An aerial view of a downtown environment with a river running beneath a bridge.
An aerial view of a downtown environment with a river running beneath a bridge.

2019 RWJF Culture of Health Prize Winner

Greenville County, S.C: Progress, and a Healthy Push ‘for All People’

On any given day in Greenville County, S.C., the 22-mile Prisma Health Swamp Rabbit Trail thrums with the sound of spinning bicycle wheels.

Starting at the edge of the Blue Ridge Mountains, the 10-year-old greenway brings cyclists, walkers and runners all the way to the heart of the city and the cascading waters of Falls Park on the Reedy River.

Along the way are markers of progress and rapid change. New riverside hotels. Luxury lofts in old textile mills. Flocks of construction cranes. End-to-end restaurants on Main Street.

Greenville County is having what one resident calls its “wow moment.” The challenge is to make sure it’s wow for everyone.

“In Greenville [County], we’re aware of our shortcomings, which I think is a strength,” says Katy Smith, executive director of the Piedmont Health Foundation, as well as the Greenville Partnership for Philanthropy. 

Greenville County, South Carolina

Greenville County, S.C., is engaging around public transportation, affordable housing, and education to improve the community's health and wellbeing.

As one of the fastest-growing places in the United States, the city of Greenville attracts legions of newcomers, young and old, drawn to its quality of life and jobs with nearby global employers like BMW and Michelin. And yet, Greenville County, with a population of 507,000, including 67,000 in the city of Greenville, is also one of the toughest places in the country to climb out of poverty, according to a study by the Equality of Opportunity Project, conducted by researchers at Harvard, Stanford, and the U.S. Census Bureau. This reality has motivated private and public partners to begin the work of changing through policies and systems the way things are done. A nexus of stakeholders is engaging around such health-impacting issues as better public transportation, more affordable housing, and stronger educational outcomes. 

Pastor Stacey Mills of Mountain View Baptist Church in the historically black neighborhood of Southernside, on the western edge of the city of Greenville, has witnessed its stunning change from a down-and-out mill town to a vibrant destination city for both tourists and job transplants from around the world. 

We know what we need to work on, and we’re trying to do it.

—Katy Smith, executive director, Piedmont Health Foundation and the Greenville Partnership for Philanthropy

“Our role,” he says, “is to make sure that it’s accessible for all people and that we feel at home in the community that we call home.”    

Partners across the county are pooling resources as well as influence. Greenville Partnership for Philanthropy, a five-year-old collaboration of regional grantmakers, leverages its moral and social influence for maximum impact. Greenville Dreams supports resident leadership in neighborhoods with high unemployment and health risks, while LiveWell Greenville partners with churches, workplaces, and schools to set and implement health-improving goals and strategies. 

To help create healthier options, a coalition convinced the tax-averse County Council to approve a 2-percent levy on prepared foods by presenting the economic benefits of expanding the recreation and tourism infrastructure. The tax has since generated $50 million for recreational improvements, including expansion of the Swamp Rabbit Trail into low-income neighborhoods throughout the county and supporting the $70 million Unity Park in a historically segregated neighborhood. Smith says having policies and systems in place to support this recreational infrastructure does more to change behavior than just telling people that walking is healthy for them.

Community partners say the Culture of Health Prize strengthens the collective resolve to face entrenched obstacles and reduce disparities so that the county can be the best for everyone. “We don’t have everything figured out,” says Meghan Barp, president of United Way of Greenville County. “But we see possibility and it’s within reach.”

A sign in Spanish welcomes students to school.

Where Education is About Learning, Life, and Health

For Edward Anderson, the principal of Tanglewood Middle School, the news at the start of the school year was thrilling: Greenville County’s 2019 Teacher of the Year wanted to transfer schools in order to work with him. 

Not only was he gaining a distinguished science teacher, Anderson was reconnecting with someone who made a profound difference in his life. As a 9-year-old, Anderson says he and his mother, then 24, were homeless, bouncing from one relative’s couch to another. But he found refuge in school, where Susan McCoy, then a fourth-grade teacher and now Teacher of the Year, connected him and his mother with help to get them through a rocky time. 

