Iowa Rural Vitality Coalition Formed to Bolster Health, Wealth of Rural Iowa

Did you know 80% of a person’s health may be determined by factors that exist outside of the health care system? Where people live, learn, work and play have a profound impact on their overall health. This is especially true for rural communities.

A strong community cannot exist without healthy people. Unfortunately, many people in rural areas experience worse health outcomes like shorter lives and more preventable diseases than their urban counterparts. Rural communities are aging, declining in population and becoming more diverse, and may not have the necessary resources to address these changes.

Healthier people are in better physical and mental health and are more likely to engage in education and skills training. A strong community means better jobs, better benefits and higher pay. When people are paid more, they are more likely to invest in higher education and invest in healthier lifestyles, which in turn improves health and income.

To improve the health outcomes in rural areas, we must stop thinking of health as something we manage at the doctor’s office, but instead as something that starts in our families, in our schools and workplaces and in our playgrounds and parks.

No single organization can do this alone. Collaboration is key to making a significant impact.

Uniting for Change

A variety of Iowa-based organizations have been working in the rural health and community space separately until now. These organizations came together and agreed that by pooling resources they can work together to create sustainable solutions for rural communities.

The newly formed Iowa Rural Vitality Coalition is comprised of the Governor’s Empower Rural Iowa Initiative, the Iowa Rural Development Council, Iowa State University Extension and Outreach, the Institute for Decision Making at the University of Northern Iowa, the University of Iowa College of Public Health and Wellmark Blue Cross and Blue Shield.

Drew Conrad, Director of the Institute for Decision Making at the University of Northern Iowa, says the power in the coalition comes from collaboration. He maintains that working with the College of Public Health at the University of Iowa and Wellmark is a win-win and that the sum is greater than the parts.

Jason Henderson, Vice President for Iowa State University Extension and Outreach, reports that the University’s involvement in the coalition was a no-brainer and utilizing state resources can help change the narrative surrounding deficits in rural Iowa.

From Concept to Community

Work from the coalition is already underway. In April, the Iowa Rural Vitality Coalition announced the community of Manchester in Delaware County and Van Buren County were chosen as pilot projects to use the Comprehensive Rural Wealth Framework in developing strategic plans for the community. This framework is comprised of eight categories or “wealth capitals” and was developed by the Rural Policy Research Institute (RUPRI) at the University of Iowa in collaboration with the Economic Research Service at USDA and is based on work originating decades ago at Iowa State University by internationally known sociologists Jan and Cornelia Flora.

The framework defines wealth as more than just financial means and takes a comprehensive approach to identifying the assets and gaps in a community. Each fall under one of eight categories called wealth capitals: intellectual, human, social, cultural, political, physical, natural and financial.

Van Buren County and Manchester are engaging with the coalition to explore the interconnectedness of these capitals and how they can be impacted to create ripple effects of sustainable, positive change.

Metrics will then be established for each community to monitor baseline, leading and lagging measures. This will help each community plan for a bright future for all citizens and find solutions specific to their needs that improve the overall economy and the health of community members.

Both communities were ultimately invited and chosen to play a critical role as a pilot community based on quantitative and qualitative data.

For Joy Padget, President of Engage Keosauqua in Van Buren County, it’s an honor to be chosen as a pilot community.

Both Manchester and Van Buren County are currently undergoing an assessment and planning process using data and the wealth framework tools. One of the foundations of the framework is assembling a community-based wealth capital group. The group consists of volunteers from the community.

Sarah Maurer, Manchester Rural Vitality Lead, says new eyes will provide insights on where rural Iowa communities are headed.

Old Challenges, New Vision

Many rural communities rely on the work of the few and frequent volunteers each year. While valuable and appreciated, forming a community planning team around the wealth capitals challenged each community to find new volunteers of diverse backgrounds and demographics. Coupled with the rural wealth framework, the communities are already seeing old issues in a new way.

Maurer says getting new people involved, especially in the form of the eight wealth capitals, has helped them cast a wider net of volunteers, too.

Diverse volunteers spur more comprehensive results. Due to the diversity of the eight wealth capitals, the Rural Wealth Framework goes far beyond financial and economic outcomes.

When asking the communities in orientation meetings to paint a picture of their ideal community, building towns for the health of the people who live in them is the top priority, says Laura Jackson, Executive Vice President, Health Equity/Access and Improvement at Wellmark.

Inclusivity is a critical piece of the wealth capital groups. Communities are also involving immigrants and non-English speaking residents.

Padget reports this holistic approach has already benefited the communities in Van Buren County.

Padget hopes that by bringing new ideas and fresh perspectives to the table via the framework, they found that the communities were hungry for an entertainment venue. The building now serves as a cultural hub with live music and art that attracts visitors of all ages.

And attracting people to rural communities is a theme heard across the state. With declining populations, inadequate housing and fewer available workers, these challenges have led to a change in the quality of life and access to resources for rural Iowans, making it more difficult for the people and the economies they depend on to thrive. These factors have also led to an increase in the rates of certain chronic diseases. With 1.2 million Iowans living in rural communities, higher rates of chronic diseases contribute to the unsustainable climb in health care costs.

Jackson says Wellmark knows the rising cost of health care is unsustainable. Since 80% of what it takes to create a healthy life happens outside of the health care system, the company can do more than finance health care and can help others understand the value of working upstream so that over time, they need less health care in the future.

Pilots for Brighter Futures

The pilot communities will serve as examples of what could eventually be refined and offered to other rural communities throughout Iowa. According to Jackson, the goal is for people in rural communities to live longer and healthier lives.

However, such a significant outcome requires diligence in all eight categories of the wealth capital framework. Bringing families back to fill storefronts, retain a workforce, attract new business and industry and improve housing is one of the goals for the city of Manchester, according to Maurer, who wants to see Manchester as a place people don’t want to leave.

For Van Buren County, Padget reports a similar goal, envisioning bustling streets, outdoor restaurants, festivals that grow and sidewalks for kids to walk to schools so that residents feel a sense of community pride as soon as they pull in.

Edith Parker, Dean at the University of Iowa College of Public Health, says learning from and incorporating partner and community experiences will be critical in evaluating the success of this initiative. A participatory process that allows for adjustments and a framework that can be adapted to the strengths and needs of each community is essential.

Measurements of success will be conducted by the universities after rigorous efforts to determine the most appropriate metrics for each community.

Iowa State’s Henderson says success measurement will rely on data from the pilot communities. Data, including location-specific metrics instead of a one-size-fits-all approach will help determine commonalities that can be applied to other communities as well.

Read more about the Iowa Rural Vitality Coalition here.

Follow Wellmark on social media and search the tag #IARuralVitality for ongoing updates.

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