Community Context and Challenges

  • After the Civil War, the local economy began to suffer due to a lack of diversification and manufacturing capability; by the start of the 21st century many major companies began departing or shutting down their plants, sparking severe economic disruption.

  • Adams County residents experience higher rates of infant mortality, smoking, obesity, and diabetes than the nation as a whole, with black residents disproportionately affected.

  • Among Adams County children, 86% are eligible for a free lunch and 24% of black residents receive food stamps, compared with less than 4% of white residents.

  • Just 80% of Adams County residents have health insurance, compared with 85% nationally, in part due to the state’s decision not to expand Medicaid under the Affordable Care Act.

  • The county faces severe shortages of primary care, dental, and mental health providers.

Community Actions: A First Look

Across Adams County, individuals and organizations are actively focused on creating a healthier future.

Though still young, local, state, and national initiatives are designed to create jobs, improve built environments, and meet high priority community needs. Although many initiatives share common values and objectives, they do not appear to be working in close collaboration or coordinating efforts to maximize overall reach and impact.


These baseline reports, created in 2016, track community programs and initiatives in their early stages and measure initial progress only. Future reports will provide more in-depth insights and analysis into this community's efforts to build a Culture of Health.

Going Forward: Questions for Consideration

Individuals, groups, and corporations in Adams County are taking steps to revitalize the social and economic environment, which are key drivers of health inequities. Additional surveillance, data and information gathering, analysis, and reporting will examine how the initiatives are coordinating their efforts with each other and assess the impact of these initiatives on increasing employment, decreasing poverty, and improving health outcomes, particularly among black residents.

The following questions could provide insights into the degree to which meaningful change is taking place and can be sustained:

  • How are the various initiatives communicating and collaborating with each other and the people they aim to serve, and how are underserved groups involved in decision making?
  • Which initiatives are addressing health inequities that disproportionately affect black residents? How is success being measured?
  • In what ways have grassroots accomplishments, such as Natchez, Inc. and Natchez Trails, improved the social, economic, and health-related environments?
  • What evidence exists to demonstrate effects of the Natchez Trails Initiative or other initiatives on the decrease in residents’ physical inactivity that occurred between 2011 and 2016?
  • Have public projects to increase access to physical activity through park facilities and trails had a measurable, equitable impact?
  • How is Adams County measuring the impact of completed and ongoing initiatives to create jobs and change the environment to support healthy behaviors?
  • What evidence is there that the initiatives are equitably improving the health and well-being of Adams County residents? For instance, what are the trends in employment and obesity prevalence among white and black residents? Are any of the gaps narrowing?
  • How is Adams County sustaining or expanding the local and national initiatives, particularly given the community’s serious economic challenges?