Improving Access to Healthy Foods in Kentucky

By Daniel Kahl, CEDIK Associate Director and Jayoung Koo, CEDIK Community Design Specialist

You can’t get that here!

At the beginning of a new year many people make resolutions to improve their diet by eating healthier. But eating healthier is not always as easy as making a resolution to do so.  In a recent study,  Survey of SNAP Food Providers in Eight Kentucky Counties: Store Access and Availability of Food Types the barriers of access to healthy foods became evident.

A survey was conducted of stores accepting SNAP electronic benefit transfer (EBT) cards in the Kentucky counties of Bourbon, Boyle, Breathitt, Jackson, Knott, Lincoln, Madison, and Owsley.  The survey was a component of research conducted by CEDIK at the University of Kentucky, in conjunction with the Kentucky Grocers and Convenience Store Association to gain a better understanding of local food environments and to learn more about grocery store policies and practices. While survey response numbers were small, this study revealed multiple barriers to healthy food access to consumers in the study area.

Access Impediments

Stores responding to the survey acknowledged that transportation can be an issue for customers. Lack of reliable personal transportation, restricted public transportation, and cost of travel all contribute to challenges of EBT card users when wanting to access stores. In addition, distances of travel in rural areas can often add to the challenge of access to groceries.


Restricted Hours of Store Operation

Like many businesses, some stores operate on a regular business time schedule. SNAP food service providers who responded to the 2018 Grocer’s Survey in Central and Eastern Kentucky have hours of operation that overlap with a typical work day. This can create an accessibility issue for people working a typical 8am-5pm job. On average, consumers in Eastern Kentucky experience 49% fewer hours of access to food per week than consumers in Central Kentucky counties.

Limited Food Types

The types of foods available to customers in the study differed depending on the store’s main function. In particular, convenience stores were the most frequent respondents to the survey in the eight counties and had the most limited fresh or healthy food options. Availability of foods offered in the store were assessed by the percent of floor space dedicated to food type.  In a graphic comparison between Grocery and Convenience store type between Eastern and Central Kentucky regions, it is easy to see that food access in Eastern Kentucky is distinctly different than in the more populated counties in Central Kentucky.

Key Insights

While the number of businesses participating in this survey make it difficult to generalize broadly, the results did indicate challenges related to healthy food access for EBT Card users. Ultimately, the consumption of fresh, healthy foods is a two-part process that must be embraced by all parties involved to achieve the desired goal. Residents must be willing and purposeful to seek out and consume healthy foods, while food providers need to better supply stores with healthy food options and adjust business operations to accommodate their customers. Healthier eating is a resolution that needs to be supported by the entire community!  Want to learn more? See the full series of reports on Food Access on the CEDIK website.

Daniel Kahl is the Associate Director of CEDIK and an Assistant Professor in Community and Leadership Development at the University of Kentucky.

Jayoung Koo is a CEDIK Community Design Specialist and an Associate Professor in Landscape Architecture at the University of Kentucky.


Improving Business Communication

By Daniel Kahl*, CEDIK Associate Director

Advertising is a necessity for business.  Obviously, for people to purchase a business’ products and services, customers must know about the business.  This is why much of marketing focus is on pushing messages out to the broadest crowd possible to increase awareness and connection to the business.  When CEDIK asked EBT food providers in Kentucky about how they communicate with customers (Namkoong, Fawcett, Kahl, Koo, & Rossi. 2019), nearly 60% indicated they use social media, 29% utilize their local newspaper, and 18% use radio to inform customers about their business.

UK Economic Development Collaborative

While most advertising is about pushing a message out, how do businesses receive feedback from their customers? The most frequent way of getting feedback in this study (indicated by 71% of respondents) is word of mouth.  One important implication of using word of mouth as a communication system is that due to the informality of “word of mouth” communication, it is possible that feedback will be missed. Typically, “word of mouth” is not a formal system of collecting feedback. Customers may share comments to staff or other customers, without the feedback making its way to the owner or manager. Without a formal structure in place, customers do not have a clear avenue to share insights, ideas, or feedback. Not having a mechanism or system in place may also send a message to customers that their concerns are not important.  Waiting on word of mouth comments to filter up to management also means that management may only be hearing a comment once, when it was expressed by a dozen people, or inversely, management may be making decisions based on one person’s feedback.

Improving the communication loop

Customer feedback is more than fielding complaints. If a customer invests their energy to speak up, there is an opportunity to listen and to retain that customer.  Stores wanting to hear customer needs, suggestions, or concerns can develop systems to improve the collection of feedback. Customer comment boxes, on-line or paper surveys, and social media polls are just some of the ways businesses can connect more purposefully with customers to learn about their shopping and service needs.

Business owners can actively use social media polls to better understand their customers shopping preferences, shopping schedules, or purchase needs. For a report on business tactics and more ideas visit Getting the Word Out: Communication Methods on the CEDIK website.

Businesses need customers like communities need businesses

Just as businesses must listen to their customers, communities must also listen to their businesses. If your community would like a process to listen to business owner needs, the Business Retention and Expansion program offered through CEDIK can help your community improve the communication loop.

*Daniel Kahl is the Associate Director of CEDIK and an Assistant Professor in Community and Leadership Development at the University of Kentucky.


Going About Your Business

By Daniel Kahl*, CEDIK Associate Director

Communities are in a relationship with local business

Experience tells us that relationships demand attention. Relationships require the investment of time, energy and attention to maintain effective communication and trust. The risk is, of course, that if we stop investing in relationships, the relationship will suffer and could even end completely.

Communities are in a relationship with local businesses. Without on-going communication, trust building, and concern for the well-being of those businesses, the business/community relationship can begin to break down.  When the relationship ends, the business may just begin to search for a more engaged community.

Downtown Cynthiana, Kentucky. Photo credit: Sarah Bowker, December 2019.

What do we learn by listening?

The Community and Economic Development Initiative of Kentucky (CEDIK) at the University of Kentucky has been listening to business needs. Across Kentucky, surveys and listening forums are telling us that small businesses need community support. In a recent report published by CEDIK (Kahl, Fawcett, et.al. 2019)  73% of store representatives identified finding and retaining employees as one of their greatest business challenges. Other challenges raised include: taxes, training employees, and keeping up with rules, codes, and policies. While the above study was a small sampling, a statewide assessment of community issues hosted by University of Kentucky Cooperative Extension (Statewide Community Needs Assessment, 2019) noted business support and workforce development as some of the most pressing issues in counties across Kentucky.

What can a community do to improve the local business environment?

While every business will have unique needs, businesses in a community often share common concerns that the community can address. The Business Retention and Expansion (BR&E) program offered through CEDIK is one way to document business needs and keep business and community relationships on track. The BR&E program is designed for local government, economic development offices, or Chambers of Commerce. The program is designed to facilitate a listening process that can bring the interests of local business into clear focus. By listening to the concerns of the local businesses, leadership can mobilize resources and energy to respond to local business priorities.

Businesses frequently support local efforts, and the BR&E program helps communities find ways to reciprocate investment in the relationship. For a community, “going about your business” means strengthening the economic environment and relationships with local businesses. Visit the CEDIK website for more information on services to improve your economic environment, including the BR&E program.

Referenced work:

Kahl, D., Fawcett, K., Koo, J., Namkoong, K., and Rossi, J. (2019). Survey of SNAP Food Providers in Eight Kentucky Counties: Business Needs and Community Connections. Available online at:  http://cedik.ca.uky.edu/files/business_needs_community_connections_pse.pdf

Kentucky Cooperative Extension Community Assessment, Statewide Report (2019). https://extension.ca.uky.edu/files/kentucky_extension_community_assessment_2019.pdf

*Daniel Kahl is the Associate Director of CEDIK and an Assistant Professor in Community and Leadership Development at the University of Kentucky.

Summer 2019 Promise Zone Downtown Convening Recap

By Shane Barton, Downtown Revitalization Coordinator

The summer ‘19 Promise Zone Downtown Revitalization stakeholder convening was recently held in Williamsburg, Kentucky on Friday, July 19th, 2019, at the Whitley County Fine Arts Extension & Community Arts Center.  The Fine Arts Center, located on Main Street in the heart of downtown, offered a central location to gather, share, and explore what downtown communities throughout the Promise Zone have recently accomplished.  The Kentucky Extension Fine Arts Program is coordinated by the Kentucky Cooperative Extension Service and the Community and Economic Development Initiative of Kentucky with a mission to create and support opportunities in the arts for citizens that will stimulate creativity, promote participation, and recognize artists, arts educators, and arts supporters at all levels and mediums. Following previous convenings in Harlan, Barbourville, Pineville, Hazard and Middlesboro, the Summer ‘19 convening was planned to provide a timely and impactful experience focused on preparing for, and sharing, proposed efforts associated with Promise Zone Downtown Revitalization Implementation Grant investments.

Like previous convenings, the day began shortly after 10am as the location and presence of one-way streets proved to be a bit difficult for some to navigate, given that GPS was slightly confused about the physical location of the building.  Upon arrival, attendees were invited to choose their own adventure for the morning, picking one of two concurrent experiences offered. One focused on utilizing intercept surveys to measure impacts, while the other offered a guided walking tour showcasing a variety of creative placemaking efforts in Williamsburg. Both sessions were developed to inform and inspire similar efforts.

dt_convening_july19_the-burgThe walking tour provided context to a variety of specific sites but more importantly focused on the synergy being built between local government, citizens’ groups like Why Whitley, the University of the Cumberlands, and College of Design and Landscape Architecture students from the University of Kentucky.  Together they have been able to reshape the future vision for downtown Williamsburg and make strategic investments to reach their goals.  The tour included stops at a previously vacant lot recently transformed into a viable community event space hosting outdoor concerts and festivals (River Fog), a newly updated boat launch on the Cumberland River attracting water enthusiasts downtown as well as a series of adjacent buildings being transformed into housing and retail in the heart of downtown by the University of the Cumberlands.  While isolated each project may not appear to have much of an impact but efforts to link each in cohesive ways has helped reframe the downtown experience in Williamsburg for future generations.

dt_convening_july19_shaneWhile half of the group experienced Williamsburg by foot the remaining attendees participated in a training focused on utilizing intercept surveys to gain insights on the economic impacts associated with downtown investments.  This training provided a foundational understanding of survey methods used to develop and deploy intercept surveys for a variety of projects with special attention given to trails, wayfinding, festivals, and infrastructure improvements. Attendees worked through a series of guided reflections to develop question sets specific to their local needs and adapted an existing survey to reflect what they could utilize in their own community.  The session wrapped up as each attendee ‘intercepted’ a walking tour attendee as they rejoined the group.

Similar to all previous convenings lunch was provided by a local caterer and Handlebar Nate’s Gourmet Food Truck did not disappoint.  Attendees were treated to a Tex-Mex buffet featuring both grilled chicken & ground beef with sides of Spanish rice, black beans, corn, grilled peppers and onions, spring lettuce, shredded cheese, nacho cheese, tomatoes, jalapeños, banana peppers, and black olives with a choice of Nate’s homemade sauces featuring local ingredients. While attendees filled their plates, Nate shared his story – one of service and perseverance. Nate described his rehabilitation after experiencing severe and disabling trauma while serving in an active combat zone and how he launched, and has since, used the food truck as an opportunity to feel productive again while helping transitioning veterans reenter the workforce.

Keeping within the tradition of hosting a lunch program, Ryan Sandwick, CEDIK Community Design Specialist, and student interns (Harrison Knifley, Jordan Hackworth, Lily Hutzell, and Rachel Crosslin) shared about their efforts this summer partnering with One Harlan County, Harlan Tourism and the Harlan County Cooperative Extension Office to inventory and analyze downtown Harlan. This summer the students have focused specifically on the buildings and places in downtown Harlan that give it its unique character with special attention given to how each can be capitalized to support broader revitalization efforts. Each student spoke about their particular specialty, how it intersects with the collective efforts and how their insights support the long term vision of Harlan’s downtown revitalization process. The presentation featured 3D modeling and wrapped up with an extensive, digitally-rendered, fly-over showcasing specific efforts and elements the students highlighted as catalytic projects to downtown Harlan’s revitalization.

The afternoon featured a session led by CEDIK Economic Development Extension Specialist Luke Ramsay. It was tailored to assist communities in their preparation of ‘pitches’ to potential investors. The interactive training introduced participants to the concept of a pitch book and offered examples showcasing how other communities have marketed themselves to potential Opportunity Zone funders.


Throughout the day community stakeholders from five downtowns took the stage to share presentations on their recently submitted Promise Zone Downtown Revitalization Implementation grants.  Bell County Tourism director Jon Grace spoke about collaborations in Middlesboro and Pineville to invest in murals and additional wayfinding directing a passerby to their downtowns.  Maggy Krieblel, director of Corbin Tourism and Aaron Sturgill, Corbin’s Downtown Manager spoke about their efforts to install additional wayfinding signage to direct potential visitors from interstate 75 to their downtown.  Downtown Development and Event Director for Harlan, Laura Adkisson, and Harlan City Tourism Director, Brandon Pennington, shared about Harlan County’s efforts. One such effort involves investing in improved accessibility, focusing on sidewalks. Laura and Brandon explained that infrastructure updates taking place around the county will ultimately make each impacted community more accessible for visitors of all abilities. Manchester Downtown Proud members Christie Green and Amy Dunzweiler discussed their multi-pronged proposal that features elements touching on codes and ordinance digitization and enforcement, wayfinding, historic banners and an incentive fund to support new businesses and entrepreneurs in Manchester. Bailey Richards, Hazard’s downtown coordinator, described their recent success in acquiring funding for a substantial downtown pavilion and articulated how additional investments in public bathrooms, wayfinding and supplementary infrastructure will amplify the user experience for current residents and potential visitors.

Our next convening will take place in the fall of 2019 and is tentatively scheduled to take place in Manchester, Hyden or Whitesburg.

Want to learn more about the Promise Zone Downtown Revitalization project? Visit our website or connect with Shane Barton, Downtown Revitalization Coordinator.

CEDIK Summer 2019 Interns: Harlan County, Kentucky

By Ryan Sandwick, CEDIK Community Design Specialist

Building upon the successes of last year’s summer community design internship program that focused on downtown Manchester, we are excited to share the work our 2019 interns have been doing in downtown Harlan this summer. Partnering with ONE Harlan County and the Mountain Mural Mega Fest, the students are halfway through their schedule and have been busy inventorying and analyzing downtown.

Before we talk more about this summer’s program though, I would like to introduce the interns:

20190509_112928.jpgHarrison Knifley
Hometown: Columbia, KY
University: University of Kentucky
Major: Undergraduate in Landscape Architecture

Jordan Hackworth
Hometown: Cumberland, KY
University: Northern Kentucky University
Major: Undergraduate in Visual Communication Design 

Lily Hutzell
Hometown: Annapolis, MD
University: University of Kentucky
Major: Graduate in Historic Preservation

Rachel Crosslin
Hometown: Hendersonville, TN
University: University of Kentucky
Major: Undergraduate in Architecture

Given the diverse backgrounds of the students, this summer’s work will have a focus on the buildings and places in downtown Harlan that help give the downtown its unique character. Once these elements have been identified the students will work together to determine how these elements can be capitalized on to support downtown revitalization.


During our work in Manchester last summer we used a pop-up mobile design studio located in a downtown storefront every Thursday. However, due to the length of time it takes to travel to Harlan from Lexington, day trips are not as feasible. Therefore, we have worked with our local partners, including Harlan County Tourism, for monthly overnight visits to Harlan where we stay in a historic downtown bungalow. Scheduled for a Wednesday morning through Friday evening each month, and using the Harlan County Cooperative Extension’s Depot as our mobile office, the students are getting fully immersed in what life is like in downtown Harlan, such as getting morning coffee from the Huddle House, walking to the Commissary in the evening for an ice cream, and going to a punk show and eating pizza on Main St. Each of these are everyday activities, but they enrich our work as we experience life in Harlan as overnight residents rather than daily visitors.


