According to the U.S. Census Bureau, 43 percent of children under the age of 18 in Barnwell County live below the poverty level. Because of their parents’ economic status, those children face more health disparities and inequities than others. For the majority of those children, it means living in affordable housing, also known as public housing.
Affordable housing communities can be found in almost every area of South Carolina, and Barnwell County is no exception. You’ve seen them around—complexes of multi-unit apartments with some green spaces but no visible outdoor recreational structures and no park within a safe walking distance. The HYPE team in Barnwell County saw the same thing. The lack of playgrounds in multiple affordable housing communities concerned them enough to do something about it.
Key partners were rounded up.
A HYPE team member helps with the obstacle course setup.
As soon as the HYPE team decided to focus on improving access to outdoor recreation in affordable housing communities, they turned to the South Carolina Regional Housing Authority No. 3 (SCRH3), the organization tasked with managing public housing and connecting residents to community resources. Getting buy-in from SCRH3 was integral to the success of the project.
“Our kids need something to do. You know, society complains a lot about this particular population, and I mean those residents who live in low-income housing, but they don’t provide any resources,” said Lisa Creech, resident opportunity and self-sufficiency service coordinator at SCRH3. “If you don’t want them to do something in particular, you have to provide another outlet, another resource for them. And I think that’s where we were lacking.”
Prior to joining SCRH3, Creech worked at an agency that wanted to partner with local housing and provide some recreation resources to the kids. As the HYPE team entered the picture, the affordable housing communities received basketball courts. But according to Creech, the kids wanted more.
Creech said on partnering with the HYPE team, “Many of these properties don’t have playgrounds, and for the ones that do have the basketball courts now, that’s all the kids have. So, we were really hoping to give them an opportunity to just be kids.”
Barnwell youth leaders take action.
Children play with the parachute as one boy has fun with tug of war.
With funding from Wholespire, Barnwell County HEALing Partners (funding from Healthy People, Healthy Carolinas) and other leveraged sources, youth were able to follow The HYPE Project process of observing their community, collecting data, and choosing their project focus area. They chose to increase access to physical activity in six local affordable housing communities located in Barnwell, Williston and Blackville. The team relied on a needs assessment they conducted the previous year to determine what type of physical activity to provide through their project.
They already knew SCRH3 and Barnwell County HEALing Partners hosted a field day event, which was successful but needed a little work. So, they analyzed the needs assessment and community feedback from the event and decided to enhance the activities of the field day and take it to multiple affordable housing communities during spring break.
“I thought it was very important that the youth take the lead on this project, and they did so well. I’m so pleased that I did not even imagine they would take it on the way that they did. But I think it’s because we made them understand that this is your project, and I think that message took it to another level,” said Pamela McKnight, HPHC project coordinator at Axis 1 Center of Barnwell, the fiscal agent for Barnwell County HEALing Partners.
The HYPE team planned the improvements from start to finish, adding additional (and traditional) field day games, purchasing recreation equipment, increasing the frequency from once a year to twice a year, and creating a HYPE Tour that would take the event to multiple affordable housing communities in the county.
The obstacle course tested everyone’s agility with the use of pool noodles, cones and other affordable materials.
“We brought out all the games that we played as kids for Field Day. We had tug of war; jump rope, hula hoops; obstacle courses; the large parachute—all things field day. The kids came out in droves, and they had a great time. We provided healthy snacks, and they got to be kids,” said Creech.
Not only was the purpose to increase access to physical activity, but it was also to give those particular community members a sense of community and belonging.
“I think it actually gave the parents and the children the opportunity to do something together because, when you think about it, everybody’s lives are busy. You have parents working long hours, and then you may have an older sibling taking care of the younger kids while the parent is working,” said Susan Ingram, HYPE advisor and project coordinator at AXIS 1 Center of Barnwell. ”But this project allows the parents and the children to play together. It was a beautiful thing to see.
In addition to field day games, McKnight said the HYPE Tour also included arts and crafts, health and wellness information from local vendors, and healthy snacks. “We also use that opportunity to show parents how easy it is to have a nutritious snack, and the children loved it. We did fruit kebabs with yogurt, and the children absolutely loved it. Nine times out of ten, none of those children had fruit or yogurt.”
Leveraging the HYPE Project for a greater impact.
Tug of war was popular among everyone.
