco Program,
clinic and HANDS
and Healthy Start
Program.
Promote the usage of
Timeline:
Who:
Quit Now Kentucky
February 2014 Whitley County
to OB doctors,
Ongoing
Health Department
Pediatricians, which
and Whitley County
would target pregnant
Community Coalition
women and parents
that smoke.
Educational programs
Timeline:
Who:
at local schools and
February 2014Whitley County
youth events on
February 2017
Health Department
Whitley County Community Health Improvement Plan - MAPP
Page 29
dangers of tobacco
use.
UNITE Activities in
schools.
Objective #4: Increase access the availability of fresh fruits and vegetables in Whitley
County. (Baseline: Consume 5 or more fruits and vegetables/day. Data Source 2008-2010)
Strategies:
Create community
Timeline:
Who:
gardens within the
city to promote access
Ongoing 2017
Whitley County
to fresh fruits and
Healthy Community
vegetable
Coalition, and
community
organizations
Promote and educate
Ongoing
Whitley County
the public on the
Extension office
importance of
Whitley County
supporting Farmers
Healthy Community
Markets in Whitley
Coalition
County. Promote the
Whitley County
WIC Vouchers usage
Farmers Market
with patients.
Strategic Issue #1: How can the Whitley County Healthy Community Coalition address the
issue of substance abuse in Whitley County?
Goal: Increase education and awareness of substance abuse issues in Whitley County.
Objective #1: From February 2014 through January 2017 the Whitley County Healthy
Community Coalition will provide educational information to the public twice per year on
substance abuse and use the accidental dealer program to decrease prescription drug abuse.
Strategies:
Educate individuals
Timeline
Who
on the risk of sharing Yearly in October
Whitley County
medications and how during the month of
Healthy Community
to safely dispose and
Red Ribbon.
Coalition, UNITE,
store medication with
RPC, Police
a locked box.
Departments, Baptist
Health, and Whitley
County Health
Department, and
KYASAP, Bell, Knox
and Whitley.
Participate in Take
April and October
Whitley County
Back Initiatives that
Healthy Community
are held twice per
Coalition, UNITE,
Whitley County Community Health Improvement Plan - MAPP
Page 30
year.
Partner with Whitley
County UNITE by
going to meetings and
participating in
activities.
UNITE Camp for
teens
WIN ONE WAY
PROGRAM (Andy
Croley)
Monthly meetings
UNITE Camp
Ongoing
WIN ONE WAY
PROGRAM (Andy
Croley)
Promote through
education and media
permanent Drug
Drop-off location(s)
within Whitley
County.
Ongoing
RPC, Police
Departments, Whitley
County Health
Department.
Coordinate with
Police Departments
Whitley County
Healthy Community
Coalition, Whitley
County UNITE, and
University of
Cumberland’s
Coroner Andy Croley
and Speakers that
were former drug
users that present at
assemblies in the
three school systems
of Whitley,
Williamsburg
Independent and
Corbin City Schools.
Drugs kits for parent’s
pickup places, health
department, Coroner
office, area
organizations.
KYASAP of Bell,
Knox and Whitley
County, Whitley
County Healthy
community coalition.
Whitley County Community Health Improvement Plan - MAPP
Page 31
Objective# 2: From February 2014 through April 2017, provide educational and
prevention programs that will decrease the youth access and initiation of ATOD in Whitley
County.
Strategies:
1. Coordinate
with UNITE to
have the Drug
Mobile Unit in
all three
school systems
targeting 6th,
7th, 10th grades
2. Provide
Lifeskills
Science Based
Curriculum in
two schools
systems 6th or
7th grade.
Look for other
grants and
funding
sources to
implement
LIFESKILLS
into schools.
3. Accidental
Dealer
Program to
target Parents
and
Grandparents
Timeline
February 2014 – May
2015
Who
Whitley County
Health, Whitley
County Healthy
Community Coalition,
UNITE, school
systems FRSC, YSC
Timeline
February 2014
Spring and Fall
Who
Whitley County
Health Department
Health Educator
KYASAP, YRC,
FRSC
Ongoing
Timeline
Ongoing
Whitley County
Healthy Communities
Coalition and School
Systems
Who
Whitley County
Healthy Community
Coalition, health fairs,
and provides
presentations.
Whitley County Community Health Improvement Plan - MAPP
Page 32
Objective#3: From February 2014 –January 2017, will promote Quit Now Kentucky quit
line and support Smoke-free Kentucky Initiatives. Baseline: 32 individuals per year
average from 2012-2014.
Source: Kentucky Department for Public Health, Manager Health Promotion Branch.
Strategies
1. Support,
Timeline
Who
promote,
Ongoing until State is
Whitley County
Smoke-free
Smoke-free
Healthy Community
Kentucky
Coalition members
Initiatives for
the State of
Kentucky to
become
Smoke-free.
Coalition
members will
write editorials
for
newspapers,
and contact
legislators.
2. Promote the
Timeline
Who
Quit-Now
From February 2014
Area organizations,
Kentucky quit
ongoing
Whitley County
line to
Healthy Community
pregnant
Coalitions, Whitley
women and
County Health
tobacco users.
Department.
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