County Health Learning Challenge

In partnership with the County Health Rankings & Roadmaps program, NACo’s County Health Learning Challenge is a year-long program intended to help counties strengthen cross-sector partnerships, identify potential action and implement data-driven strategies to build healthier communities. The three cross-sector county teams engaged in projects aimed at improving the social, economic and physical environment factors that impact health in their communities. Learn from the progress that each of the three county teams – Cabarrus County, N.C.; Knox County, Tenn.; and, Salt Lake County, Utah – made over the course of the past year.


County policymakers serve a critical role in ensuring the health of the communities they represent. Many of the policies and initiatives they develop and implement directly affect the many factors that drive the length and quality of life for their county residents. As illustrated in the County Health Rankings model, focusing on policies and programs that support economic development, housing, education, safe travel and access to high quality medical care all contribute to better health for all. To build and sustain effective local health promotion efforts that have an impact in all of these areas requires community-wide collaboration. County officials are well-positioned to lead and coordinate local collaborative health initiatives because they have the capacity to bring together county agencies, leaders from business, education, health care and non-profits and community members.

With support from the Robert Wood Johnson Foundation, NACo seeks to assist counties with utilizing data, tools and guidance available from the County Health Rankings & Roadmaps program to help improve overall health in communities. As part of this partnership, NACo is engaged three county teams in the County Health Learning Challenge, an opportunity to learn together and take action to improve the health of their counties.

In July 2015, NACo selected three counties to participate in the NACo County Health Learning Challenge.

  • Cabarrus County, N.C.
  • Knox County, Tenn.
  • Salt Lake County, Utah

Over the course of a year, these three counties:

  • Formed multi-sector teams to address shared goals in their communities
  • Identified and implemented a strategy to improve health
  • Worked with a Roadmaps to Health Community Coach who provided tools and guidance to support the team's work, and
  • Participated in a collaborative with their peers to learn from each other.

Using the Roadmaps to Health Take Action cycle​, the process helped the county teams develop and strengthen cross-sector partnerships, select potential policy, systems and environment changes to improve county health and put ideas into action to build a Culture of Health in their county.

About the Challenge

What is the NACo County Health Learning Challenge?

In July, 2015, three county teams were selected to participate in the NACo County Health Learning Challenge - Cabarrus County, N.C.; Knox County, Tenn.; and, Salt Lake County, Utah. Each team includes a county-elected official and members from different sectors represented in the Take Action Cycle. The sectors represented include members from inside and outside of county government. Each team identified a focus area that aligned with the County Health Rankings model ​and proposed goals and strategies that they aimed to implement over the course of the year-long Challenge. Counties are not expected to make quantifiable data changes, such as a percentage decrease in the county-wide obesity rate within the year. Instead, goals reflect what reasonable progress the county teams hope to attain such as identifying and advancing a policy, program and/or environmental change.

As part of NACo's collaboration with the County Health Rankings & Roadmaps program, each County Health Learning team worked with a Roadmaps to Health Community Coach. Coaches also connected the counties who are part of the Challenge so they could learn from each other. One way this co-learning happened is through the NACo Annual Conference.

During the 2015 Annual Conference, the County Health Learning teams and their identified focus area, goal and planned strategy were recognized during the conference. At the 2016 NACo Annual Conference, each of the County Health Learning teams showcased a video that highlighted their year-long efforts. At both conferences, the County Health Learning teams were given an opportunity to network with their peers. In addition, NACo staff worked with selected County Health Learning teams to identify other opportunities to feature their accomplishments with the NACo membership during the conference.

Each County Health Learning team attended the NACo County Health Learning Lab in Spokane County, Wash. The Learning Lab was a unique opportunity for each of the three county teams to engage with experts, other county teams and their Roadmaps to Health Community Coach on critical issues impacting their projects. As a previous RWJF Culture of Health Prize winner, Spokane County served as a host and peer county throughout the Learning Lab.


Roadmaps​ to Health Coaching​ provides county leaders with direct support from community coaches to strengthen their capacity to advance efforts to build a Culture of Health in their communities. Roadmaps to Health Coaching is part of the County Health Rankings & Roadmaps program, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. County teams that are selected to participate in the NACo County Health Learning Challenge will receive guidance from Coaches during the year-long Challenge.​

The RW​JF Culture of Health Prize is awarded annually to honor outstanding community efforts and partnerships that are helping people live healthier lives. Winning communities will each receive a $25,000 cash prize and have their accomplishments celebrated and shared broadly with the goal of raising awareness and inspiring locally-driven change across the country.

The 2016 County Health Rankings was released on March 16. An easy-to-use snapshot, the Rankings reveal the overall health of nearly every county in the nation. It allows each state to see how people from one county to another compare on a range of factors from housing to transportation to community safety and offers ways to take action to promote lifelong health and ensure that every community is a healthy place to live, learn, work, and play.

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