Hickman County CES

County Emphasis:

Stronger Together: Boosting Mental and Physical Health for a Thriving Hickman County

Concentration 1:

Health and Wellbeing

Concentration 2:

Substance Use Prevention and Recovery

Concentration 3:

Mental Health and Well-Being

Concentration 4:

Food Safety, Quality, and Access

Situation:

The opportunities and resources available to support the health and well-being of adults and families in Kentucky vary widely. Disparities in health-promoting knowledge, resources, and infrastructure contribute to higher rates of chronic health conditions and lower quality of life. Prevention, early detection, and care are essential to maintain and/or improve quality of life. Yet, this burden is often placed on individuals to navigate the 

healthcare system and traditional public health entities. Additionally, for decades, little attention has been given to the external factors that undoubtedly affect health such as access to care, education, nutritious foods, and safe physical spaces. 

 

Thriving youth are healthy, productive, and engaged (Arnold, 2024). According to Kentucky Kids Count Database (AECF, 2023) 41% of Kentucky teenagers are obese or overweight. Youth are also experiencing alarming levels of negativity about themselves, their confidence in the future, and their ability to find contentment in life (McKinsey & Company, 2022). 30% of youth are chronically absent (United States Department of Education, 2024). The University of Kentucky Cooperative Extension Service Needs Assessment (2024) identified key priorities issues related to health and wellbeing as need for improved access to mental health and wellbeing resources, reducing youth obesity through nutrition education and/or exercise, minimizing bullying and/or school violence.  

 

Though substance use and substance use disorder have been pressing social problems for decades, the public health burden and consequence associated with substance use has rapidly worsened in recent years. Drug overdoses have surpassed car accidents as the leading cause of accidental death and overdoses have contributed to a reduction in average life expectancy in the US. Much of the substance use-related morbidity and mortality is a result of a persistent treatment gap. Each year, about 90% of people who need treatment for SUD in Kentucky do not receive it. To address this gap in service provision, more community-level programming is required to meet the complex needs of Kentuckians who use drugs. Kentucky youth fare worse than their US counterparts in terms of numerous indicators of drug use and drug-related harm including cigarette and smokeless tobacco use, vaping, alcohol use, and illicit drug use such as opioid and methamphetamine use. Accordingly, the recent University of Kentucky Cooperative Extension Service Needs Assessment (2023) indicated substance use prevention is the primary concern among most Kentucky counties.  

 

More than ever before, people are feeling the burden of stress on their wellbeing. More than 1 in 5 adults in the United States lives with a mental illness; in Kentucky, 43% of adults report signs or symptoms of anxiety or depression across their lifespan. At the same time, suicide is a leading cause of preventable death in Kentucky for individuals aged 10-34, and those over the age of 59. 

Cooperative Extension is poised with the research and evidence-based resources needed to serve as a beacon of hope in times of distress through our ability to help overcome stigma, connect people to care, and amplify the voices of many to advocate for better quality of life for all. 

 

Kentucky’s youth population deserves safe and nurturing environments that foster their growth and wellbeing.  

Unfortunately, mental health challenges affect a significant portion of our youth, with 17% of those aged 6-17 experiencing mental health disorders, according to the National Alliance on Mental Illness (2023), and only 50% receiving treatment. The impact is profound, with one person in the U.S. dying by suicide every 11 minutes, and in Kentucky alone, 800 lives were lost to suicide in 2022. Recognizing the urgency, the Kentucky Cooperative Extension Service’s 2019 and 2023 statewide programming issue surveys highlighted mental health and wellbeing as priority areas. Nationally, 45% of 4-H participants reported high stress in a 2023 survey by 4-H.org. The University of Kentucky Community Needs Assessment (2023) indicates priorities of improve access to mental 

health and wellbeing resources, minimizing bullying and/or school violence, stronger parenting and relationship-building skills, and social, emotional, and/or behavioral education for adults working with youth.  

 

It is proven that people who have access to and consume their daily dietary requirements of fresh fruits and vegetables are less likely to suffer from chronic conditions such as obesity, diabetes and cardiovascular disease and have an increased quality of life. Having the knowledge and skills to prepare or preserve fresh fruits and vegetables presents an additional barrier beyond obtaining fresh food access. 