Focus Areas
This is an exciting, multidisciplinary project that will not focus on buildings, parks or streets as individual pieces of the city, but rather will approach downtown Harlan as a cohesive ‘place’. This will be accomplished by each of the interns in the cohort bringing their specific expertise to the table. While each intern will work on their particular specialties, such as architecture or historic preservation, it will be necessary for them to support each other’s efforts while learning allied vocabulary, skills and techniques. These efforts center around collecting and evaluating each of the pieces that contribute to the downtown experience. The final deliverable of a comprehensive document of the findings and recommendations will be presented to our partners and key stakeholders at the end of the summer program and provided to the community as a hard document in the following months.


Project Goals
Our project seeks to create a master plan of downtown Harlan that will identify the downtown’s opportunities and constraints to formulate recommendations on how best to capitalize on them moving forward. This master plan provides a foundation for prioritizing future investments to support downtown revitalization. The following themes will be addressed as important focus areas within downtown Harlan:

  • Evaluate the downtown experience and make recommendations on public realm improvements based on findings/observations.
  • Explore which public spaces and corridors in the downtown should be prioritized as investment opportunities.
  • Identify the downtown’s current pedestrian experience (sidewalks, seating, public art, trash cans, etc.).
  • Identify the downtown’s current vehicular experience (street circulation patterns, traffic speeds, parking locations, etc.).
  • Explore opportunities to address the physical and visual impact of the flood walls.
  • Understand what and how people would like to see, use and experience downtown Harlan in the future (short, medium and long terms).

Through July, the student interns will be diligently working to understand the unique character of downtown Harlan, what it means and how it can be capitalized upon for the future. We will keep you updated as the project continues!

For questions or further information please reach out to Ryan Sandwick, CEDIK’s Community Design Specialist at: Ryan.Sandwick@uky.edu

Ambulance Services: How Does Kentucky Compare to the U.S.?

By SuZanne Troske, CEDIK Research Associate

At CEDIK, we have three studies of ambulance services in the U.S.:

Our goals in researching ambulance services are:

  • To understand quality and costs of ambulance services and how to deliver effective emergency services for the lowest cost,
  • To discover the characteristics of patients who use ambulance services and how usage varies across the U.S. and between rural and urban areas,
  • To understand emergency healthcare – especially in rural areas – more specifically, how emergency services change if a hospital closes in a community.

After learning more about ambulance service operations across the U.S., we now wanted to see how Kentucky compared to the national average in ambulance service characteristics. For ownership types Kentucky has, on a percentage basis, fewer ambulance services managed through fire departments and more through community non-profit organizations (Figure 1). From conversations with EMS managers, there is no “typical” mix of ownership types in the states. Each state is unique.

Figure 1. Kentucky and U.S. EMS Agencies by Ownership Type (Percentage).

We summarized data from the Kentucky Board of EMS which reports the average call times of all ambulance calls for the state. Unfortunately, the latest data are from 2017 which do not include calls from Louisville. Louisville started reporting in 2018. The times in Kentucky are very similar in the time it takes to arrive at a scene (time to scene) and time at the scene (scene time) as the national average (Figure 2). The time traveling from the scene to the hospital emergency room is longer in Kentucky. One reason may be because Louisville data are missing which would presumably have shorter transport times as it is more urban.

Figure 2. Ambulance Call Times (in Minutes), Kentucky and U.S.

The last comparison we want to make is about how much Medicare beneficiaries are using ambulance services. Based on Medicare claims, on average more Medicare beneficiaries are transported to a hospital in a year (15.9%) in Kentucky than the average state (12.2%). Those beneficiaries who use the ambulance service travel more miles per trip (15.5 miles) than average (12.5 miles) and use the service more often (2.0 days per year) than the average (1.8 days per year).figure_3

March 2019 Promise Zone Downtown Convening Recap

The first Promise Zone Downtown Revitalization stakeholder convening of 2019 was held Tuesday, March 5th in Middlesboro, Kentucky at the newly constructed Southeast Community and Technical College Middlesboro Educational Alliance Center. The center features applied medical training facilities utilizing technology to advance the career readiness of students enrolled in a variety of health related degrees. The center’s meeting space proved to be the most technologically advanced space we have held a convening at to date with smart screens at the front and rear of the room, while the walls featured a number of flat screens – there truly wasn’t a bad seat in the house. Following previous convenings in Harlan, Barbourville, Pineville and Hazard – the Winter ‘19 convening was planned to provide a timely and impactful experience aligned with the Promise Zone Downtown Revitalization Implementation Grant RFP release.

