Working together for the larger cause of a healthier community was a central theme of discussion when the "Healthy Greeneville" action group for the Town of Greeneville's Vision 20/20 initiative met Tuesday afternoon for the first time.

Several well-known citizens, including key figures in the local healthcare community, gathered in the board room at Greeneville Town Hall to brainstorm and talk about pooling resources as the Town begins an official effort to address local health concerns and promote wellness.

Chuck Whitfield, Laughlin Memorial Hospital president and CEO, and Daniel Wolcott, president and CEO of Takoma Regional Hospital, jointly facilitated the discussion.

Both noted that the two local hospitals had already been working together for just over a year on conducting a community health assessment -- a federal mandate for not-for-profit hospitals.

Conducting the health assessment is a three-year process for the hospitals.

It involves both internal and external committees, and reviews of health, demographic, and hospital data for Greene County, with an objective of identifying major health concerns.

"I think it's good for the community that the hospitals are working together on a project, and it's been great," said Tracy Green, wellness director for Laughlin Memorial Hospital.

"It has," agreed Bob Kamieneski, Takoma Regional Hospital wellness director.

The federal mandate has tasked the hospitals not only with conducting the community assessment and identifying top health concerns, but also with identifying the top three concerns where the hospitals can have an impact.

Those top three health concerns the hospitals can address, according to Kamieneski, have been determined to be tobacco use, obesity, and diabetes.

All of those factors contribute to cardiovascular disease -- the number one cause of death in Greene County.

"When you look at the health issues in Greene County, a lot of them are interrelated. They're interconnected. If you impact one, you're probably going to impact three or four others," Kamieneski said.

City Administrator Todd Smith said supporting the alliance between Laughlin Memorial Hospital and Takoma Regional Hospital was a natural step when promoting health became a priority of the Vision 20/20 initiative.

Smith said he was excited to hear about the hospitals' goals of reducing tobacco use, obesity, and diabetes.

"We certainly want to offer our resources and see what we can do to fit in," he said.

Smith pointed to the Greeneville Parks and Recreation Department's facilities and programming.

"I think we can have an effect on lifestyle issues -- on activity issues," he added.

Parks and Recreation Department Director Butch Patterson provided some insight about facilities and plans in his department.

He pointed to a new project that, when completed, will provide a 4.3-mile trail in town that will provide citizens a new route for exercise.

"We have Phase One done of a trail system and have been awarded money from TDOT [Tennessee Department of Transportation] for a Phase Two project," he said.

"Ultimately, we'll be able to have some sort of trail system where you'll be able to start at Town Hall, go all the way to Hardin Park, through Takoma [Regional Hospital] property, through Forest Park, and eventually a whole route where you can connect back to town," he added.

Patterson also raised what he said is the need to emphasize physical activity in the education system.

He said that, in the schools, importance is not put as heavily on physical activity as it is on core subjects such as mathematics or science.

"We're forgetting the part about how we've got to take care of our bodies and stay in shape," he said.

Group members in attendance all agreed, and discussion turned to addressing health needs of children and the need to promote good habits early, since, it was pointed out, behaviors are difficult to change.

"The culture of Greene County will never be changed until all groups come together -- and that includes families, not just civic groups, city hall, and the hospitals," Kamieneski said.

He noted what he said is the need for collaboration in such a large undertaking as transforming the community's health.

Greene County Partnership President Tom Ferguson brought the discussion to its primary focus when he posed what group members agreed was the "big" question.

"How do you change the habits in the home?" he asked the group.

Numerous factors that can impede a family's ability to make health-conscious decisions were discussed, including poverty, lack of widely available access to locally-grown, non-processed healthful food, transportation issues, and, quite simply, the failure of some parents to lead by example when it comes to promoting healthful practices.

Discussion moved a step closer to the planning phase when Sally Causey, Director of Rural Resources, suggested a local marketing effort and the possibility of identifying incentives to encourage Greene Countians to get serious about getting fit.

The group moved from that suggestion into another discussion about using resources in the community -- such as facilities of the Parks and Recreation Department and programs offered by the two hospitals -- to promote wellness.

"What bothers me a lot of times that you hear about Greeneville is that there's nothing to do," said Mayor W.T. Daniels.

"There is a lot to do if people will just look around and see what we have.

"We put a lot of emphasis on recreation," he said, noting the new athletic complex on Hal Henard Road and the Baileyton Road soccer complex.

Daniels posed a rhetorical question to the group, saying, "You sit around and scratch your head asking, 'Why don't people participate?'

"I don't know."

The discussion further evolved to encompass "sick care" -- such as care given in hospitals -- and "well care" -- such as preventive measures.

One possibility, noted Whitfield and Ferguson, is encouraging businesses to promote healthy practices in their hiring habits and expectations of employees.

"We've [Laughlin Memorial Hospital] really tried to make it as difficult as possible to smoke at work," Whitfield said.

He also noted a trend in which some employers are now refusing to hire nicotine users at all. An example he cited is Mountain States Health Alliance, which recently adopted the policy.

"That's a big step, but a lot of places are doing that," said Whitfield.

"We are fortunate here in Greeneville to have Takoma [Regional] Hospital and Laughlin [Memorial] Hospital," said Daniels.

"One thing that's important for local folks to realize is what good healthcare providers we have."

Daniels noted that the number of individuals who go outside the community for care has a negative effect on local healthcare providers in the same way that shopping out-of-town hurts local retailers.

"That's one thing I want to point out -- the importance of people utilizing our own facilities that we have here," he added.

Wolcott and Whitfield agreed on the impact of an estimated 35 to 40 percent of individuals who travel outside the community for health care.

"When you think about that from an economic standpoint," said Wolcott, "that's huge.

"When you think about the number of jobs that could be created to keep 25 percent of that 35-to-40 percent of 'leakage' in our community -- that could be huge from a jobs standpoint."

As the discussion concluded, group members decided that another meeting will be held in the coming weeks to begin developing a plan of action.

Some ideas that may be developed into a plan include:

* making a marketing effort;

* posing challenges to businesses to promote healthy practices;

* establishing a resource that will give citizens access to as much available information as possible;

* determining how to help healthcare infrastructure in the community, and

* determining how to reduce healthcare "leakage," and keep that healthcare business in Greene County.