Now as a principal, Anderson is part of a district-wide initiative called OnTrack Greenville that he describes as accomplishing in a purposeful way what his teacher did instinctively to help him. 

“People lined up in my life to help me get where I got in life,” Anderson says. “OnTrack intentionally does that.”

An elementary school principal with his arm around a teacher. Tanglewood Middle School Principal Edward Anderson hugs science teacher Susan McCoy, who taught his fourth-grade class.
Three girls smile while eating together at school. Students eat lunch in the cafeteria at Tanglewood Middle School, which participates in a healthy school lunch program.
A nurse talking with a student during a sports physical. Nurse Holly Bryan meets with student Kanye Fleming for a sports physical at Tanglewood Middle School. Bryan visits several schools as part of an initiative to improve student education and health outcomes.

The OnTrack Greenville initiative is an example of how Greenville County is eliminating barriers in schools in order to increase the odds of students graduating on time. Launched in 2015 by the Greenville School District and United Way, the initiative reflects an awareness in the community of the importance of education to the long-term health of children. 

The OnTrack initiative takes a multitiered approach to improving educational outcomes. Schools employ a data-based early warning and response system that attempts to identify students who are beginning to disengage. Faculty and staff are trained to deal with students facing trauma such as homelessness, divorce, abuse, neglect or hunger, and counselors work to bring support to families. 

As part of OnTrack, the district and Prisma Health System have added school-based health clinics at four middle schools and one high school. Change is also happening in the lunch line. Cafeterias serving 78,000 children in public schools, too, have overhauled their offerings to ensure daily servings of fresh fruits and vegetables as well as more protein-rich selections prepared from scratch with locally sourced ingredients. 

School-based clinics have allowed students to miss fewer days of school and expanded access to clinical care by offering such services as vaccinations at the start of the school year and, for those who want to participate in sports, health physicals. With medical staff able to provide evaluations and begin treatment, 97 percent of students return to class, says Kerry Sease, medical director of Community Child Health and Advocacy, which runs the school clinic program. “If a student has no need to leave school, then the parent doesn’t have to leave work, and can be more economically productive on the job,” Sease says. 

The OnTrack initiative was started in four schools, including Tanglewood, which is located in one of the highest poverty areas of the county. Elements of the program now are being offered at all schools, with funding from local philanthropies replacing an original three-year federal grant to start the program. 

Since its introduction, the OnTrack initiative has influenced how schools deal with children experiencing a high level of trauma. “It’s actually changing behavior, systems and structures,” says Meghan Barp, president of United Way Greenville. “It’s understanding where kids and families are coming from, what’s happening within that time outside of school that is showing up when they are in school.”

An OnTrack team including Anderson and teachers, as well as a nurse practitioner and family counselors, meets weekly to discuss students who are flagged for behavior, attendance or course performance. They go over possible interventions or how parents should be involved. Help could take many forms from referrals to community services or something as simple as showing students how to effectively advocate for themselves. “Our teen leadership course provides students with confidence and an ability to speak up and self-advocate and be agents for themselves and for their communities,” Anderson says.

Last year, the school saw a 40-percent drop in disciplinary referrals among seventh-grade students.

Without his fourth-grade safety net, Anderson says he could have easily dropped out of school. Adverse experiences can impact the direction of students both psychologically and physically, he adds. “All those things impact us in a way that changes our trajectory if we don’t do something about it.”  

Now as a principal, he says his goal is to give students their own tools for positive behavior. “The school district really sees what needs to happen,” Anderson says, “to make sure that our kids are prepared for what’s next.” 

2016 Culture of Health Prize Winner
Two children holding guinea pigs in their classroom.

24:1 Community, Missouri

This suburban community’s long-term goal is great schools for its children. 

The school district really sees what needs to happen to make sure that our kids are prepared for what’s next.

—Edward Anderson, principal, Tanglewood Middle School

A mural, featuring children's faces, decorates a wall of a small brick building.

How Inclusion is Lifting Up People’s Futures—and the Economy

In a workshop jammed with rows of old wood salvaged from barns and cottages, workers turn discarded planks and beams into high-end furniture like farmhouse tables or barn-style sliding doors. 

