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Date Available

4-24-2026

Year of Publication

2026

Document Type

Graduate Capstone Project

Degree Name

Master of Public Health (M.P.H.)

College

Public Health

Department/School/Program

Public Health

Faculty

Paula Arnett, DrPH, MBA

Committee Member

Keith Knapp, PhD, MHA, HSE, CNHA, FACHCA

Faculty

Amanda Ellis, PhD

Abstract

Obesity and type 2 diabetes are among the most significant public health challenges in the United States, with Kentucky consistently ranking among the states with the highest prevalence of both conditions. Together, these conditions contribute to reduced quality of life, rising healthcare costs, and increased morbidity and mortality, underscoring the need for targeted, community-centered interventions. The disease burden of obesity and diabetes is particularly pronounced in rural areas, including the state’s westernmost region, the Jackson Purchase. Among rural populations, chronic disease risk is driven by a combination of factors, including low socioeconomic status, limited access to healthcare/supermarket options, and food insecurity. To address these gaps in Graves County, one of the eight Jackson Purchase counties in Kentucky, a comprehensive, evidence-informed program centering on increasing community food access is proposed.

The Graves County Healthy Foods Initiative (GCHFI) is designed to address nutrition-based risk factors for diabetes and obesity through improvements in food access and affordability, as well as nutrition education. The program centers on the establishment and expansion of farmers’ markets across Graves County. These markets will function as community nutrition hubs by providing access to fresh produce sourced from local vendors, financial incentives through acceptance of Supplemental Nutrition Assistance Program (SNAP) and Women, Infants, and Children (WIC) benefits (supplemented by the Kentucky Double Dollars program), and recurring nutrition education sessions. This multifaceted approach targets environmental and behavioral determinants of nutritional health, thereby promoting sustainable changes in dietary behaviors.

Over a five-year period, the GCHFI aims to achieve measurable improvements in health behaviors and outcomes. Short-term goals focus on increasing farmers’ market access, expanding community engagement, and improving dietary patterns, while long-term goals emphasize population-level reductions in chronic disease burden. Program implementation and sustainability will be led by the Graves County Health Department, in collaboration with the Kentucky Department for Public Health, University of Kentucky College of Public Health, and other county- and state-level partnerships. By improving food access through physical farmers’ markets, reducing financial barriers to healthy eating, and fostering local engagement via nutritional education, the Graves County Healthy Foods Initiative represents a community-centered approach to address obesity and diabetes in a high-need rural population in western Kentucky.

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