Since the HYPE Tour, Creech says that she has noticed a change. “Since the field day, I do see the kids out playing, but it would be really nice to have some permanent structures for them.”
When you leverage a policy, systems and environmental change project for a greater impact, it means you influence additional change. You brought more attention to the needs of the community, and another entity or partner is investing in the community’s future. The HYPE team in Barnwell County did just that. Their actions and concerns about the lack of outdoor recreational structures in affordable housing communities put a brighter light on the situation.
According to McKnight, there have been conversations about adding some permanent structures to some of the low-income properties. Things could change for the children, and the HYPE team would play a role. Barnwell County HEALing Partners is considering building naturalized play areas on the properties because, through this project, they realized that not all of the affordable housing communities have areas for children to play. The health coalition continues to research naturalized play areas.
“Another project we were looking at in concert with the Housing Authority is sidewalk play,” says McKnight. “We want to make it permanent. So, permanent sidewalk directives like do jumping jacks or do hopscotch on the sidewalks to give children something that they could do.”
The HYPE team has inspired Barnwell County HEALing Partners to do more to improve access to physical activity throughout the county. There are tons of ideas, big and small, and several larger projects in the making. It’s safe to say that the movers and shakers of all ages in Barnwell County are doing some pretty big things that other communities can learn from, and a lot of it involves youth engagement.
We recently caught up with Lori Phillips, director of the Division of Nutrition, Physical Activity and Obesity Prevention (DNPAO) at the SC Department of Health and Environmental Control. Historically, SCDHEC founded the coalition that became Wholespire and DNPAO has been a long-standing partner. Their partnership and shared vision have contributed to the growth and recognition of policy, systems and environmental change strategies as a foundation of community health improvement across South Carolina.
Question: What is DNPAO and what does it do? Answer: The Division of Nutrition, Physical Activity, and Obesity Prevention (DNPAO) aims to support equitable opportunities for healthy eating and active living statewide through the facilitation of collective state-level actions. It serves as the state arm of the Centers for Disease Control and Prevention’s Division of Nutrition, Physical Activity, and Obesity and a bridge between national nutrition and physical activity best practices and state and local actions.
DNPAO strategies include:
Improving early care and education and school environments to support healthy eating and active living
Improving student health through the implementation of a statewide, web-based FitnessGram system
Engaging partners to guide state-wide healthy eating, active living, and healthy weight efforts
Question: You’ve been the director for quite a while. Can you tell us how the DNPAO and its work have evolved over the years? Answer: I have served in the director role since 2013. The division’s evolution has predominantly been driven by funding changes over the years. In the past, the division received substantial federal funding which sustained a team of 10 staff with specific subject matter expertise. When this federal funding was cut in 2018, the division was down-sized to focus on nutrition, physical activity, and obesity prevention in the main settings where children spend time – in communities and early care and education and school systems. The division was funded by the state legislature in 2023 to sustain these efforts as well as to maintain the SC FitnessGram system and to serve as a backbone organization (along with Wholespire) for Healthy Palmetto.
Question: Your division and Wholespire are co-leaders of Healthy Palmetto. Will you explain what Healthy Palmetto is and how it’s work is impacting community health improvement? Answer: South Carolina has had a state obesity plan since 2005. In 2019, the previous plan was wrapping up and key state stakeholders were convened to determine a path forward. It was determined that creating environments and systems that support healthy eating and active living throughout South Carolina is important for the future health of the state. So, Healthy Palmetto was established in 2020 with a commitment to serve as the state lead coalition of organizations responsible for collectively addressing healthy eating, active living, and healthy weight within the Live Healthy SC State Health Improvement Plan.
Healthy Palmetto supports healthy eating and active living priorities that would benefit from collective elevation. This includes creating space for partner organizations to share resources and connect with other state-level leaders, developing and disseminating collective communication assets, tracking the progress of priority measures, and blending funding for greater impact.
Healthy Palmetto is serving as the lead for the 2025-2030 State Health Improvement Plan Health Behaviors Work Group and planning is currently underway to determine strategies for the next five years. Although Healthy Palmetto focuses on state-level population strategies to improve nutrition and physical activity, there is a role for everyone to play. Local stakeholders can implement the Healthy Palmetto priority strategies and can connect with state-level leaders in each of the priority areas for assistance. Healthy Palmetto provides infrastructure for organizations to work towards common goals collectively.
