Coal bins are moved along train tracks in Williamson, West Virginia

2014 RWJF Culture of Health Prize Winner

Big Impact on Few Resources

Say “Williamson, West Virginia” to a crowd and you’re likely to get no more than a few curious facial expressions. Say “the Hatfields and the McCoys” and most everyone will know exactly who you’re talking about.

Resting against the state’s Kentucky border in the heart of coal country, Williamson was home to a feud so famous that it’s now synonymous with the entire concept of feuding—which makes it ironic that a town best known for quarreling has spent the past several years coming together in a shared mission to build a Culture of Health. And in many ways that drive—that sense of community responsibility—has its roots in the industry that once powered the region: Coal. As reliance on coal has declined, however, the corresponding economic decline has also had devastating effects on the people’s health.

A Shared History, A Sustainable Solution

“Coal has been such a large part of our community. It’s a heritage that many generations have passed on from father to son, grandfather to son to grandson,” said Dino Beckett, DO, CEO of the Williamson Health and Wellness Center and Board Chair of Williamson Redevelopment Authority. “We’re very proud of that heritage, but we have to discover other opportunities so that we can still raise our families here and have that ability to live here.”

Fortunately for Williamson, their resources as a coal community can also be reimagined to support and build a healthier community.

“You have coal miners and engineers that can take items, reconstruct them, and build these massive pieces of equipment that can do amazing things,” said Beckett. Williamson’s efforts capitalize on that spirit of ingenuity to create better health outcomes. “Once they identify the disadvantages they have and we give them the tools, they’re able to take control of their destiny and improve their health and wellbeing.”

Panoramic view of a riverside town.

A Culture of Health in the Heart of Appalachia

Sustainability, access to care and community camaraderie are driving significant health improvements in the coal town of Williamson, W.V.

Williamson leads West Virginia in categories such as obesity, hypertension and diabetes—and that’s in a state that on the whole usually ranks among the worst in those categories. They’re working hard to empower their residents to turn that around—through everything from health behaviors to entrepreneurism. The catalytic force behind this has been a collaborative effort called Sustainable Williamson.

“We were working on tourism, we were working on healthy foods, we were working on better housing—these were all being addressed, but they were being addressed independently,” said Beckett. Williamson was able to pool its many distinct efforts together to work toward the same goal under the Sustainable Williamson umbrella.

Now a walk through Williamson will expose you to sites unimaginable five years ago, according to Beckett: People running actively, whether in a half-marathon or for the first time in one of Williamson’s monthly 5ks; families taking their children to the Farmer’s Market; and people who once didn’t have the ability to farm or garden, but are now a part of their community garden — stories all captured on the community’s website.

“You’re able to see a lot of people that have empowered themselves to identify the problems that they have—whether it be obesity or diabetes—and then what they’ve been able to do is take the tools that the community has given them to work on addressing those issues,” said Beckett.

Health and Wellness

The Health and Wellness Center started as a simple idea. The economic downturn that affected people across the country also underscored the entrenched health disparities that had plagued Williamson for more than a generation, since the coal industry began to wane. Beckett saw an increasing number of residents who were unemployed or without insurance, so they couldn’t afford to go to the doctor’s office. On Good Friday of 2011 they started a free clinic.

“We didn’t ask them for any money—they came for services,” he said. “We helped them with trying to get medications at a discounted rate or even free from some programs.”

The clinic grew quickly.

What emerged was the Williamson Health and Wellness Center, which was designated as a Federally Qualified Health Center in the fall of 2013. Veteran coal miners, putting in the same dedicated work ethic they honed in the mines, built the center in 90 days, retrofitting a historic building with energy efficient design.

The clinic now serves all of Mingo County and Pike County, Kentucky. One priority is targeting the diabetes epidemic through a comprehensive program that includes identifying and screening those at risk, providing comprehensive clinical care, and deploying community health workers who follow up with patients at home arming them with self-management skills while also addressing social and economic needs. Patients who went through this program experienced a drop in hemoglobin A1c levels by 2.2 percent. “That’s huge,” said Beckett. “If you were a drug manufacturer and you were able to drop [A1c levels] by just 0.6 percent, you would have a billion-dollar drug.”


