Health promotion programs have long focused on education about personal health behaviors like tobacco and alcohol use, diet, and physical activity. Health behaviors have an important role in health, but they are not the whole story. The conditions in the environments where people live, work, learn, and play have an even greater influence on one’s quantity and quality of life. These conditions, known as social determinants of health, include social and environmental factors such as housing, access to and quality of health care, education, social support, and income. 

In national rankings, Kentucky currently ranks near the bottom for health behaviors and outcomes and in the lower half for many social, economic, and clinical care factors that influence health. According to the County Health Rankings, Breckinridge County ranks lower in the occurrence for health factors that influence health outcomes than the Kentucky average. Some opportunities to improve the conditions in which people live, learn, work, and play in Breckinridge include food insecurity, high school completion, access to parks and safe outdoor physical activity and unemployment.

In response to the need for programming that supports individuals and where they live, work, learn, and play, the Breckinridge County Extension Service offered Pathways to Wellness in February 2023. Pathways to Wellness bridges other individual-focused health promotion programming with policy, system, and environmental efforts by generating conversations about the complexity of the influence that people and places have on a community’s health. Ten people took part in this series of four interactive lessons. Participants in the program represented Family Resource Centers, the local chamber, public library, detention center, Extension Homemakers and the faith-based community.   Also, a family with limited mobility participated and shared the need for improved accessibility throughout the community.

The goal of Pathways to Wellness is to prompt action to promote a culture of health through increasing knowledge about social determinants of health and increasing beliefs in the ability of individuals and the community to take action to change factors in the environment that promote health for all people. Of those who completed surveys, 86 percent reported increased understanding of examples of social determinants of health. Participants also reported increased understanding of the influence on the conditions of the environments where people live, work, and play have on individual and community health. Participants also reported increased confidence in their or their community’s ability to support changes that make healthy choices easier and accessible in the community. One participant reported that Pathways to Wellness was a great springboard to get community discussion started on how to address health issues.  Another reported that they now see that focusing on policy can make the biggest changes.