Question: SCDHEC is preparing for a new name and a new brand. How will this transition impact the division, the work and its partnerships? Answer: Yes, as of July 1, 2024, DNPAO will be housed within the SC Department of Public Health. While there will be name changes and perhaps some structural changes internally, this should not impact DNPAO’s work or its partnerships. The work that we do is long-term in nature and we are thankful that we can continue contributing to a healthier South Carolina.
Question: What do you think has made Wholespire a good partner? Answer: DNPAO was a catalyst to establish the original organization that is now Wholespire. While I was not director at that time, it is my understanding that the impetus for that was to create opportunities for a public-private partnership to spearhead and lead the state’s obesity prevention efforts. Although there have been major changes in both DNPAO and Wholespire over the years, I believe this original intent continues to serve the state positively.
Wholespire serves a role that state agencies cannot in that it can be more flexible and fluid. Wholespire is a leader in advocacy and communication for healthy eating and active living and community health overall. Wholespire also provides direct technical assistance for local stakeholders. The work that Wholespire does complements DNPAO’s work and together we can have greater impact.
Question: Would you like to share any other important details about DNPAO? Answer: DNPAO is a small team with over 65 years of combined experience and subject matter expertise in nutrition and physical activity best practices, specifically within early care and education, schools, and communities. Please reach out if you think we can help you. We are always open to connect people to the appropriate resources or partners to make South Carolina a healthier state.
The HYPE Team on the steps of City Hall after they advocated to City Council for park improvement
A group of young changemakers at the Dillon County Girls and Boys Youth Center in the City of Dillon have sparked significant improvements in a local park and influenced elected officials to address other outdoor community amenities. Through the Healthy Young People Empowerment (HYPE) Project, youth learned how to assess their community, advocate for change and make Harmon Field a destination for everyone.
In 1924, Harmon Field was given to the City of Dillon and “dedicated forever to the plays of children, the development of youth, and the recreation of all.” The dedication plaque speaks volumes about the intentions of the HYPE team’s civic action project – reinvigorate Harmon Field for everyone.
“We had been taking the kids to a park, not far from us, and the park had to have had the same equipment as I had when I was a child,” says Annie Smith, Dillon County Girls and Boys Youth Center and HYPE Advisor. “The only people that would use the park were our kids (Youth Center) and maybe a few more kids you might see, but everything was dilapidated. It was just terrible.”
As a HYPE advisor, Smith’s responsibility is to lead the youth through the HYPE curriculum and help them learn the process of choosing and implementing a civic action project focused on healthy eating or active living. Once the HYPE team understood what they were doing, they quickly knew they wanted to make Harmon Field a more comfortable and safer place to spend time outdoors.
They used their HYPE grant funds to paint benches, but they had their site set on something bigger, something huge, something that required a lot of courage and determination. They wanted the City Council to devote some of its budget to improvements that would help get Harmon Field back on a path to greatness.
A HYPE team member demonstrates the new working water fountain at Harmon Field.
Speaking on behalf of the HYPE team, Smith says, “Our main concern was water. There was no water fountain for the kids. There was no water fountain for anyone. There’s a walking trail there, so you know people will get thirsty while walking. And there is no bathroom.”
Backing Up Their Big Idea
Although the youth knew what they wanted to do, they still needed to collect data and information supporting the need for improvements. They had to assess the park to determine exactly what was missing. Then, they had to get the community’s opinion on the park. While some HYPE teams may choose to conduct a survey, this HYPE team was confident that the community would support their desires. So, they petitioned as many people as they could.
“The kids went to the park on a daily or weekly basis to get signatures from anyone there. They could’ve been students, their parents, their grandparents, anybody in the neighborhood, and visitors,” says Smith. “We have people that visit from out of town. Roland (NC) is right across the border, and I have seen people having a cookout a couple of times. And still, there was no water and no bathroom.”
After collecting around 250 signatures, the HYPE team was ready to approach the City Council. When advocating for something we want, many of us know that we have to be prepared before approaching leaders with a request. Elected officials and decision-makers at all levels want information about the issue, proposed solutions and community support before making any decision. For youth, it took courage to overcome such an intimidating task, to find their voice and speak to elected officials in a public setting.
