Construction staff and community officials discuss plans for a new store.
Construction staff and community officials discuss plans for a new store.

2017 RWJF Culture of Health Prize Winner

A ‘Scrappy’ Push for Health: ‘Our Best Asset Is Our People’ 

When your county’s population is half what it was a century ago, you may begin to think your best days are behind you.

But despite the shift, the 13,000 residents of Allen County in rural southeastern Kansas are instead experiencing a watershed moment. They are banding together to foster a sense of belonging and to create a shared vision—everything from improving the collective health of the community to enhancing the livelihoods and prospects of everyone.

Allen County is working hard to address problems and devise real solutions. The results are there for everyone to see:

  • A new hospital, two new medical clinics, and better access to health care with a 10 percent uninsured rate, down from 21 percent in 2013
  • Miles of new biking and hiking trails and more ways to live actively.
  • Neighbors helping neighbors and engaging in sometimes-difficult conversations around poverty, hunger and homelessness.

Allen County, Kansas

Banding together to foster a sense of belonging and create a shared vision of health.

“This isn’t a rich place,” says David Toland, CEO of Thrive Allen County, a nonprofit that promotes programs around health and wellness, recreation, education and economic development. “We don’t have natural advantages, but we’re scrappy, we’re resourceful, and our best asset is our people.”

Spread over 505 square miles, Allen County is blanketed with bountiful fields of corn and soybeans, and pasture land for cattle. But veins of poverty run through its small towns, which are 100 miles from the nearest big city. The impact of poverty on the well-being of residents surfaced in the first County Health Rankings in 2010. Allen County placed 94 out of 105 counties in Kansas. “That was a catalyst for us to plant a flag in the sand and say we have a goal of being the healthiest rural county in Kansas,” Toland says.

He sees the Culture of Health Prize as a sign of progress. “When you’re trying to change culture, it’s a generation-long project, and there are so many setbacks along that road,” Toland says. “To have seen our community be recognized in this way, it’s an affirmation of what we’ve all done together.” 

This isn’t a rich place...we don’t have natural advantages, but we’re scrappy, we’re resourceful, and our best asset is our people.

David Toland, CEO, Thrive Allen County

Nurses prep an emergency exam room.

A Paradigm Shift: When ‘Whether’ Becomes ‘How’

David Toland, CEO of Thrive Allen County David Toland is CEO of Thrive Allen County, which promotes access to healthcare, healthy lifestyles, and overall well-being among Allen County residents.

How could Allen County not have a hospital?

That was a real threat in 2010. The hospital in Iola, a relic from 1952, was deteriorating. David Toland, CEO of Thrive Allen County, called it a “slow-motion train wreck.”

“No one was quite sure what to do,” Toland says. As he recalls, people began to realize: “There’s no one who’s going to come in on a white horse and save us; we must and we can do this on our own.”

Whether securing something as basic as a county hospital or access to food, or elevating residents’ quality of life with hiking and biking trails, Allen County has forged new and innovative pathways that are leading toward a Culture of Health.

When the matter was put to a vote, 72 percent of people approved raising the local sales tax by a half percent to cover a $30 million bond issue, the first in the county in 40 years.

“They saw the big picture,” Heard says.

The new Allen County Regional Hospital opened in 2013, with state-of-the-art equipment thanks to another $2.2 million in donations, grants and tax credits. Bolstered, people took that win and parlayed it into more action. Residents petitioned for a new grocery store. On the site of the old hospital, Iola Industries, an economic development group, built 12 apartments in order to convince a grocery chain—G&W Foods—to follow the lead and invest in a new market. “The pride is back,” says Mary Ross, who knocked on 1,000 doors for the supermarket petition.  

Helping the process along is Thrive Allen County, a nonprofit that works as an engine to connect people and turn ideas into reality. In Moran (pop. 500), residents want to convert the town’s sole grocery store, which the retiring owners want to sell, into a food cooperative. Working with the Thrive team, they held a “God, Country and Groceries” rally last July where they recruited 40 members. “We have to succeed,” says Dale Johnson, a pastor from a neighboring town. The nearest place to buy food is the Walmart in Iola, 15 miles away.

