Many rural areas have strong agricultural industries, deep manufacturing roots and committed local residents. Yet, people living in these communities are less likely to have access to health services and have a lower life expectancy than their urban neighbors.

One of those communities is McDowell County, N.C. in the Appalachian Mountain region of western North Carolina. This scenic location provides abundant natural assets such as Pisgah National Forest, Linville Caverns, the Catawba River, Lake James and the Blue Ridge Parkway. These attractions draw tourists, retirees, and sightseers. Like many rural areas, McDowell County has felt the effects of lost manufacturing, but has been able to maintain and attract key employers.

Since 2012, the Kate B. Reynolds Charitable Trust has worked with Healthy Places NC in counties like McDowell to develop change networks and build capacity for residents to lead the work. Residents have set clear goals and strategies and are tackling health issues as well as social determinants of health — the factors outside of the medical office that impact a person’s health — head on.

They are working on critical health concerns including: obesity reduction; substance misuse; access to care; and adverse childhood experiences. Throughout the Healthy Places NC journey, the trust has learned valuable lessons that have helped reshape its grantmaking approach and can serve as a guide to the field:

  1. Start by listening.
  2. Make a long-term commitment.
  3. Put equity at the center of everything you do.
  4. Champion grassroots leaders and bring unlikely partners to the table.
  5. Invest in impact.

Read the full article about insights on rural philanthropy by  Jason Baisden, Paula Swepson and Mary Snow at the National Committee for Responsive Philanthropy.