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, Boyd County ranks in the lower middle range for health factors in Kentucky. Some of the strengths in Boyd County include 93% high school graduation rates, 68% of people owning their own homes, and 85% having access to Broadband Access. Some opportunities to improve the conditions in which people live, learn, work, and play in Boyd County unemployment, with 6.2% is higher than in the state, 27% of children live in poverty compared to 21% for the state and 35% of deaths occur due to alcohol-impairment while driving compared to 25% for the state.

In response to the need for programming that supports individuals and where they live, work, learn, and play, the Boyd County Extension Service offered Pathways to Wellness in May-June 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. 5 people took part in this series of four interactive lessons and a web-based platform to support continued learning, engagement, and action between lessons. Participants in the program represented older woman who tend to volunteer and are actively involved with their communities.  

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, 100 percent reported increased understanding of examples of social determinants of health. Participants also reported increased understanding of the influence the conditions of the environments where people live, work, and play have on individual (95 percent) and community (80 percent) health. Participants also reported confidence in their (100 percent) or their community’s (85 percent) ability to support changes that make healthy choices easier and accessible in the community.