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Like many rural communities in the state, the town of Nevada, Missouri is struggling in more ways than one.00000178-cc7d-da8b-a77d-ec7d2f800000Nevada’s adult obesity rate has reached 30 percent; 11 percent of the population has diabetes. In 2012, nearly 20 percent of Nevada’s residents participated in government assistance programs, and in 2010 nearly 40 percent of children were eligible for a free or reduced price lunch. Improving health outcomes in Nevada will take more than convincing a few residents to adopt a healthier lifestyle.00000178-cc7d-da8b-a77d-ec7d2f7f0000According to some health policy experts, an approach that could save Nevada and other rural communities like it is a concept called population health – programs that target the health of an entire community. And now the health technology company Cerner, based in Kansas City, is looking to develop and market a population health model that could successfully improve outcomes in any rural town in America. To do this, Cerner has partnered with the town of Nevada on a new population health experiment it’s calling “Healthy Nevada.”Since 2011, Cerner has been a quiet presence in the Nevada community - supporting public works projects, sponsoring health initiatives and encouraging changes in healthy behavior. But navigating the new partnership hasn’t exactly been easy. Time and again Cerner has been met with resistance by a community slow give up the status quo, which has left some wondering whether Cerner’s investment in Healthy Nevada will have been worth it.KBIA’s Health & Wealth Desk explored Cerner’s population health initiative in a five-part series on Healthy Nevada.

Part 1: A game changer for Nevada

This is the first story in a series from the Health & Wealth desk on Healthy Nevada

Pookie Decocq is the healthy living coordinator for the YMCA in Nevada, Missouri. She’s also the town’s official Pickleball Ambassador, which is a team sport played with two wooden paddles, a whiffleball and a low net, like ping pong or badminton.

Pookie’s dream is to hold a pickleball tournament here in this rural town in southwest Missouri. But the average Nevada resident isn’t exactly the picture of health. Like a lot of small rural towns in the state, Nevada has very high rates of obesity and heart disease. Its diabetes rates are some of the highest in the country at 11 percent.

“We have difficulty with access to healthy foods, healthcare, and transportation,” said Nevada City Manager J.D. Kehrman. “We’ve got very high levels of persistent poverty, generational poverty. That lowers people’s expectations.”

But Nevada is also going through a time of change. Big change. The kind of change meant to shake up the status quo.

In 2010 The Kansas City-based, health technology company Cerner was looking for a city to partner with on a new health project – a kind of experiment. And it chose Nevada as it’s laboratory. They called the project “Healthy Nevada.”

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"There is not a company or corporation in this world that's going to be able to tell a community what they should or shouldn't do"

    

Nevada is a town of about 8,300 people, 90 miles south of Kansas City. It’s got a Walmart, a few parks, a local 2-year college, and a small downtown district. When I asked some kids at the local community center if they’d ever heard of the Healthy Nevada project, they looked at me like I was crazy. And admittedly, I was surprised by this. I expected Cerner’s presence in Nevada to be a huge affair, one accompanied by a clever marketing campaign.

But Erik Gallimore, the Cerner executive in charge of the Healthy Nevada project, says Cerner’s strategy is to remain behind the scenes.

“We're really a catalyst behind this. It’s the community doing this work,” Gallimore said.  “There is not a company or corporation in this world that’s going to be able to tell a community what they should or shouldn’t do.” 

Cerner’s area of expertise is health information technology, but recently they’ve starting investing in R&D projects in the area of population health. In 2005 the company started experimenting with ways to improve the health of its employee population. The next step was to go bigger and work with an entire town.

“You have to go embed yourself at a grassroots level and work with everybody on a lot of different things,” Gallimore said. “I think that’s what moves the meter.”

That grassroots approach involves enlisting the help of important community leaders like Kehrman who could identify what exactly Nevada needed.

"You've got to make a model work here or it's not going to work anywhere"

“You’ve got to make a model work here or it’s not going to work anywhere,” Kehrman said.

But early on in the project the team realized that its message of healthy living wasn’t resonating with Nevada residents. So Gallimore tapped into what people were most concerned about – jobs. They crafted a new message that emphasized a healthy workforce and economic opportunity. It got a huge response, and Cerner learned from the experience.

“People actually resist being told about becoming healthier,” Gallimore said. “You have to make it much simpler than that. Make it small things, make it personal,” he said. 

The Healthy Nevada project is in its third year and is just now beginning to pick up speed. There’s a revitalized farmers market and community garden. And there are plans underway for a new walking trail to be built next to the middle school, and a clinic to help address Nevada’s diabetes problem. Gallimore says Cerner has committed to being in Nevada for five years - possibly longer. It takes time to do things that have never been done before and to make sure the results last long after the company is gone.

“To run in and think you'll do something in a year or two is a mistake,” he said.  

At the end of the day Cerner gets a model it hopes to sell to other communities like Nevada. And for being the ginea pig, Nevada gets a revitalized, sustainable, healthy community. And maybe even a pickleball team.

INSIDEOUT_webextra.mp3
Cerner executive Erik Gallimore talks about the development of Cerner's message for Healthy Nevada.

Katie Hiler is a former reporter for KBIA, who left at the end of 2014.
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