With the goal of increasing the consumption of fresh fruits and vegetables, the Kentucky Cooperative Extension Service (CES) aims to increase access to fresh food, as well as increase knowledge and awareness of how to select, store, safely prepare, process, and preserve these foods. CES prioritizes statewide partnership development that helps us meet our goals and objectives. The rapidly changing social and economic landscape underscores the need for a healthy, productive, and engaged young people to contribute to a prepared workforce and engaged community to tackle these challenges.  

County Situation:

Hickman County, Kentucky, like many other areas in the state, faces health disparities that contribute to higher rates of chronic health conditions and a lower quality of life. The county's population, estimated at 4,447 in 2023, is predominantly White (88.2%), with notable African American (8.5%) and Hispanic (2.7%) communities. Despite relatively high health insurance coverage (95.3% in 2022), challenges such as adult obesity persist, with 41% of adults aged 18 and older having a body mass index (BMI) of 30 kg/m² or higher. These health disparities are exacerbated by limited access to healthcare, education, nutritious food, and safe physical environments, as highlighted in the 2023 UK Cooperative Extension Community Assessment. The assessment highlighted the need for improved access to healthy food and the development of strategies to reduce youth obesity. The University of Kentucky Cooperative Extension aims to address these gaps through comprehensive health and wellness programs. 

 

In Hickman County, mental health also poses significant challenges, as 43% of adults in Kentucky report symptoms of anxiety or depression. This is reflected in the community’s priorities, with residents seeking improved access to mental health resources. Moreover, the high obesity rate underscores the urgency of addressing youth health concerns, such as childhood obesity and mental health struggles. According to the 2023 UK Cooperative Extension Needs Assessment, top priorities for the county include improving mental health resources, reducing youth obesity, and minimizing bullying and violence. Programs like Kentucky 4-H are playing a crucial role in fostering physical, emotional, and intellectual health among youth by equipping them with essential skills to thrive. 

 

Substance use and mental health issues are pressing public health concerns in Hickman County, as in the rest of Kentucky.  

The county faces a persistent gap in treatment for substance use disorders, with about 90% of individuals requiring treatment not receiving it. This treatment gap, alongside Kentucky's high rates of mental health disorders and suicide, has underscored the need for more community-level programming to meet the complex needs of Kentuckians. Cooperative Extension is well-positioned to address these challenges, providing evidence-based prevention programs and supporting holistic solutions for individuals, including mental health services, substance use prevention, and access to nutritious food. In Hickman County, improving access to healthcare services and reducing obesity and substance use are vital to enhancing the well-being of residents. 

 

Long-Term Outcomes:

• Community environments that equitably support health-promoting behaviors where people live, learn, work, and play 

• Routinely meeting guidelines and recommendations for health behaviors that promote wellness and quality of life 

• Increased number of 4-Hers who pursue employment in the health and wellbeing field. 

• Youth will increase contributions to their communities through applying critical thinking, problem-solving, and effective communication learning in the 4-H Health and Well-Being Core Content Area. 

• Kentucky 4-H members report a reduced number of youth who are considering suicide 

• Family farms become economically viable. 

• Decrease in the number of Kentuckians with chronic health conditions such as diabetes, obesity and cardiovascular disease. 

• More Kentuckians routinely met the guidelines for the consumption of (locally-grown) fresh fruits and vegetables. 

Intermediate Outcomes:

• 4-H members will increase physical activity.? 

• Increased health-promoting behaviors that support family, community, and occupational health and safety 

• Increased and/or strengthened partnerships to address community health or safety issues 

• 4-H members will practice general wellness habits.?? 

• Increase in the number of farmers’ markets and local food retailers that accept one or more food benefits as payment. 

• Improved dietary habits through the consumption of more fruits and vegetables, a variety of proteins, and the number of meals prepared at home. 

• Increased awareness of Extension resources and programs supporting food access. 

• Improved skills related to safe food preparation and food preservation. 

• Increased participation in home-based microprocessing workshops. 

• Increased awareness and accessibility of community resources available to access fresh foods. 

Initial Outcomes:

• Increased knowledge and awareness of healthy habits and practices among 4-Hers.? 

• Improved attitudes and beliefs towards healthy habits and practices among 4-Hers.??? 

• Increased knowledge about health-promoting behaviors. 

• Youth will learn how to make wise nutrition choices.   

• Youth will learn the importance of food safety.   

• Youth learn how to access nutritious foods.   

• Youth will learn how to prepare nutritious foods.   

• Youth will aspire to eat a variety of healthy foods daily. 

Evaluation:

Initial Outcome: Youth will increase knowledge and awareness of health and well-being aspects.

