RENEE MONTAGNE, HOST:
Next we have an unlikely success story. It comes from rural Franklin County, Maine, which has a low-income, aging population, a place where you'd expect health challenges. More than 40 years ago, community leaders launched a grassroots effort to reduce cardiovascular disease, the number-one cause of death in the U.S. And a recent article in the Journal of the American Medical Association found that what they did in Franklin County worked in a big way. Maine Public Radio's Patty Wight reports.
LAURA QUYNN: So a quarter of a cup, can you see where that is?
PATTY WIGHT, BYLINE: At a child care center near the mountains of western Maine, a group of parents huddle around a table armed with measuring cups to make quiche. This is a nutrition class to teach low-income residents how to cook healthy meals on a limited budget. Nutrition counselor Laura Quynn gives tips to those unfamiliar with the measuring cups in their hands.
QUYNN: That's a half. And so this right here would be a quarter; that's half of a half.
WIGHT: The community health system in Franklin County has offered nutrition classes for years. Some isolated residents without transportation do most of their shopping at their local convenience store, so cooking a fresh meal from scratch is a rarity. Becky Booker signed up to learn how to incorporate more vegetables into meals.
BECKY BOOKER: My daughter is very picky about what she eats, and if I can blend it in with food or make it look better, she eats it.
WIGHT: As parents crack eggs for their quiche, their kids build a fruit tower of watermelon, pineapple and grapes. The idea is to get the whole family involved to build healthy habits. This collaborative approach mirrors the philosophy of health care in this community going on 40 years.
SANDY RECORD: I think the uniqueness was to go out to where people were.
WIGHT: Sandy Record is a retired nurse who helped manage Franklin County's early efforts to reduce cardiovascular disease starting in the 1970s. One of their most effective initiatives, she says, sent nurses out in the community to do blood pressure screenings for residents.
RECORD: Where they live, where they worked, where they played, to schools, to worksites, to communities and had one-on-one with each individual over a long period of time. And so there became that trusting relationship.
WIGHT: Doctors distributed walking maps to patients. Schools helped teens quit smoking. These days, a mobile health unit travels to residents who live hours from resources. Jennifer McCormack is executive director of the Healthy Community Coalition of Greater Franklin County.
JENNIFER MCCORMACK: I think that we are going against what the norm is.
WIGHT: These seemingly simple interventions have had remarkable results. According to the Journal of the American Medical Association, Franklin County's efforts led to smoking, hypertension and cholesterol rates that improved between 20 to 30 percent. By 2011, Franklin County was one of 17 in the country identified by the Institute for Healthcare Improvement as having better-than-expected health outcomes.
MCCORMACK: The overall health of individuals should be a lot worse than they actually are.
WIGHT: The nutrition classes, with donated food and space, are a classic example of Franklin County's collaborative approach to health. After taking the class, Erin Robichaud says a certain green vegetable has replaced crackers as a favorite snack for her 5-year-old daughter, Reese.
REESE: They're little round green things.
ERIN ROBICHAUD: Brussel sprouts.
REESE: Brussel sprouts.
(LAUGHTER)
WIGHT: The percent of Franklin County residents living below poverty has nearly doubled since these efforts began. But sustained collaborative health efforts have helped stave off cardiovascular disease in a battle that will likely continue for years to come. For NPR News, I'm Patty Wight. Transcript provided by NPR, Copyright NPR.