1. Centerville Farmers’ Market A Fresh Approach

2. Background Overview Hickman County (in the South Central Region) encompasses 613 square miles, with a population density of 40.3 persons per square mile. (Smaller than both the nation and the State of TN (87.4, 153.9) Hickman County has a larger percentage of children living in poverty compared to the State (31.3%, 25%) More than 1 in 4 children were living in poverty in 2010. Percentage of Hickman County residents who receive TennCare (the State of TN Medicaid program) is 20.8% - higher than both the State (18.3%) and the Nation (16.1%) Hickman County, Tennessee Community Health Needs Assessment, March 2013 Prepared by Hickman Community Hospital, Saint Thomas Health

3. Health of the County 68.7% of adults in the South Central Region are either overweight or obese, compared to the state and nation (67.3, 63.7) Males in South Central have a higher prevalence of overweight or obesity. They are also less likely to eat 5 fruits and vegetables a day, but are more likely to participate in physical activity. 32% of Hickman County adults are considered obese (compared to the state at 32%) Hickman County, Tennessee Community Health Needs Assessment, March 2013 Prepared by Hickman Community Hospital, Saint Thomas Health County Health Rankings, 2012

4. Health of our Youth In 2013, 17% of Tennessee students were obese 10% of Tennessee students did not eat fruit or drink 100% fruit juices during the 7 days before the survey. 9% of Tennessee students did not eat vegetables, during the 7 days before the survey. 2013 Tennessee Youth Risk Behavior Survey Report

5. Hickman County Residents and Food Insecurity* 34% have limited access to healthy food (compared to the State at 11%) Percentage of fast food restaurants 30% (National benchmark: 25%) *Food insecurity represents the percentage of the population who did not have access to a reliable source of food during the past year. Hickman County, Tennessee Community Health Needs Assessment, March 2013 Prepared by Hickman Community Hospital, Saint Thomas Health

6. Focus Group Few home vegetable gardens, not cooking at home, single parents Perception that fresh food tends to cost more Only two grocery stores to serve the entire county. Rural County (possible transportation issues) Hickman County Health Department Data collected 2012-2013 Learning objective: to determine the focus group’s perceptions about risk factors, cultural influences, environmental factors, current workforce milieu, and satisfaction of services in regard to heart disease an diabetes issues in Hickman County.

7. Community Survey In the Survey Section on Healthy Food: Question: Do you think the cost of fresh food plays a part in developing diabetes? 57% said YES. Learning objective: to determine if the public-at-large knows about the causes of diabetes, and understands the need for healthy food choices, recreational opportunities and quality health care. (Seventy-Nine, men, women and adolescents surveyed at a community event.) Hickman County Health Department Data collected 2012-2013

8. Community Meeting Negative: southern culture likes fried/sweet foods, and most foods are overcooked. Positive: Fresh foods are affordable at the local farmers’ market (when in season). Learning objective: to determine from Hickman County Chamber of Commerce members what they see as risk factors for heart disease and diabetes, and how these health issues affect our quality of life in Hickman County. Also addressed were questions related to our county’s demographics/culture and if these factors tend to worsen our chronic disease rates. Hickman County Health Department Data collected 2012-2013

9. Hickman County Health Dept. Patient Perception Survey 51 Patients Surveyed ( administered during two weeks of July, 2014 and two weeks during Aug., 2014) 46% have visited the market. 54% have never visited the market. Of those who have visited: 28% say they do so to enjoy fresh/nutritious food for their family. 14% say the market days are convenient 31% say the prices are better/don’t have to pay sales tax 8% have only visited the market once or twice/ no opinion.

10. Of those who have not visited/reason why: 22% say the market hours are not convenient for them. 6% say they cannot use their WIC vouchers. 2% say they don’t know how to cook the vegetables. 25% say they have not visited because they don’t know anything about the market. 8% say the would like to know more about the market and may visit soon. Health Dept. Patient Perception Survey (cont’d)

11. The Need One farmers’ market in the county Lack of vendor participation and low customer base (HD patients are not familiar) Local farmers taking produce to other counties where there is a larger profit margin Few resources to promote the program

12. Planning Strategies Utilize CDC 1305 Grant Funds and promote with the TDOH “Primary Prevention Initiative” Organize Stakeholder committee

13. Planning Strategies (cont’d) Establish a “branded” market logo Advertising and promotions Special market day, events, festivals

14. Market Activities and Promotions Grand Opening (400 in attendance!) Development of Newsletter

15. Mid-Summer Event (day for kids)

16. Vendor Promotions

17. Vendor Promotions (cont’d)

18. Community Promotions Walking Program at adjacent River Park Adopted as a Primary Prevention Initiative! Local Musicians perform On Market Days!

19. Health/Nutrition Education Hickman County Health Department and the Saint Thomas Hickman Hospital partner weekly with Dietitian Education.

20. Program Feedback “Word of mouth has been our best advertisement. New people are coming each week because they hear about the variety of vendors and market promotions.” ----Ginny Lundell, Market Promoter/Vendor “The 1305 money has allowed us to do more media advertising, along with large banner displays throughout town and incentives for the public. And the one great thing that has tied it all together is the development of our new ‘branded logo’ which is being used on everything we do.” ----Troy Dugger, UT Ag Extension/Market Director

21. Hickman County Health Department: Teresa Gregory, Health Educator Teresa.m.gregory@tn.gov David Rash, Health Department Director David.rash@tn.gov UT Ag Extension: Troy Dugger, Farmers’ Market Director pdugger2@utk.edu Teresa.m.gregory@tn.gov David.rash@tn.gov pdugger2@utk.edu Teresa.m.gregory@tn.gov David.rash@tn.gov pdugger2@utk.edu For more information: