In early 2024, nonprofit health provider Northern Counties Healthcare (NCHC) brought together partners from the Vermont Department of Health and a group of nine community organizations to form a collaborative with the shared goal of prioritizing and improving health across Vermont's Northeast Kingdom (NEK) region.
The NEK is the most rural area in the state, populated by dozens of small towns and communities. Though known for its idyllic landscape of farmland, lakes, mountains and forests, life in this remote part of Vermont comes with challenges.
Joe's Brook watershed in the NEK where historic storms in July 2024 caused flooding and widespread damage. (photo credit: Laural Ruggles)
A fishing camp in the NEK, Vermont’s most rural region. Residents in the NEK often must travel for hours to access health care and services. (photo credit: Laural Ruggles)
An autumnal landscape in the NEK which is the state’s most rural region spanning over 2,000 square miles. (photo credit: Kari White)
“The people in the NEK reflect the land—strong, proud, hard-working and fierce,” said Kari White, director of special projects for NCHC, the lead partner for the Vermont collaborative. “This place isn’t for everyone; life can be hard and isolating here.” Counties in the NEK fall behind the rest of the state in measures of health and well-being—residents experience higher rates of poverty and unemployment; doctors and health facilities are few and far between and people often must travel for hours to access care. “The list of resources we lack could fill the Kingdom’s 2,000 square miles,” said White.
Through a nationwide initiative to address health disparities and strengthen local health systems, the Vermont collaborative began to assess community health data and local policies to identify where change was needed. The CDC Foundation, the Association of State and Territorial Health Officials (ASTHO) and the Michigan Public Health Institute (MPHI) provided the organizations in the collaborative with capacity building and technical assistance, including workshops and regular meetings with a core team of subject matter experts who provided guidance on prioritizing transparency, accessibility and local needs in their work.
Sometimes we need to show up in different ways, in bigger ways.
However, in July 2024, the Vermont collaborative was forced to put many of their long-term plans on hold when the NEK was battered by two historic, back-to-back rainstorms that caused widespread flooding. Roads and bridges were destroyed, and residents faced catastrophic damage to their homes and property—some washed away completely.
Two men examine a washed-out road after two back-to-back storms caused catastrophic flooding in July 2024 in the NEK. (photo credit: Kari White)
Cars were swept up in flooding caused by historic storms that hit the NEK in July 2024. (photo credit: Cara Robechek)
“It's Mother Nature's fault. We got two big floods in July, so we needed to take a step back from this work to take multiple steps moving forward,” said Terri Lavely, program supervisor for the nonprofit Northeast Kingdom Human Services, a partner in the Vermont collaborative. “Sometimes we need to show up in different ways, in bigger ways.”
The organizations quickly went to work, putting into action many of the community health concepts they’d learned through their newly built collaborative. They leveraged their collective resources and created additional partnerships with faith organizations, philanthropists, government agencies and other local entities to connect NEK residents with the help and support they needed. Using a citizen-led, cooperative approach, they worked with regional leaders to assess needs and deploy over 300 local volunteers to help residents safely remove debris, mud and damaged materials from buildings and homes—a process referred to as “mucking and gutting.” Throughout this difficult recovery, the organizations worked closely with the Vermont Department of Health, strengthening the partnership they had forged only months before the floods.
Volunteers gather to celebrate and raise funding to continue community-driven local flood recovery efforts in the NEK. (photo credit: Northeast Kingdom Organizing)
Volunteers gather to help with flood recovery efforts in the NEK after two historic storms hit the region in July 2024. (photo credit: Northeast Kingdom Organizing)
Local volunteers in the NEK helping with efforts to muck houses affected by flooding that occurred after two powerful storms hit the NEK in July 2024. (photo credit: Northeast Kingdom Organizing)
“It just opened up a lot of opportunity to work in a way that was transparent. We had to be on the ground together, and we had to figure this out, so there wasn't this hierarchy,” said Stacy Thrall, a local businesswoman and board member of Northeast Kingdom Human Services. “It felt like we were in this together.”
The Vermont team worked tirelessly to ensure that no one in the NEK felt left behind or forgotten. Because natural disasters can contribute to mental health issues like depression, anxiety and post-traumatic stress, the collaborative developed support systems for flood survivors and responders. They also offered residents directly impacted by the floods the opportunity to be involved and engaged in all aspects of disaster recovery.
“In our flood work, everybody got treated the same, right?” Lavely said. “We did mucks and guts, and we helped out all our neighbors, and that was equitable work across the Kingdom.”
Although the Vermont collaborative wasn’t initially formed to respond to natural disasters, they are proud of their work and the resilience of the NEK. “Because of the relationships we built, we were able to help people in ways we could not have imagined before the devastation,” White said. The organizations remain committed to building on the valuable lessons of the 2024 flood response as they continue to work to improve health systems in the NEK.
“How do we duplicate that across the other areas of NEK?” Lavely said. “We're really taking that deep dive and looking at how all of our community organizations and these different groups can align across everything we do together as a whole.”
The STRETCH Initiative is supported by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of RWJF.