Indicator:

• Number of youth who reported that they have identified an interest in health or wellbeing initiatives in their community.? 

• Number of youth who reported that they understand the importance of habits or choices that promote health and wellbeing.?? 

• Number of youth who reported that they learned ways to be physically active?? 

• Number of youth?who?reported that they learned how physical activity contributes to overall health? 

• Number of youth who reported that they learned how food impacts their overall health.? 

• Number of youth who reported that they have identified at least one job/career in health and wellbeing that fits their interest.?? 

Method: Standard Evaluation for 4-H Health and Wellbeing: Survey  

Timeline: Immediately after program/event?  

Initial Outcome: Increased knowledge of mental health and well-being resources (interpersonal and community-based)  

Indicator: Number of participants who intend to adopt strategies to support or promote mental health and well-being in their community  

Method: Post-participation survey/evaluation results  

Timeline: On-going; Surveys should be administered immediately after a program  

Intermediate Outcome: Increased ability to recognize and respond to a mental health concern  

Indicator: Number of participants who intend to adopt strategies to support or promote mental health and well-being in their community  

Method: Post-participation survey/evaluation results  

Timeline: On-going; Surveys should be administered immediately after a program  

Intermediate Outcome: Increased use of self-care and other coping strategies 

Indicator: Number of participants who adopted self-care strategies to improve their own mental health and well-being.  

Method: Follow-up survey/evaluation results  

Timeline: On-going; Surveys should be administered at least 3-6 months after a program  

Intermediate Outcome: Youth will report using?nutrition as a means to improve their overall health.?

Indicator: 

• Number of youth who reported that they have used knowledge and/or skills learned in health and wellbeing programs to complete a project.??? 

• Number of youth who reported that they have used?nutrition as a way to improve their overall health.?? 

• Number of youth who reported that they have taken steps to pursue gaining more knowledge for a job in health and wellbeing based on their interests.? 

Method: Standard Evaluation for 4-H Health and Wellbeing: Survey  

Timeline: End of Club/Program Year?  

Long-term Outcome: Youth will increase contributions to their communities through applying critical thinking, problem-solving, and effective communication learning in the 4-H Health and Well-Being Core Content Area. 

Indicator: Long-term evaluation will be conducted using the National 4-H Index Study.  

Method: Survey or Interview?  

Timeline: ?1+ years?  

Learning Opportunities:

Audience: Communities  

Project or Activity: Policy, Systems, and Environmental (PSE) Approaches  

Content or Curriculum: Pathways to Wellness, Faithful Families, Story Walks, Shared Space Agreements, parks and trail development, Active Community Toolkit, resources for early case and education settings, food system work (e.g. farmers’ markets, backpack programs, community gardens), SNAP-Ed toolkit, creating and Maintaining Health Coalitions, Arts in Health publications, CEDIK Healthy Communities toolkit  

Inputs: Programmatic materials, paid staff, community partners, volunteers, grant funds, local organizations and community partners, health coalitions, Nutrition Education program, local farms/growers/producers, key stakeholders, elected officials, Department of Transportation, employee health and wellness, schools, etc.?  

Date: Ongoing  

Audience: Families & Individuals  

Project or Activity: Physical Activity  

Content or Curriculum: Publications, Faithful Families, Story Walks, Health and wellness Ambassadors, Shared Space Agreements, Health Coalitions, WIN, Health Partners, Bingocize, Walk Your Way, Families on the Move, County Walking Challenges, Mindfulness Trails, Fit Tips, Hiking for Health  

Inputs: Programmatic materials, paid staff, volunteers, community partners, facilities, health coalitions, healthcare providers, health department, non-profits, schools, company health & wellness, faith-based organizations, Homemakers, community centers, etc.?  

Date: Ongoing  

Audience: Youth  

Project or Activity: Nutrition and Food Preparation  

Content or Curriculum: Wellness in Kentucky, Jump into Food and Fitness, Cooking Camps and Programs, Cookie Camp, 4-H Cooking 101, 201, 301, 401, Fair Project Days,  International Foods  

Inputs: 

• 4-H Family and Consumer Sciences programs in which youth experience a sense of belonging, and developmental relationships, explore their spark, and actively engage in meaningful opportunities.?? 

• Accredited and certified volunteers in 4-H FCS projects.? 

• Kentucky Extension Homemakers Association?? 

• West Ky 4-H Camp.?? 

• Cooperative Extension Educational facilities.?? 

