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Collective Impact: Muskegon County is on its Way to Wellville

[Editor’s note: the following is an article from the Winter 2015 edition of the MAFP Magazine Michigan Family Physician]

Muskegon County is on its Way to Wellville by Dana Lawrence, Director of Communications & Member Outreach ([email protected])

Dr. Ramona Wallace being interviewed for a documentary on expanding access to healthy food. Dr. Wallace is active in Muskegon County’s collective impact initiatives.
Dr. Ramona Wallace, takes time out of a busy day to be interviewed for a Michigan Healthy Food Access documentary on expanding access to healthy food. Dr. Wallace is active in Muskegon County’s collective impact initiatives – ‘1 in 21’ and ‘Way to Wellville.’ You can watch the documentary at

There is a growing body of evidence around the significant impact social determinants have on health outcomes, and in a community where smoking, obesity, and physical inactivity are prevalent; access to nutritious foods is a challenge; and the need for social and emotional supports exceeds resources, an innovative “all-in” approach for improving health behaviors, health outcomes, and quality of life is making a difference.

1 in 21: Collective Impact

An expansive cohort of partners in Muskegon County—encompassing the cities of Muskegon, Muskegon Heights, Roosevelt Park, Norton Shores and North Muskegon—is working tirelessly, creatively, and collectively toward achieving its ‘1 in 21’ vision of Muskegon County being the healthiest county in Michigan by 2021. Chosen by the Health Initiative Coordinating Council (HICCup; now Wellville) in 2014 as a “Wellville 5” community, Muskegon County is now steps closer to making that vision a reality.

“The resources that Muskegon County is receiving from HICCup and its partners through the national ‘Way to Wellville’ challenge are already helping to move the needle on our ‘1 in 21’ initiative,” said Ramona Wallace, DO, a MAFP member who lives in Norton Shores and practices in Muskegon.

Dr. Wallace has been a catalyst in Public Health-Muskegon County’s ‘1 in 21’ campaign, having served on the healthcare committee since its inception.

Collaborating to improve health rankings

Under the leadership of the local Rotary Club, ‘1 in 21’ launched in 2011 after the need for drastic change became highly evident with the release of the Robert Wood Johnson Foundation’s (RWJF) county health rankings. Each year, the RWJF compares counties’ health behaviors, factors, and outcomes that, if improved, can help make communities healthier places to live, learn, work and play. Muskegon County ranked 67th of 82 counties in terms of health outcomes, 75th for quality of life, and dead last for healthy behaviors. Just next door, Ottawa County placed first for health outcomes and third for quality of life and healthy behaviors.

“This disparity between the two counties raised a red flag that could not be ignored, and it was a driving force for action,” said Dr. Wallace.

Several years into the ‘1 in 21’ initiative, Gwen Williams, then the community services supervisor at Public Health-Muskegon County, learned of the ‘Way to Wellville’ challenge and how ‘”it was a perfect fit with what our community was doing with ‘1 in 21,’” she said.

In May of 2014, Muskegon County was one of 42 communities in 26 states to submit an application to HICCup for consideration as a “Wellville” community. Its selection as one of the “Wellville 5” – along with Clatsop County, Oregon; Lake County, California; Niagara Falls, New York; and Spartanburg, South Carolina – generated a great deal of excitement and community pride.

The “Wellville 5” are receiving five years of support in the areas of data and measurement, evidence-based health solutions, and innovative financing strategies, with the goal of making significant, visible and lasting improvements in five measures of health and economic wellness. The focus is on impact and institutions, not programs and inputs.

Reducing ACEs for better health and wellbeing outcomes

Muskegon County’s work, which combines the values and vision of the ‘1 in 21’ and the ‘Way to Wellville’ initiatives, is focused on reducing smoking and adult obesity, increasing post-secondary education, and improving child nutrition, the county’s overall food environment, and the provision of preventive and chronic disease care.

To raise awareness of the impact that adverse childhood experiences (ACE), such as abuse and neglect, can have on health and well-being later in life, ACE scoring developed by the Kaiser Permanente’s Health Appraisal Clinic and the Centers for Disease Control and Prevention is being used to identify community residents in need of social and emotional support.

Accomplishments such as this are being achieved by leveraging strong partnerships with the local Rotary Club and other partners that were already collaborating in the ‘1 in 21’ campaign.

Among the campaign’s values is inclusiveness, said co-chair and Hackley Community Care Center CEO Linda Juarez.

“Every single one of the county’s 175,000 residents are invited to participate in the ‘1 in 21’ campaign and join our collective journey on the way to Wellville,” said Juarez. “’Wellville’ is a symbol for different sectors of the community joining forces to improve lives, so we invite every person, business, school, community and faith-based organization, physician and other healthcare professionals to get involved.”

Other major stakeholders include the local health system, Mercy Health Partners; the 38 primary care practices that comprise its Accountable Care Organization; and its community benefit program, the Muskegon Community Health Project.

So what does Muskegon County’s road to Welllville look like? Picture safe streets, parks and bike paths where children, teens, and adults are physically active. Picture an abundance of fruits and vegetables available at farmers’ markets, community gardens, and the travelling YMCA Veggie Van, plus healthy cooking demos where residents learn how to prepare produce. Picture community residents who finally quit smoking, receiving one-on-one education and support as well as free smoking cessation aides. Picture engaged advocates persuading their state legislators to pass legislation that promotes breastfeeding, tuition assistance, and mandated physical activity opportunities during the school day for all grades.

But most important of all will be the impact of all these changes, fulfilling the vision of HICCup’s founder and angel investor, Esther Dyson, that the ‘Way to Wellville’ will create outcomes and health that will inspire communities and policy-makers across the country to make similar changes and achieve similar outcomes.

“As a Family Physician and a Muskegon County resident, I see first-hand how good health is the foundation for academic achievement and economic prosperity that impacts families and our community as a whole. Through ‘1 in 21’ and the ‘Way to Wellville’, our community is making tremendous strides in changing lives and building a healthy future,” said Dr. Wallace.

You can follow Muskegon County’s journey on its way to Wellville by following @WayToWellville on Twitter, or by visiting and

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