Current projects
- Stories of connection and coming together in a rural community
- Food Farmacy for Sustainability and Patient Health
- Incorporating Food Bags, Resources, and Food Delivery into Patient Care
- Fall Mountain Community Corps
- Supporting Vermonters with Substance Misuse Disorders through the Windsor Recovery Center
- Better Oral Health for Rural Children Ages 0-5 Years
Stories of connection and coming together in a rural community
The Upper Valley is a unique place, roughly 1,200 square miles. The region spans two states, often addressing the same challenges with different political and social solutions. Communities unite across political and geographic boundaries to support each other. Friends, neighbors, and strangers all work together to create a better world.
This series celebrates the incredible work in the Upper Valley by individuals and the organizations they’ve created. We hope that these stories will illuminate the power of collaboration and inspire you to work with others to address a need in your community!
This story series is the product of Ella Harper-Schiehl's CARHE internship. Ella recently finished her Master of Public Health degree at Dartmouth.
Ella is passionate about giving ordinary people a voice in public health to highlight their strengths and weaknesses. Raised in rural Wisconsin, she saw firsthand the impact that access to healthcare can have on a community.
Her mom instilled in her a sense of empowerment and empathy. She puts those values into practice to create a better healthcare system in the US.
Ella lives in Lyme, New Hampshire, with her cat, Harvest. In her spare time, she loves to knit, woodwork, and read.
Car Repair Program
The rurality of the Upper Valley can present a barrier for residents who don't have access to reliable transportation. Car repairs are rarely cheap, and for some, deciding whether or not to get the only car in the house fixed might mean deciding whether or not to pay rent.
Candy Reed, Sullivan County's Mobility Manager, teamed up with J.S. Automotive in Charlestown, New Hampshire, to help those in need get their car repaired at no or very little cost to them. Ella talks with Candy and Sara Svendsen from J.S. Automotive in this episode about what the program involved and what the future might look like.
Kearsarge Neighborhood Partners
A few years ago, a group of Kearsarge-area residents saw the need for a community-based organization to provide assistance and connection together. They founded Kearsarge Neighborhood Partners, which serves the Kearsarge region, helping anyone in need with a variety of tasks.
Last year, volunteers helped stack wood, create winter weather window inserts, provide transportation to appointments, shovel snow, cook meals and grocery shop, and check in on neighbors living alone. Steve Allenby, the organization's President, talks to Ella about how the organization got started and where it's going.
Lebanon Opera House
Staff at the Lebanon Opera House have worked hard over the past year to create space for all community members. A few examples include their expansion of Pride work throughout all months of the year and the implementation of sensory-friendly programming and kits for anyone who wants one. Ella chats with Lucas Mendelsohn and Kristen Coats about these initiatives and more in this episode.
Marlow Library
Libraries represent a place in their community for anyone, a portal to whoever or wherever they want to be or go. Within the last few years, libraries have expanded their repertoire of programming and resources, and the Marlow Town Library is a perfect example of that expansion. Jennifer Brown talks with Ella about the place that the library holds in the community there and how she's worked to provide programming for everyone together.
New Hampshire Grand Families
When a child cannot be cared for by their parents, the state often turns to extended family members to step in. This experience was frustrating and lonely for Tawna Fisher: there seemed to be no support for kinship caregivers from the state or other local organizations. In the face of this, she worked with Becky Keenan to found New Hampshire Grand Families, which helps support other families in the same position as Tawna. Ella talks with Becky and Tawna about the need for this project and its impact on the families.
Food Farmacy for Sustainability and Patient Health
Organization: Little Rivers Health Care, Inc. (LRCH)
Contact: Ashleen Buchanan via email at abuchanan@littlerivers.org
The goal of LRCH's Food Farmacy is to increase access to healthy food for rural, at-risk populations in Vermont while creating a sustainable food farmacy model for the next 5-10 years.