Advocating to City Council
When advocating for something we want, many of us know that we have to be prepared before approaching leaders with a request. Elected officials and decision-makers at all levels want information about the issue, proposed solutions and community support before making any decision. For youth, it took courage to overcome such an intimidating task, to find their voice and speak to elected officials in a public setting.
The new playground equipment exceeded the team’s expectations.
Smith said about 15 youths attended the council meeting and showed solidarity wearing their HYPE t-shirts. It was their first time attending a City Council meeting for all of them. The HYPE advisors identified one youth who was outspoken and very active on the team to address the City Council.
“We made a folder and passed it out to everybody on the City Council so they would follow along with us as we talked. We showed them pictures of what the park looked like. And at the end, we showed them a convenient bathroom that wasn’t that expensive that they could actually put out there, and the bathroom had a place to put a water fountain in front of it”, says Smith. “We talked about statistics. It was all written down, and they had it so they could see it, visualize it, and see where we were coming from.”
Council members were surprised to hear from youth, a group of citizens who usually don’t speak at meetings or talk about issues or business that may affect them. Several residents complained about the lack of running water at the existing water fountain, but no action was taken. Perhaps that’s why the City Council agreed to fulfill most of the HYPE team’s requests.
The City Council did not agree to install a bathroom, citing concerns about misuse of the facility, such as potential crime, drug paraphernalia being left behind, lack of staff, and other deterrents.
“We’re going have to keep going back. I understand their concerns, but we’re still going to try to work on them and find a grant that would fund an employee because they desperately need a bathroom.”
The Proof is In the Pudding
The HYPE Advisors were surprised by the amount of new playground equipment.
Since installing new playground equipment and a water fountain, Smith has noticed an increase in adults and children at the park. They’re staying longer, playing longer, and enjoying the great outdoors. Even teens have been spotted using the walking track.
“I am so excited to go to that park now. They have a water fountain that’s working, and the equipment is beautiful. They put new equipment everywhere. I went to the park twice last week, and there have been so many kids out there playing. It actually made kids come to the park! It’s just beautiful to be sitting in the park now. You’ve got older people coming out there walking their dogs. We’re still excited about what we started.”
The ultimate goal of this HYPE project was to increase physical activity in Harmon Field. While there is evidence of that goal being met, the HYPE team gained an experience they can be proud of. They used their influence and voice to express a desire and a need for community health improvement.
“It’s a good thing for kids to get involved,” says Smith. “It’s something they get to call their own, something they can be proud of. They get a chance to use their input, and we get a chance to listen to them.”
Ava Dean, BSN, MPH, Out the Lifeline: A Mission to Families and HYPE Advisor, added, “I was going to say the same thing, to let them have ownership of it and not to let us as adults come up with the project, but to allow them. Once you allow them to do it and see the final project, they will walk away knowing, ‘Hey, I had something to do with this,’ and they will be proud of that. They will forever have that accomplishment.”
The HYPE team in Dillon indeed started something. The City Council plans to update the playground equipment in all its parks. The City Manager approved Dean and the Tobacco-Free Health Disparities Coalition to place a “Clean Air is Fair” sign to keep the park smoke-free. Smith and Dean have also discussed possible collaboration amongst local coalitions to volunteer and remove graffiti from the park shelter.
So, while the HYPE team certainly had a successful civic action project and learned new leadership and advocacy skills, they have also influenced other groups to answer the question, “What’s next?”
Rural municipalities are relying on increased community engagement to enhance amenities and opportunities for families to explore local businesses, as well as provide inclusive play opportunities for children of all abilities. Focusing on these types of improvements means looking at the built environment, which influences healthy eating and physical activity.
The built environment includes the man-made spaces where we live. When community leaders value the surroundings and what they offer to attract residents and visitors, there is an opportunity to create more liveable, thriving spaces for recreation and transportation purposes. In Ridge Spring, SC, community leaders are investing in changes to the environment to increase walking, bicycling, outdoor playing and the local economy.
With assistance from the Upper Savannah Council on Governments, the Town of Ridge Spring applied for a Healthy Eating and Active Living (HEAL) Mini-Grant to purchase and install bike racks and inclusive playground equipment. The small, rural Saluda County town wanted to encourage residents to become more active. They proposed installing bicycle racks at the farmers market and interactive sensory equipment at the community playground.
