In the foothills of Tennessee’s Great Smoky Mountains, Knox County boasts hundreds of miles of green space, parkland and hiking trails. But some children in the county, the largest in East Tennessee, rarely get to enjoy such amenities. They live in poor, blighted communities—in urban, suburban and even rural settings. For them, Knox County has an altogether different landscape.

One such place is Lonsdale, part of the city of Knoxville’s urban core. More than half of its elementary-aged children are overweight or obese and thus at risk for health problems such as diabetes and high blood pressure.

The Knox County Health Department is partnering with nutrition, physical activity and public health experts at the University of Tennessee, the Knox County Schools Coordinated Health Program, the local Transportation Planning Organization and others to provide healthier nutrition and activity options to all children. With funding from Healthy Kids, Healthy Communities, their initial focus will be on Lonsdale and two other communities, Inskip and Mascot.

Nearly half of primary-school children living in Inskip, a northern Knoxville neighborhood, are obese or overweight. In Mascot, a rural community 14 miles to the northeast, the rate is 53 percent.
“We’re hoping to make a difference by pushing that obesity curve down over the next five years,” project director Stephanie Welch said.

Among Knox’s more than 400,000 residents—88 percent of whom are White—the partnership will work both across the county and in the identified areas to remove some of the environmental barriers to maintaining a healthy weight. The project’s objectives include:

• Providing children with healthy food options in vending machines on public property
• Working with restaurants and food stores to offer nutritious foods as well as appropriate serving sizes
• Expanding neighborhood Safe Routes to School options, an especially critical goal given the paucity of sidewalks in the targeted communities

The effort already has a base on which to build, including a community surveillance system of children’s body mass index (BMI) and Knoxville’s draft policy to require city sidewalks. Each of the three targeted communities also brings assets to the project. Mascot, for one, has a farming heritage that could offer opportunities for consumers as well as farmers.

To succeed, project leaders know they must get residents of these at-risk neighborhoods to recognize environmental factors contributing to the high obesity rates. Is it a lack of sidewalks? A need for safes place to play? Or because no grocery store is easily accessible?

But just as importantly, the project must prompt residents to push for changes in their built environment.

“People in these at-risk communities expect to find chips and cigarettes at the corner store,” Welch said. “We want to change that norm so that residents start to demand fresh produce, safe streets and green space.”