Williamson Wellness Dr. Donovan “Dino” Beckett consults with his wife, Stacy, at his practice in the Williamson Health and Wellness Center.


Selim Sandoval Speaks Selim Sandoval speaks to locals about the importance of the Health Innovation Hub in their community.
Williamson Food Prep Entrepreneur and caterer Debbie Young prepares food at the Williamson Health and Wellness Center.


Community Garden The Entrepreneurship for the Public Good Program at Berea College creates a multi-year, learning experience for undergraduate students.


Joe Ramella Community Garden Local residents plant edibles at the Joe Remella Community Garden.

Health Innovation Through Entrepreneurism

The Health Innovation Hub is a Williamson event that gives local entrepreneurs the opportunity to present their ideas about new businesses and healthy enterprises to the community, and introduces them to experts who are able to help them develop their plans.

One notable Williamson entrepreneur is Debbie Young, a caterer who will soon be opening a healthy restaurant in town.

“Debbie was able to identify a large need in the community,” said Beckett. “We have many restaurants, many fast food restaurants, but there weren’t a lot of healthy restaurants for our citizens. So Debbie...was able to put a lot of healthy recipes together and then start her enterprise as a healthy restaurant.”

Other entrepreneurial initiatives capitalize on the area’s rich history—some with a focus on cultural tourism based on the Hatfield-McCoy legend, and others tapping into the region’s historic position as a leader in meeting energy demands. On the cultural tourism side, a lodging and campground service has recently opened outside of town, the Hatfield-McCoy Trails will soon also welcome mountain bikers and walkers, and a local man has launched the Hatfield-McCoy Guided Tours. And while Williamson was once known for driving the coal industry, it’s now becoming a leader in sustainable, environmentally-friendly energy sources. As the energy sector diversifies in West Virginia, one local business, Gilliam Solar, is preparing displaced workers with sustainable technology skills.

Community Garden

The community garden began with simply creating plots that were accessible to everyone in the community. Its central location meant people could easily walk across the street and be an active member of the community—and an active member of making the community healthier. The idea has since blossomed into 42 plots.

“The participation has just been very high,” he said. “The previous year we only had 24 plots and those went rather quickly, so we doubled our size. Still the demand has been very high and we’ve had to turn people away. So we’re looking at housing more plots to allow people to carry on that gardening.”

Beckett said the community garden has served a multitude of purposes. People are connecting with their neighbors and learning to enjoy gardening, and many are also selling what they’ve grown at the Farmers Market.

“The community garden has been a way to empower our residents to take a product that they’ve grown and use it to develop their skills as an entrepreneur by designing market development directly into the garden’s design,” said Beckett.

I’m very optimistic about the direction that Williamson is heading. We have many obstacles to overcome, but we take those challenges on daily and we’ve been able to address them and push forward. 

Dino Beckett, DO, CEO of the Williamson Health and Wellness Center and Board Chair of Williamson Redevelopment Authority

Making the Most of Few Resources

Beckett said perhaps the most important lesson they’ve learned—and the most important lesson other communities can take from Williamson’s successes—is that they were able to accomplish all this with very little money. “Call it sustainability or call it market-driven development, the end result is always the same; by linking health and innovation we ensure the long-term resilience of our community.” These are replicable efforts that other communities can adopt and then adapt to fit their particular needs. Being such strong stewards of the resources they have offers the community great hope for the future.

“I’m very optimistic about the direction that Williamson is heading,” he said. “We have many obstacles to overcome, but we take those challenges on daily and we’ve been able to address them and push forward and then the overall goal is being achieved. So the ability of Williamson to turn the page and move the needle and become a healthy community—and a community that’s going to be looked upon as an example for other communities to look to for guidance and ideas—is very strong.”

Culture of Health Prize 2015 - Everett. COH website.
,Culture of Health Prize 2015 - Everett. COH website.

The Culture of Health Prize

The Prize honors and elevates U.S. communities working at the forefront of advancing health, opportunity, and equity for all.