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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 2: In Nevada, healthy change starts with 'bleeps' and 'bloops'

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

The town of Nevada, in southwest Missouri, is changing in very subtle ways. To see it you really need to know where to look. For example, Walton Park, on Atlantic Street, used to be one of the town’s less popular parks for kids – just a small slide, a merry-go-round, and two swings. But today Walton Park is where all the cool six-year-olds go, thanks to one new piece of playground equipment.  

“I feel like this was strategically placed right here because this is an area where we need improvement,” says Kelly Ast, a Nevada mother of two. Ast taps the dark blue orb that’s sitting on top of one of five aluminum rods protruding from the earth like a piece of sculpture, and the equipment shudders to life with bleeps and bloops.

“You’ve got to keep slapping it and stay up with it. And so they run back and forth,” Ast said. “I know this may look simple but this is [my kids’] favorite park right now. We never came to this park.”

"I'm never going to leave, my investment is in the dirt of this county"

Ast is also a community coordinator working with a team of people from Cerner, the $3 billion Kansas City-based health technology company that is trying to develop a model for improving the health of an entire population of people. And the company is trying it first in this small rural community, with a project it’s calling “Healthy Nevada.”

• • •

When Cerner came to Nevada in 2011 with the radical idea of improving the health of an entire community, the organizers knew they were going to need some help on the inside.


“I got a phone call from an early coordinator,” Ast said. “I thought, ‘I really don’t need to do this.’ They just said, ‘Come in and talk.’”

As a cattle farmer’s wife, Ast was tapped to reinvigorate the town’s small farmers market and start a community garden. Vegetables from the garden and several farms up north now provide produce for cooking classes and Nevada’s community outreach program, which serves the towns WIC members and EBT SNAP card holders, which make up roughly 15 percent of the population.

Ast became inspired by what Nevada – a town with diabetes and obesity rates in the bottom third of the state – could one day be.

“I guess I was passionate because I’m never going to leave, my investment is in the dirt of this county,” Ast said. “I think our schools are strong, but if you look at job potential…it’s a little iffy.”

Job potential is actually a big part of the Healthy Nevada message. Early on Cerner polled Nevada residents on how they perceive their health. The team found religion and family were the two most important things to both low and middle-income groups.

"Could you be motivated enough to want to live a healthier lifestyle for your family?"

“It’s not so much about your look or what you’re eating. It’s about could you be motivated enough to want to live a healthier lifestyle for your family?” Ast said. “And when you’re talking about family you’re talking about culture, and when you talk about culture you’re talking about jobs and economic development.”

As Cerner works to develop its model for population health, one thing is certain – it won’t be based on sweeping reforms or expensive initiatives. No, so far Healthy Nevada has been defined by small victories, like a new piece of playground equipment, or getting six year olds to silly dance their way from the school bus to the classroom.

“They turn up the stereos and with the teachers and the principal, they silly dance to their classes,” Ast said. “That was never there before. The PTO had just bought a huge big screen TV for them to sit in the cafeteria and watch TV before school.”

And all this cost Cerner essentially nothing. To help get the community garden off the ground, Cerner put up the money for a tent and a tablecloth and covered Ast’s copying expenses.

“It’s not like we had these big huge grants for $10,000 or $20,000,” Ast said. “No, it was nothing like that.”

And this was Cerner’s plan all along – to get people like Ast thinking about the potential of their community and to make progress toward the goal of a reinvigorated Nevada, one piece of playground equipment at a time.

Nevada resident Kelly Ast talks about what makes the Healthy Nevada project sustainable.

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