LRHC will achieve this by:
- Supporting local agriculture to keep food local and accessible
- Supporting patients with chronic conditions and limited access to healthy food by establishing a shelf-stable food box program that is accessible anytime
Through financial sustainability, continued staffing, and efficiency, this project will allow LRHC to continue to offer their Food Farmacy to all patients with a chronic condition and barriers to food access. These people include BIPOC, LGBTQ+, and under/uninsured or low-income.
Incorporating Food Bags, Resources, and Food Delivery into Patient Care
Organization: Northwestern Medical Center, Inc.
Contact: Denise Smith via email at dsmith@nmcinc.org
Northwestern Medical Center, Inc. provides care to a rural, underserved population in northern Vermont and has found that poverty and lack of resources negatively impact their populations health outcomes. Northwestern Medical Center will provide food bags and resources to patients who have a positive screening for health-related social needs. In addition to shelf stable food, these bags will contain:
- Local food shelf and meal resources
- Referrals to WIC
- Referrals to 3 Squares
- Referrals to Pantry Soft (CVOEO)
- Referrals to regional pre-made food and food delivery
NMC hopes to establish this program as a low barrier, easily accessible way to provide resources to patients with health-related social needs. The ultimate goal is to phase this project over time to all hospital departments including specialty care and outpatient clinics.
Fall Mountain Community Corps
Organization: Fall Mountain Regional School District (SAU 60)
Contact: Alice Cable via email at acable@sau60.org
SAU 60 is located in rural New Hampshire and serves towns from two separate counties with limited resources and significant barriers to health and social necessities. The SAU seeks to become an anchor institution for this rural region by establishing a group of volunteers and leveraging relationships with community partners to support residents with various needs, including:
- Transportation
- Access to meals
- Access to fresh produce
- Reducing isolation
The SAU will build this group of volunteers from local community members and partner organizations.
Supporting Vermonters with Substance Misuse Disorders through the Windsor Recovery Center
Organization: Connecticut Valley Addiction Recovery Incorporated
Contact: C. Frederick Lord via email at cflord@cvarsinc.org
Windsor Recovery Center is a non-profit, community-led-and-governed organization that focuses on substance misuse, recovery, and prevention. WRC serves residents of Windsor, Ascutney, Brownsville, and Hartland, Vermont. Through collaboration with CARHE they seek to improve:
- Resources for mental health and recovery
- Prevention education and services
- Support for families and individuals struggling with addiction
- Barriers to access of community support, health education and the lack of free teen programs
- Access to and knowledge of social determinants of health (housing, transportation, food and economic security) to improve the chances of recovery
The overall goal of this project is to support those struggling with substance misuse. WRC supports all pathways to recovery. WRC will work to reduce the stigma and negative consequences associated with drug use and improve the health and wellbeing of those who struggle with substance use. They will achieve this by developing a plan that offers services that are appropriate to Windsor’s culture and partnering with other community organizations to address identified needs.
Better Oral Health for Rural Children Ages 0-5 Years
Organization: A Partnership of Dartmouth Health’s Population Health Department, Vermont Department of Health, New Hampshire DHHS Oral Health Program, and Pediatric Practices in Vermont and New Hampshire.
Contact: Lynne Chow via email at lynne.c.chow@hitchcock.org
The Vermont Department of Health and CARHE are partnering to train pediatricians in rural Vermont and New Hampshire communities to provide Silver Diamine Fluoride (SDF) treatment as a means to halt dental decay in children ages 0-5 years, addressing a significant gap in care for our youngest community members. Early Childhood Caries is the most common disease of childhood in the U.S. Many rural families in Vermont and New Hampshire do not have access to dental care and few have fluoridated water at home. Each year, about 400 children in Vermont undergo general anesthesia for dental issues that may be preventable. SDF is a safe, effective, and minimally invasive treatment that does not involve sedation, local anesthetics, drilling, or filling cavities.
This project is partnering with at least five pediatric medical practices on the integration and use of SDF to treat Early Childhood Caries. This initiative includes:
- A stipend to each practice
- Education through didactic lecture and hands-on training
- Technical support integrating SDF into medical practice
The Vermont Department of Health submitted this project idea to CARHE in 2023. CARHE convened partners from Vermont, the North Country Health Consortium, and pediatric clinics to collectively pursue support for the project. These partners successfully obtained funding from the U.S. Health Resources Services Administration (HRSA), as part of the Northern Border Region Technical Assistance (NBR-TAC) Subawardee Grantee Program.
