HEALTHY COMMUNITIES INITIATIVE
Transforming Rural Health Through Community-Led Solutions
Rural America is Plauged by Poor Health
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Poor health outcomes tend to cluster in underserved, low-wealth rural areas.
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These outcomes are driven by more than medical issues; they reflect deep-rooted social, economic, and geographic inequalities.
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Addressing rural health disparities requires a holistic, place-based approach that meets people where they are—physically, culturally, and economically.
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The traditional healthcare system is often unwilling or structurally unable to reach the most vulnerable rural residents.
A Radical New Strategy to Improve Rural Health
Healthcare alone cannot address the full spectrum of factors that influence health; social determinants like employment, education, and environmental conditions profoundly impact health and well-being. Improving health outcomes in underserved areas demands a shift from treating illnesses reactively to preventing them through strategic health promotion and disease management. The approach involves meeting individuals within their communities, removing care barriers, and tailoring programs to address the specific needs of vulnerable neighborhoods.
Place-Based
HCI uses a place-based model that focuses on defined geographic areas (U.S. Census Blocks) to deliver targeted, door-to-door outreach and services. By concentrating efforts where health disparities are most severe, HCI ensures that no household is overlooked and that interventions are tailored to the specific social, economic, and cultural context of each community.
Proactive Engagement
HCI is built on the belief that waiting for people to seek care (patient activation) is not enough—especially in underserved communities where barriers to access are high and trust in traditional systems is low. Instead, HCI uses a proactive engagement model to bring services directly to the people who need them most.
Local Control
At the heart of the Healthy Communities Initiative (HCI) is the principle of local ownership—the belief that sustainable health improvement must be led by the people who live in and know the community best. HCI empowers local residents, organizations, and leaders to shape every phase of the initiative, from planning to implementation and evaluation.
What Makes HCI Unique
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Place-Based, People-Focused
HCI targets geographically defined communities to ensure every household is reached. By employing Community Health Workers (CHWs) from the area, we build trust, deliver culturally appropriate care, and respond to the specific needs of residents—block by block, home by home.
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Beyond Healthcare Access
Unlike traditional interventions, HCI addresses both medical and social determinants of health. From housing and food insecurity to transportation and chronic disease education, we connect participants to comprehensive resources that influence long-term health outcomes.
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Community-Led Governance
HCI is guided by a Community Action Board (CAB) made up of local leaders and residents. This ensures every decision reflects community priorities and builds sustained engagement—making the initiative not only for the community, but by the community.
Community Impact
The community impact of the Healthy Communities Initiative (HCI) can be described across several key dimensions:
Improved Health Outcomes
HCI reduces disparities in chronic disease—particularly heart disease—by proactively engaging residents through home visits, early identification of risk factors, and timely referrals to social and medical services. This leads to better disease prevention, management, and reduced emergency care utilization.
Increased Access to Services
By addressing both medical and social needs (e.g., food insecurity, transportation, housing), HCI helps residents overcome barriers to health and well-being. Many community members access services for the first time through CHW engagement.
Empowered Communities
With decision-making guided by local Community Action Boards (CABs), residents gain agency in shaping the health initiatives that affect their lives. This fosters trust, strengthens local leadership, and ensures the program is culturally responsive.
Success Story: Reaching the Unreachable in Helena, AR
Helena, Arkansas, has some of the poorest health outcomes in the US. HCI launched its pilot project to improve heart health outcomes among residents. Within just three months, Community Health Workers conducted door-to-door outreach across two US census blocks, enrolling over 33% of eligible households on the first home visit
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One notable success involved a 63-year-old resident with uncontrolled hypertension who had not seen a healthcare provider in over five years due to lack of transportation and trust in the system. After engaging with a CHW, she was connected to a local clinic, received medication, and was referred to a food pantry and senior meal service to address her nutrition needs. Within six weeks, her blood pressure was stabilized, and she expressed renewed hope and confidence in managing her health.