Thrive Allen County pushes the message that residents must work with what they have. That’s why it rallied residents to carve a network of biking and hiking trails among 300 underutilized acres around the abandoned Lehigh Portland Cement Plant and quarry. Volunteers with chainsaws cleared 10 miles of paths through dense woods, a chore that took two years to complete.

Everyone chipped in. When the trail-blazers needed a bridge to span a gully, the county government offered an old one. A house mover was hired to move it to the trail. Another business donated old conveyer belts to use as decking.

At first, naysayers thought the trails were a waste of time and money. Now that they see how popular they are, the question is how to add more. “That’s a big paradigm shift,” Toland says. “It shows that we have made it over a huge hurdle as a community from the ‘whether’ to the ‘how’.”

2015 Culture of Health Prize Winner
Community members talking at a neighborhood event.

Kansas City, Missouri—Block by Block

Kansas City is creating a safe, healthy environment for all its residents by addressing what impacts health. Over the past decade, life expectancy improved for all. 

Michael and Kim Boeken walk with their family. Michael and Kim Boeken walk with their family down a section of the Lehigh Portland Rail Trail, developed on a former quarry site on the outskirts of Iola, Kansas.
A poster asking "How's Our Health?" hangs on a building near the town square in downtown Iola, Kansas. A poster asking "How's Our Health?" hangs on a building near the town square in downtown Iola, Kansas.
Kansas residents take a community bike ride. Local Kansas residents take a community bike ride from Humboldt to Iola along the new Southwind Rail Trail.
Young children enjoying lunch at a picnic table.

Fighting Poverty in the Moment and Long-Term

MARV has lots of young friends across Allen County.

Children run for the big white school bus, painted with bright, smiling fruits and vegetables, as soon as they hear its horn. Onboard, they get breakfast or a brown-bag lunch, depending on the hour, and sit in booths to eat or read one of the many books within arm’s reach.

MARV—short for Meals and Reading Vehicle—is the answer to a problem: In the summertime, instead of making children travel somewhere for free meals, the school district brings nutritious food to them.

MARV reflects a growing awareness in Allen County that softening the blows of poverty by cultivating conversations and addressing the long-standing barriers that contribute to generational poverty are both essential ingredients for health equity.

In the Iola school district, one of three in the county, 64 percent of students qualify for free or reduced price meals. Sheryl Hill, a newcomer to Iola, has three children and appreciates the help from the MARV program. “For families like us who sometimes run short on groceries, I know the kids are covered for breakfast and lunch,” Hill says.

In the school system, Iola has a long-term initiative to help families called SAFE BASE. Over the course of six years, the organization worked with three dentists and local service clubs and organizations to screen 5,000 students countywide and to provide follow-up dental treatment to more than 700 Allen County students. The annual health fairs, held in conjunction with school enrollment each August, also provided free physicals, immunizations, eye glasses, head lice treatment and school supplies for local students. “The reason we help one another is the kids are our kids,” says Angela Henry, director of SAFE BASE.

Thrive Allen County began bringing middle-class residents together with lower-income neighbors in “conversation circles” to encourage frank discussion, as well as connections and understanding. Helen Ambler, a retired school district employee, formed a bond with an unemployed younger woman and helped to coach her through a job interview. “When you actually get to know people, to set aside prejudice, we can begin to listen,” she says.

From these community conversations, leaders stepped forward and started to put ideas into action. Some were simple gestures, like covering the cost for a free load of laundry to remove the embarrassment of having to wear soiled clothes, or setting up “Blessing Boxes” stocked with canned goods and household products. Others required advocacy, such as successfully pushing municipal utilities not to turn off service in below-freezing weather.

At the First Presbyterian Church of Iola, volunteers serve free meals on Sundays to keep the conversations going. “People don’t get out of poverty if the only people they know are other poor people,” says the Rev. Linda Whitworth-Reed. “This helps in relationship building.”