The motto of the workshop is “reclaiming wood, reclaiming lives,” and the idea for it can be traced back to the days when Jerry Blassingame was serving a 20-year sentence in state prison. What future was there for people like him? “There was nothing,” Blassingame concluded.

Paroled in 1999, the now-52-year-old earned money through recycling and grew that enterprise into a nonprofit called Soteria — Greek for salvation. Today, it helps formerly incarcerated people with temporary housing, life skills and job training. “It’s hard to climb the economic mobility ladder if you don’t have access to jobs and good housing,” he says.

People in Greenville County, both those who grew up here and those new to town, talk about shaping a new narrative, saying this is who we are, what we’re about, and who we want to be. And just as places can change and adapt, people can too.

A woodworker concentrates on a task in a wood shop. Jerry Blassingame, founder of Soteria Community Development Corporation, works on a reclaimed wood project. The corporation provides work, training, and transitional housing for formerly incarcerated individuals.
Bicyclists riding through a town. Members of the Momentum Bike Club ride through downtown Greenville, S.C., on the Swamp Rabbit Trail.
Sarai Bautista, a member of Upstate DREAMers, has been working for greater engagement in Greenville's Hispanic community. Sarai Bautista helped found Upstate Dreamers, an organization for immigrant youth.

In Greenville County, you meet people like Blassingame, who has worked with 5,000 men and women, only four percent of whom go on to commit repeat offenses. And David Taylor, a former pastor who started the Momentum Bike clubs to engage disconnected youth around cycling and provide mentoring and social support. And Sarai Bautista, a founding member of Upstate Dreamers, which opened the door for DACA recipients—those immigrant youth with federal protection from deportation—to bring their experiences and stories to centers of power and influence in the region. They have shared their personal experiences with the county’s school board and Chamber of Commerce, as well as legislators in the state capital as well as Washington, D.C.

These are some of the leaders working to create an environment of inclusion, shifting policies, building connections, and strengthening communities. “It’s just so important because it recognizes us as people who matter,” the 28-year-old Bautista says of her work with Upstate Dreamers. “Right now, our biggest challenge to living healthy is to live without fear.”

For Stephanie Morales, 15, the Momentum Bike Club is like family. “You can go to anyone here, you can talk about anything, and they will give you advice and confidence,” the 15-year-old high school junior says. 

At Soteria, Wallace Justice, 47, says he left prison five years ago “scared to death” about what came next. Now, he works full-time at the workshop training others and owns a house, pays his bills, and even has enough money left over to help out his mother in West Virginia. “My health, my mental health, my stress level,” he says, “It’s helped me all around.”

Blassingame recognizes how having a job is essential to anyone’s well-being, and how a criminal record can be an automatic roadblock. With state legislators, he advocated for expunging the records for men and women with non-violent felonies like drug charges, and found an ally in the Greenville Chamber of Commerce. The passing of a state-wide expungement law in 2018 immediately gave more than 70,000 people a better chance to find jobs to support themselves and their families, says Carlos Phillips, the chamber’s president. He adds that there are 20,000 job vacancies in Greenville County, with many in the growing hospitality industry. 

“Now, more people have the opportunity to find work, take care of their family, achieve their career goals,” says Phillips.

“It helps society,” Blassingame adds, “to see that people can change.”

2017 Culture of Health Prize Winner
Community town hall meeting in a retail store.

Allen County, Kansas

Change in this rural county often starts with one person and an idea that spreads.

Right now, our biggest challenge to living healthy is to live without fear.

—Sarai Bautista, founding member,  Upstate Dreamers

Stratham Apartments, situated across the street from Soteria Community Development Corporation, is an affordable housing complex partially funded by the Greenville Housing Fund.

Determination and Dignity to Bridge County’s Historic Divide

Yvonne Reeder seems to know the history of every inch of land in Nicholtown, a predominantly African American neighborhood in the city of Greenville where she has lived her entire life. 

At a shaded plot, she points out where Elisha Green, a Revolutionary War veteran and plantation owner, was buried with his family and, as a historic marker indicates, his slaves. 

She explains the story behind an empty block that once housed a grocery store, dry cleaner, barber, soda shop and laundromat — buildings that were purchased, then demolished by the city at the neighborhood’s urging when they became a hub of drug activity. Today is a different story. Land values in Nicholtown are rising because of its location, just two miles from downtown bistros and boutiques on Main Street. But as property values rise, taxes are certain to follow, which could burden longtime residents who are “already struggling to survive,” Reeder says. 