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This story is just one example of how HCI’s place-based, community-centered model can rebuild trust, re-engage marginalized individuals, and produce measurable improvements in health and well-being.
National Leadership
Irion W. Pursell, DrPH, RN – Managing Director
Dr. Pursell is a public health leader with deep expertise in community-based interventions, chronic disease prevention, and rural health equity. He holds a Doctor of Public Health (DrPH) degree from Tulane University focused on Public Health Leadership, Advocacy and Equity. His previous work focused on innovative, place-based strategies to reduce health disparities in underserved populations.
As the founder and Managing Director of HCI, Dr. Pursell has led the design and implementation of a novel care delivery model that integrates Community Health Workers, local governance, and proactive outreach to improve access to both medical and social services. Under his leadership, HCI has evolved into a 501(c)(3) nonprofit, expanded its regional footprint, and demonstrated measurable impact in improving health outcomes in high-risk communities.
Dr. Pursell’s experience also includes program development, stakeholder engagement, grant acquisition, and research partnerships—making him uniquely qualified to guide HCI’s mission to create healthier, more equitable communities from the ground up.
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HCI National Team: Expertise in Service of Local Communities
The HCI National Team brings together experts in public health, community engagement, program evaluation, medical geography, data management, operations and health equity. Our team has deep experience designing and implementing place-based interventions that improve health outcomes in underserved areas. We collaborate with local communities to share this knowledge, offering technical assistance, training, and strategic support to help community-based organizations replicate and sustain the HCI model. Our goal is to empower local leaders with proven tools and insights—so that every community has the capacity to build a healthier future from the ground up.
Place-Based Approach
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Health disparities cluster geographically - specific neighborhoods and rural areas experience consistently worse health outcomes due to structural inequities.
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Place determines access to resources - transportation, housing, food, and healthcare—factors that strongly influence health.
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Targeting defined geographic areas (e.g., U.S. Census Blocks) allows HCI to concentrate resources where the need is highest and track measurable impact.
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Door-to-door outreach ensures no one is missed, especially those who are isolated, mistrustful of the system, or disconnected from care.
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Local customization is key - interventions are adapted to reflect the culture, needs, and strengths of each unique community.
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Building local trust and visibility is easier when CHWs live in and understand the communities they serve.
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Place-based models support systems change by improving the conditions in specific areas, not just outcomes for individuals.
Proactive Engagement
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Door-to-Door Outreach: Community Health Workers (CHWs) go directly into neighborhoods, visiting every home in targeted census blocks to initiate contact and build relationships.
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Early Identification of Needs: During home visits, CHWs assess social and medical needs before crises arise—allowing for early intervention and prevention.
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Personalized Referrals: CHWs connect individuals with appropriate medical care, social services, and educational resources based on their unique circumstances.
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Ongoing Follow-Up: Engagement doesn’t stop after one visit. CHWs provide continuous support, track outcomes, and adapt care as situations change.
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Trust-Based Relationships: By meeting people where they are—literally and figuratively—CHWs establish trust that leads to deeper engagement and sustained impact.
This proactive approach is essential for reaching those who have been historically excluded from care and for addressing the root causes of poor health outcomes.​​
Local Control
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Community Action Boards (CABs): Each site is governed by a CAB composed of local residents, service providers, and community leaders who guide decision-making and ensure the program reflects local priorities.
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Hiring from Within: HCI recruits and trains Community Health Workers (CHWs) from the communities they serve, ensuring cultural alignment, trust, and economic benefit.
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Shared Decision-Making: Local partners are involved in customizing outreach strategies, adapting service delivery models, and defining what success looks like in their own context.
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Capacity Building: HCI provides tools, training, and technical assistance to help local stakeholders build lasting infrastructure for health improvement beyond the life of any one grant or program.
By centering power and responsibility within the community, HCI fosters trust, strengthens social capital, and builds a foundation for long-term, locally sustained change.