View the toolkit: The Use of Silver Diamine Fluoride (SDF) in Pediatric Care (PDF)
Past projects
In December 2022, CARHE put out a Request for Ideas (RFI) for projects to help improve rural health equity in northern New England. All projects underwent a detailed review process by the Center's Leadership Council and Community Advisory Council members. CARHE selected 4 of these projects to support for 12 months in 2023.
Farm Shares for Health: Improving Access to Healthy Food and Education for Rural Cancer Patients
Organization: Osher Center for Integrative Health at the University of Vermont (UVM)
Contact: Kristie Grover
Email: kristie.grover@uvmhealth.org
The goals of the UVM Osher Center CARHE project are to improve access to and increase consumption of fresh vegetables and fruit among rural, food insecure cancer patients in Vermont. They will accomplish this by providing:
- Free CSA (community supported agriculture) memberships
- Education
- Health coaching to 20 to 25 oncology patients
They will assess feasibility and acceptability of the program and measure a variety of food access, eating habit, and general health outcomes. The results of this project will inform ongoing CSA farm share programming to address food insecurity.
Early Childhood Region 1: Building Early Childhood Supports in Rural New Hampshire
Organization: Monadnock United Way (MUW)
Contact: Ellen Taetzsch
Email: ellen@muw.org
The Building Early Childhood Supports in Rural New Hampshire project seeks to improve equitable access to family supports and engaging early childhood programming through libraries in a minimum of 3 of the rural communities with lower access to resources in Early Childhood Region 1.
They will do this by:
- Increasing the availability and awareness of family programs and resources through local libraries
- Strengthening the capacity of local libraries to provide accessible and engaging children’s programming
- Fostering opportunities for families to build connections
Improving Food Security and Nutrition Equity for Residents of Income-eligible Housing
Organization: Willing Hands
Contact: Katie Ryan-O'Flaherty (she/hers), Mission Impact Coordinator
Email: katie@willinghands.org
Willing Hands' mission is to recover fresh food in order to reduce waste, improve health and provide reliable access to nutritious food for our neighbors in need. Willing Hands recovers surplus healthy food from grocery stores, wholesalers, and farms and delivers it for free to more than 80 social service organizations across the Upper Valley of Vermont and New Hampshire.
Through their CARHE funded project, Willing Hands seeks to improve access to, and increase consumption of, fresh produce among rural residents of 6 partner income-eligible housing complexes in Vermont and New Hampshire by engaging the beneficiaries in a program evaluation and improvement plan.
Supporting Community Collaboration to Address the Impact of Climate Change on Allergies and Asthma in Children in Rural New Hampshire
Organization: New Hampshire Healthcare Workers for Climate Action (NH HWCA)
Contact: Bob Friedlander, Jr., MD, Founder of NH HWCA and CHICKS
Email: rfriedlander.jr@gmail.com
NH HWCA is a grassroots, interdisciplinary, and statewide 501(c)(3) nonprofit founded in 2021. It is the New Hampshire state affiliate of the Medical Society Consortium on Climate and Health. Its mission is to activate a diverse group of students and healthcare workers to participate in climate and health educational and advocacy initiatives with a focus on health equity.
The Climate and Health Initiative for Children in Kearsarge & Sunapee (CHICKS) is a new community-integrated and cross-sector program of NH HWCA. With CARHE support, CHICKS is creating a novel 10-week after school program for rural and low-income K-5 children to increase their knowledge of climate, air pollution and respiratory health. In addition, CHICKS is creating a resource guide for their parents/caregivers to facilitate connections with community, state and federal resources that support healthy housing (weatherization, energy efficiency and indoor air quality). Partners include the Boys & Girls Club of Central New Hampshire and Colby-Sawyer child development faculty and students.