2017 Culture of Health Prize Winner
Student petting a chicken in front of a barn at school.

Garrett County, Maryland

In Garrett County, everyone seems to know everyone, and neighbors band together to bridge economic, cultural, and health divides.

Friends dine at a Sunday Soups event at the Presbyterian Church in Iola, Kansas. Leticia Gardner (in blue), Heather Morrison (in gray), and Oriana Mendoza (in black) dine with friends at the Sunday Soups event at the Presbyterian Church in Iola, Kansas.
Ray Maloney standing near scrap material in his junkyard and auto salvage business. Ray Maloney at his junkyard and auto salvage business outside the tiny town of LaHarpe, Kansas.
Spencer and Helen Ambler at home in downtown Iola. Spencer and Helen Ambler at home in downtown Iola.
A community box reads "Take what you need. Leave what you can." A "Blessing Box" in Iola offers free pantry items and a message: "Take what you need. Leave what you can."
Community town hall meeting in a retail store.

The Power of One to Help the Many

Change in Allen County often starts with one person and an idea that spreads.

Take Joe Works. He’s a taciturn business owner whose farm roots in the city of Humboldt date back five generations. When he was young, he worked as a welder. His friend was a painter. One day, while working on a truck bed, they pondered a great mystery: How could they make a trailer hitch that wasn’t always sticking up?

“We got down and drew some pictures on the floor of the shop,” Works explains. Ten minutes later, they came up with an idea for a hitch that could turn over to lay flat when it was not in use. In 1987, their brainstorming became B&W Hitches and the idea took off.

Flash forward to the Great Recession of 2008. Works was faced with the prospect of laying off workers, by then numbering 175. “That was a scary time,” he recalls.

Instead of furloughs, Works retained everyone on the payroll but kept them busy by sending them into Humboldt to do volunteer work. Every church got free repairs. A baseball field got a facelift. Teams of five would go to an employee’s home and do repairs for a day, then hit another home the next day.

Works carried the financial cost of doing this for a year, until orders picked up.

People like Works contribute to a Culture of Health in Allen County by fostering a sense of community and sparking a spirit of volunteerism and engagement, inspiring others in the process. They understand that increasing job opportunities and improving education are the best ways to eliminate economic barriers to health.

In 2013, another business owner in another part of the county heard the story of Joe Works and thought, “If I ever get into the position where I can do something like that, I’m going to do it.”

Ray Maloney got in that position and did something just as big. He owns a sprawling metal scrapyard in La Harpe, a town of 500 and one of the county’s poorest. Maloney will be the first to tell you that school wasn’t his strong suit growing up. So he thought: Why not start a training program to help kids like him who may be struggling in high school?

His goal is to keep jobs and young people in Allen County. “We’re trying to get people to stay here, get the kids back home,” Maloney says.

He floated the idea and people liked it, including the county’s four school districts, as well as three community colleges. But to actually launch the “Regional Rural Technology Center” was like herding cats, Maloney recalls.

Money was an issue. Impatient and determined, Maloney plowed ahead, buying a warehouse from a foreclosed lumber business in La Harpe. He dispatched his crews to convert the building into a teaching space.  

One community college provided a trainer for the construction trades, another for welding and a third will begin online classes for instruction for nurse assistants. Instruction began last fall.

“Allen County and the people have been really good to me,” Maloney says. “That’s why I thought I need to give back a little bit.”


Iola's Elm Creek Community Garden at dawn. Iola's Elm Creek Community Garden at dawn.
Students Christian Jackson (left) and Kiefer Endicott work at the Regional Technology Center. Students Christian Jackson (left) and Kiefer Endicott work at the Regional Technology Center, established by local businessman Ray Maloney. The center won the 2016 Thrive Allen County Award for Community Excellence.

Revitalizing Newark in a Healthy Way

Businesses, government agencies, nonprofits, schools and community groups are joining together to revitalize the long-struggling city of Newark, New Jersey, in ways that promote not only economic growth, but health and wellness.