The day began shortly after 10am as the new building proved difficult to find for many, given it’s not yet displayed on many GPS mapping services. Attendees were invited to share upcoming community events on the large calendar covering the wall just above the coffee as they registered themselves. The shared events will be aggregated and shared with Promise Zone community stakeholders. The program for the day started with the official release of the Promise Zone Downtown Revitalization Community Implementation Grant Program RPF and discussion about the grant details.  The most substantial changes from the recently implemented mini grants are the size, scale, and scope of the projects, with importance placed on engaged processes and existing plans informing the proposed idea and the emphasis placed on utilizing data and indicators to document anticipated outcomes and success. Alison Davis, CEDIK Executive Director, addressed these changes while providing an applied grant writing workshop that included a review of why proposals often fail, the components of an effective proposal, utilizing logic models to evaluate proposed ideas, crafting a budget, and identifying additional funding opportunities. The workshop allowed attendees time to work with their local stakeholder teams to draft proposal ideas following a logic model as well as explore goals, activities, timelines, and responsible parties on a provided template.


Similar to previous convenings, lunch was a local treat. Local catering was provided by Jamie Jones and Southern Roots Catering. Jamie treated attendees to his popular Korean pork tacos and a large portion of a healthy sweet potato side. Jamie was invited to speak with attendees to share his recent success story – Southern Roots Food Truck catered our previous Pineville convening but in the time since June 2018 Jamie acquired a small business loan and recently opened his own brick and mortar restaurant establishment in Pineville, Kentucky.

Keeping within the tradition of hosting a lunch program, Colby Kirk of One Harlan County shared the story of their new effort to identify and market available vacant buildings in Harlan County. Colby discussed the partnership with Harlan Tourism and others to assess and map the 15 vacant buildings in the city of Harlan.  These buildings represent a vacancy rate of 23%, a mere fraction of what was anecdotally assumed to be closer to 75 or 80 percent. Colby explained (see video below) how the clustering of vacancy gives the perception of mass vacancy, when in fact there are simply a few clustered vacant spaces on the same block. Colby shared the letter and short survey that was sent to each building owner (identified using PVA data). The survey suggested the recipients held the keys to Harlan’s future and asked if they have considered occupying the spaces they own or if they would entertain leasing the space to new businesses.  Additionally, One Harlan County conducted an analysis of the cost of downtown commercial space as a comparative analysis in support of their marketing efforts.  As a result, four previously vacant buildings are currently being marketed for new tenants in the City of Harlan.  This presentation represented an engaged assessment opportunity that has already proven successful as previously unengaged building owners are now engaged in a marketing strategy to occupy their available buildings. Colby’s presentation was informative and motivational as communities informally discussed throughout the day how they could implement a similar effort in their own communities. Colby’s presentation was followed by a facilitated conversation framed around what success looks like and how we can measure those changes similar to vacancy rates in the city of Harlan.


The afternoon featured an interactive and applied engagement process training for all the attendees and resource partners in attendance. The round robin exercise infused problem solving, creativity, innovation, group consensus, and a bit of persuasive pitching. The process involved four rounds of individual exercises followed by multiple group rounds where individually proposed ideas for downtown projects that would positively impact the entire Promise Zone were revised and refined, until there were two proposals reflecting the general consensus of the room. The excitement in the room as individuals and their subsequent groups refined good ideas in to the great ideas was palatable and nearly uncontainable. The final idea developed by the room featured a regional arts program showcasing the significant creative and arts contributions being made in each downtown, coupled with a training program to support the creation of murals and other vibrant and reflective public art and expression.

Our next convening will take place in the spring of 2019 and is tentatively scheduled to take place in Williamsburg, Kentucky.  Date and location to be determined.

Want to learn more about the Promise Zone Downtown Revitalization project? Visit our website or connect with Shane Barton, Downtown Revitalization Coordinator.