• Utilization of approved research-based curriculum.? 

• Outreach of the Cooperative Extension Land-Grant System.?? 

• Funding from local sources, including the Hickman County 4-H Council 

• Engagement of youth and volunteers in program delivery.? 

• Community Partners: HC School District, KAPS FRYSC, Purchase District Health Dept.  

Date: September 1 – August 30  

Audience: 4-Hers, Extension Professionals, Clientele  

Project or Activity: Youth Strong: Helping Youth and Families in Times of Disaster and Stress (Club/Group/Individual)?  

Content or Curriculum: Youth Strong: Helping Youth and Families in Times of Disaster and Stress Guidebook. Additional resources include Healthy Bodies: Teaching Kids What They Need to Know, Mental Health First Aid, and National Alliance on Mental Illness.  

Inputs: These programs are supported by the research base of the Cooperative Extension Land-grant system, funding from the Kentucky 4-H Foundation, Inc., local, state, and federal sources, grants, and the engagement of volunteers, youth, communities, and external stakeholders such as civic groups. Focus is on Youth who have experienced traumatic experiences or disasters.  

Date: September 1 – August 30  

Audience: Individuals & Farmers  

Project or Activity: Nutrition Education  

Content or Curriculum: Nutrition Education Program, SNAP-Ed toolkit, Publications, Faithful Families, Cook Together Eat Together, Savor the Flavor, Dining with Diabetes, Plate it up! Kentucky Proud, Food as Health Toolkit, Family Mealtime, maternal and child health program materials,?www.planeatmove.com, Super Star Chef, Farm to School, Hunger in Kentucky  

Inputs: Nutrition Education Program, SNAP-Ed toolkit, Publications, Faithful Families, Cook Together Eat Together, Savor the Flavor, Dining with Diabetes, Plate it up! Kentucky Proud, Food as Health Toolkit, Family Mealtime, maternal and child health program materials,?www.planeatmove.com, Super Star Chef, Farm to School, Hunger in Kentucky  

Date: Ongoing  

Evaluation:

Initial Outcome: Youth will increase knowledge and awareness of health and well-being aspects.

Indicator:

• Number of youth who reported that they have identified an interest in health or wellbeing initiatives in their community.? 

• Number of youth who reported that they understand the importance of habits or choices that promote health and wellbeing.?? 

• Number of youth who reported that they learned ways to be physically active?? 

• Number of youth?who?reported that they learned how physical activity contributes to overall health? 

• Number of youth who reported that they learned how food impacts their overall health.? 

• Number of youth who reported that they have identified at least one job/career in health and wellbeing that fits their interest.?? 

Method: Standard Evaluation for 4-H Health and Wellbeing: Survey  

Timeline: Immediately after program/event?  

Initial Outcome: Increased knowledge of mental health and well-being resources (interpersonal and community-based)  

Indicator: Number of participants who intend to adopt strategies to support or promote mental health and well-being in their community  

Method: Post-participation survey/evaluation results  

Timeline: On-going; Surveys should be administered immediately after a program  

Intermediate Outcome: Increased ability to recognize and respond to a mental health concern  

Indicator: Number of participants who intend to adopt strategies to support or promote mental health and well-being in their community  

Method: Post-participation survey/evaluation results  

Timeline: On-going; Surveys should be administered immediately after a program  

Intermediate Outcome: Increased use of self-care and other coping strategies 

Indicator: Number of participants who adopted self-care strategies to improve their own mental health and well-being.  

Method: Follow-up survey/evaluation results  

Timeline: On-going; Surveys should be administered at least 3-6 months after a program  

Intermediate Outcome: Youth will report using?nutrition as a means to improve their overall health.?

Indicator: 

• Number of youth who reported that they have used knowledge and/or skills learned in health and wellbeing programs to complete a project.??? 

• Number of youth who reported that they have used?nutrition as a way to improve their overall health.?? 

• Number of youth who reported that they have taken steps to pursue gaining more knowledge for a job in health and wellbeing based on their interests.? 

Method: Standard Evaluation for 4-H Health and Wellbeing: Survey  

Timeline: End of Club/Program Year?  

Long-term Outcome: Youth will increase contributions to their communities through applying critical thinking, problem-solving, and effective communication learning in the 4-H Health and Well-Being Core Content Area. 

Indicator: Long-term evaluation will be conducted using the National 4-H Index Study.  

Method: Survey or Interview?  

Timeline: ?1+ years?