New and updated riders
According to their application, several public hearings related to streetscape (view of a street) projects and potential improvements related to walkability (a measure of how friendly an area is to walking) were held and residents responded. They were interested in being able to walk and bike to places more safely. There was also a desire to update the community playground. Like many rural community parks, the equipment was outdated, unsafe and unappealing.
With HEAL Mini-Grant funds, Ridge Spring installed a bike rack at the farmers market, providing opportunities for cyclists to secure their bicycles and feel comfortable while they browse and shop. At the playground, new sensory-related equipment was installed, which helps make the space more inclusive of children’s needs. Observations indicate increased usage of the playground and children are playing longer.
Through the mini-grant, the town found a new partnership with Kids in Parks, a non-profit organization focused on getting families and children to spend more time outside. The new partnership could lead to additional funding opportunities to assist with future projects. Leaders also have their eye on improving another community playground and placing more bike racks in other areas of the town.
The Wholespire Partner Spotlight Series shines a light on the remarkable collaborations and impactful initiatives of our valued partners. In this series, we highlight the incredible work being done by organizations and individuals who share our vision and commitment to ensure an equitable South Carolina, where everyone has access to healthy choices.
We recently caught up with Erika Kirby, executive director of the BlueCross BlueShield of South Carolina Foundation. The Foundation has been a long-standing partner of Wholespire. Their partnership has enabled hundreds of communities to increase opportunities for healthy food choices and physical activity across the state.
What is the BlueCross BlueShield of South Carolina Foundation?
The BlueCross BlueShield of South Carolina Foundation (Foundation), an independent licensee of the Blue Cross Blue Shield Association, was established in early 2000 with a vision to bridge health and health care in South Carolina. Its mission and commitment remain steadfast to identifying and supporting solutions to address gaps in care and serving as a change agent to support innovation and value-added public-private partnerships.
The Foundation is South Carolina’s only statewide state-based philanthropic organization focused exclusively on improving health. Since its first grant was awarded in 2003, the Foundation has supported projects and efforts in all 46 counties.
The Foundation supports organizations and communities across South Carolina. Aside from grant support, how does the Foundation achieve its mission?
The Foundation is committed to creating value beyond traditional grantmaking. As a statewide health funder, the Foundation uses both its financial and non-financial assets to maximize its impact and create value for those we serve. Examples of how the Foundation’s service to South Carolina extends beyond traditional grantmaking and financial support:
We use our reputation to convene partners on key health issues.
We work with partners to minimize duplication and aim to increase coordination of organizations working to improve health, as well as to promote learning across communities and organizations.
Given our statewide footprint, we interact with a wide array of organizations and are aware of many health-related efforts occurring across South Carolina. With this information, we frequently make connections across stakeholders and across communities.
An example would be convening support for the South Carolina Social Determinants of Health Roadmap and engagement with the health-focused partners and members of the Alliance for Healthier South Carolina. While not directly health-focused, the Foundation is also a member and involved in SC’s state association of nonprofit organizations and the state grantmakers network to stay abreast of issues and opportunities for South Carolina.
One of your approaches is “Working Downstream and Upstream.” How does this approach impact health outcomes in SC?
The Foundation recognizes that South Carolina faces many complex health issues and has a unique position, given our statewide reach, to influence and lead the direction of initiatives to make an impact. Accordingly, the Foundation sees its role beyond a grantmaker to a change maker. Our values below convey our commitment to a diverse array of projects and approaches.
We support a continuum of approaches ranging from providing direct care for the economically vulnerable to advancing practice and policy, systems and environmental changes.
We prioritize efforts that will improve the health of future generations of South Carolinians.
We empower organizations to increase effectiveness towards improved health outcomes.
We support efforts that represent community and statewide priorities that are locally determined, culturally relevant and data-informed solutions.
We equip our partners to connect learning to action and use data for continuous improvement.
We are a catalytic partner, supporting organizations and programs as they gain sustainability by leveraging funds and we value innovative projects that can expand to multiple geographic areas in South Carolina.
The Foundation has the ability as a corporate philanthropic statewide health foundation to help discover, introduce, and advance new, different, or more effective ways to improve health and well-being and to improve the quality of health delivered to improve individual health outcomes.
