Transylvania County’s top two causes of death and many of our morbidity statistics of concern including obesity, type 2 diabetes, high blood pressure, heart disease, certain cancers, and stroke are directly affected by nutrition and physical activity. Residents report having trouble accessing healthy food and getting the recommended amount of physical activity.

How would we experience lifelong physical, emotional, and social well-being of all residents in Transylvania County?

Community members said that we could experience the following conditions:

• Access to natural world
• Less chronic disease
• Less substance use
• Access to affordable healthy food
• Active lifestyles
• Systems that support physical activity e.g. infrastructure, sidewalks, paths
• Sense of community engagement
• Less social isolation
• Healthy social experiences
• Education and ability to make good choices
• Fewer unintentional deaths
• Supports to age in place e.g. fall prevention
• Transportation / better public transit
• Participation in youth sports
• Protected natural resources
• Employer support for healthy lifestyle
• Promoted resiliency
• Importance of vaccines understood
• Education in schools
• Experiential education and opportunities across the lifespan
• Year-round options for physical activity
• Affordable options / sliding scales
• More pools
• Life skills training
• People know how to access information
• Living wage jobs
• Access to basic healthcare
• Alternative treatments
• Prevention options
• Celebration of diversity in race, ethnicity, religion, etc.
• Intentional and collaborative efforts

What information led to the selection of this health issue and related result?

Many county residents are overweight or obese, which is connected to multiple poor health outcomes including diabetes. Residents are not meeting recommendations for nutrition and physical activity, and many residents experience regular stress and other barriers, all of which contribute to obesity. It was the #1 top concern among key informants and was selected as a health priority in 2015.

Diabetes is related to obesity, physical activity, and nutrition, and rates are increasing. It was named as a top community concern by key informants. Key informants also identified heart disease/stroke as a top community concern, and it, too, is closely related to body weight and physical activity. A large proportion of Transylvania County’s population is affected by high blood pressure and stroke, and cardiovascular disease is a leading cause of death and hospitalization. Cancer was the leading cause of death in Transylvania County. Incidence can be related to ACEs, behaviors like alcohol and tobacco use, and environmental causes like radon, but cancer is also linked to overweight and obesity. 

According to the US Office of Disease Prevention and Health Promotion, "Good nutrition, physical activity, and a healthy body weight are essential parts of a person’s overall health and well-being. Together, these can help decrease a person’s risk of developing serious health conditions, such as high blood pressure, high cholesterol, diabetes, heart disease, stroke, and cancer. A healthful diet, regular physical activity, and achieving and maintaining a healthy weight also are paramount to managing health conditions so they do not worsen over time."1 Within Transylvania County, individuals with low incomes or who work long hours; those without stable, adequate, and affordable housing with adequate kitchen facilities; those who may be far from grocery stores and infrastructure for physical activity due to geography and lack of transportation; and those who must travel long distances to and from work are less likely to have the time, desire, and opportunity to prepare and cook nutritious meals and spend leisure time being physically active. In addition, people who are overweight or obese, those who do not eat the recommended amount of fruits and vegetables, and those who do not participate in the recommended amount of physical activity are at-risk for poor health outcomes including diabetes, stroke, high blood pressure, and high blood cholesterol.

Healthy Lifestyle and the related conditions of well-being are aligned with the following Healthy NC 2020 Focus Areas. 

• Physical Activity and Nutrition: "Overweight and obesity pose significant health concerns for both children and adults. Excess weight increases an individual’s risk of developing type 2 diabetes, high blood pressure, heart disease, certain cancers, and stroke.39 For the first time in two centuries, the life expectancy of children in the United States is predicted to be lower than that of their parents. The root cause of this phenomenon is the increase in obesity.40 Increased physical activity and improved nutrition are among the many factors that can help individuals reach and maintain a healthy weight." (North Carolina Institute of Medicine. Healthy North Carolina 2020: A Better State of Health. Morrisville, NC: North Carolina Institute of Medicine; 2011.)
  • Objective 1. Increase the percentage of high school students who are neither overweight nor obese.
  • Objective 2. Increase the percentage of adults getting the recommended amount of physical activity.
  • Objective 3. Increase the percentage of adults who consume five or more servings of fruits and vegetables per day.