For all of Greenville’s success, there is an undercurrent of anxiety that the economic revival that invigorated downtown is not lifting all parts of the county equally. The Greenville of microbreweries and half-million-dollar riverside condos is a world away — and yet only a stone’s throw — from some of the racially and economically segregated neighborhoods in the county.

To give everyone the opportunity to live a better life, the city and county of Greenville are taking the first steps to tackle intractable problems that hold some people back, like limited public transportation and the negative effects of gentrification.

With extensive input from riders, as well as a 2015 study of mobility funded by local philanthropy, the “Greenlink” transit system is expanding services for the first time in more than 40 years to improve the ability of people to get to jobs, including more transfer stops outside of downtown. “Good mass transit is critical to the growth of our area, to our city, and to helping support economic prosperity for all residents,” says Inez Morris, a member of the West Greenville Neighborhood Association and vice chair of board of Greenville Transit Authority.  

Yvonne Reeder is a community activist and former president of the Nicholtown neighborhood association. Nicholtown is one of Greenville's special emphasis neighborhoods, and is experiencing rapid gentrification because of its proximity to downtown. Community activist Yvonne Reeder in Nicholtown, a predominantly African American Greenville neighborhood where she has lived her entire life.
Wheelchair accessibility is in use after a bus ride. Greenville County resident Rhonda Herrington is wheeled off the bus by her daughter, Holly Herrington, as they ride the county’s Greenlink transit on a Wednesday morning.
A sign marks a plot of land near the Unity Park site that the City of Greenville will develop into affordable housing. Property values around the park, which has just begun construction, have increased since the announcement of the project, creating fears that long-time residents will be unable to remain in the area. Greenville is converting 60 acres that used to house a prison, two landfills and a garbage-truck depot into the $70 million Unity Park, with eight acres set aside for affordable housing.


Meanwhile, the Greenville Housing Fund was launched in 2018, and with $2 million in support from the city government and local funders, will provide seed financing for developers to create more affordable housing across the county. According to a 2018 study, Greenville County has a shortage of 9,500 units of housing for households earning less than $20,000 a year. City and county governments are setting aside property for future development in lower-income areas most at risk of gentrification, while Greenville County has reduced permitting fees for affordable housing. 

One of those places is on the city’s western edge in the historically black neighborhood of Southernside, where Greenville is converting 60 acres that used to house a prison, two landfills and a garbage-truck depot into the $70 million Unity Park. Anticipating the inevitable gentrification that such a sizeable public investment might bring, the city has set aside eight acres on the park’s north side as “a beachhead of affordable housing,” says Mayor Knox White. “We’re trying to get a good balance.” 

Balance is also on the minds of the members of the Mountain View Baptist Church, a 111-year-old congregation just on the other side of the train tracks. African American residents near the proposed park do not want the broader community to forget the history of the neighborhood. Because of segregation, baseball players in the Negro League were only allowed to play at Mayberry Park, a playground and baseball diamond built in 1927 that will remain as part of Unity Park. “We have to capture the history and remind visitors who may come to this park who have no idea what ground they’re standing on, that there was a community that lived here,” says the Rev. Stacey Mills of Mountain View Baptist.

A boy hula hoops during a block party.

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.

Good mass transit is critical to the growth of our area, to our city, and to helping support economic prosperity for all residents.

— Inez Morris, West Greenville Neighborhood Association member and vice chair, Greenville Transit Authority Board

With the inevitable wave of new development that will come with Unity Park, the Mountain View community wants to influence the type of housing that is built in their neighborhood. Two decades ago, when church members thought they might have to build a more modern facility, they began acquiring available lots nearby. While they no longer see a need for a new building, the congregation owns about five acres of vacant land and would like to see it transformed into homes for people with modest incomes and also a community center. 

Mills says this is a matter of equity and being able to share the fruits of prosperity, starting with a home you can afford in a place you want to live. “Housing is critically important to the dignity of a community,” he says. “And it’s our responsibility to return that dignity to the community in any way that we possibly can.”