As a statewide organization, we balance scaling solutions statewide to supporting strategies that can most effectively address local health needs. The Foundation seeks to listen to community needs, analyze, and evaluate data, and understand local community assets and challenges. We are also respected for our approach to develop relationships that foster honest dialogue. We listen, suggest, and in many instances, co-create mutually beneficial solutions.
This commitment to serving South Carolina is communicated to key stakeholders across the state and positions the Foundation as both a source of information, accelerating action, and working to find innovative solutions to best serve South Carolina.
What are the priorities of the Foundation for the next 3-5 years?
Most recently, we have intentionally woven together and overlayed our funding pillars of access to care, workforce, improving the quality of services, and investing in the health and well-being of South Carolina children and families with an additional emphasis in three health priorities of diabetes, oral health, and mental health.
The Foundation amplifies different areas of focus annually, mostly within these noted priorities. However, we are always keeping an eye out for innovative approaches not yet tried so we balance defined priorities to needs and opportunities as we hear from partners.
Over the years, the Foundation has supported Wholespire and its work. What do you think has made Wholespire a good partner?
The Foundation views its grantees as partners, leveraging their capacity to improve health across South Carolina. We invest in strong relationships with key organizations and design initiatives that build a network of trusted partners with which we can listen, learn, ask, and receive candid ‘on the ground’ check-ins – all towards advancing action and impact.
Would you like to share any other important details about the Foundation?
We recently held our inaugural regional grantee appreciation events. These events were created to recognize the contributions of each and the potential of all. Health is local and we wanted to give grantees the chance to strengthen relationships with each other. We see the possibility and power that the cross-pollination of ideas between grantees will lead to even more positive change in the communities they serve.
Take a look at the Foundation’s website for impact stories and highlights as well as the Foundation’s new team members.
Getting multiple organizations with different missions on the same page isn’t an easy task. It takes a lot of coordination, planning and communication. But, Healthy Palmetto, the coalition responsible for implementing the healthy eating and active living portion of the SC State Health Improvement Plan, seems to be doing the right things. With financial support from Wholespire, they recently released their annual report indicating the progress being made by organizations on the ground across all six priority areas. You can see more detailed data and information by downloading the Health Palmetto Annual Report.
Improve Outdoor Environments for Early Care and Education
Grow Outdoors SC is transforming early childhood outdoor spaces into diverse, naturalized environments that spark play and learning.
South Carolina hospitals invested in Grow Outdoors SC for their child care facilities.
Prioritize Physical Activity in Schools
SCDHEC and its partners are improving student health by enhancing physical education and creating more opportunities for physical activity before, during, and after school.
Fifty-eight (58) schools in South Carolina received the 2023 America’s Healthiest Schools award for bolstering physical education and activity.
Promote Trail Connectivity
The South Carolina Trails Coalition is increasing trail connectivity in the state and promoting the use of trails through increased knowledge and outreach.
The SC Trails Coalition formed and developed a strategic plan.
Two-hundred-seventy-five (275) new trails have been added to SCTrails.net.
SCDHEC is expanding awareness of the benefits and services of the Women, Infants, and Children (WIC) program to increase enrollment of eligible participants.
A new online app to make it easier for families to pre-apply for WIC was launched. The app streamlines enrollment and recertification processes for families.
Increase Senior Enrollment in SNAP
The SC Department on Aging and SC Thrive are increasing enrollment of eligible older adults in SNAP through community-based outreach.
Over 139,00 SC residents 51 years of age or older who are eligible for SNAP are receiving SNAP benefits.
The SNAP for Seniors Toolkit was created and those assisting seniors to apply for SNAP benefits were trained. Updates to the toolkit are currently in process and will be released soon.
Increase Access to Healthy Food
The SC Food Policy Council is strengthening local food systems in South Carolina, addressing food insecurity through the health care system by expanding screening and referral tools and resources and exploring strategies to address community design for physical activity and access to healthy food.
Seven (7) local food policy councils received support from USC SNAP-Ed in partnership with the SC Food Policy Council. Multiple organizations in South Carolina received USDA funding to establish produce prescription programs.
Multiple organizations in South Carolina received USDA funding to establish produce prescription programs.
Active People, Healthy Nation Walkability Action Institute was held in South Carolina in 2023. Five (5) local communities received training and developed action plans to address walkability/moveability through community planning and design.
