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Tennessee is fighting a war to improve people’s health — and it’s years away from being won.

Gov. Bill Haslam described efforts to reverse the state’s poor health as “a slow turning battleship” in remarks at a celebration for counties making strides toward being healthier.

Both Haslam and Rick Johnson, CEO of the Governor’s Foundation for Health and Wellness, invoked conflict terminology on March 27, to talk about how critical grassroots efforts are to put Tennesseans on a healthier path.

Tennessee’s top leaders have worked for more than a decade to make significant strides in improving education and the economic outlook. But Haslam said poor health is “going to drag down all the other areas if we don’t do something.”

“Challenges are still in front of us,” said Haslam. “The battle has not been won.”

The foundation awarded 13 counties and one city, Kingsport, with plaques for achievements — ranging from logging thousands of miles walked to setting up a food pharmacy and hosting cooking classes — aimed at getting friends and neighbors moving and thinking about health.

Warren County Mayor Jimmy Haley said initiatives in his county are vital given the “severe financial burden” that the county’s 15 percent uninsured population has had on hospitals.

The governor’s foundation started designating communities in the “Healthier Tennessee Community” pilot three years ago. As years passed, the number of schools, workplaces, towns and neighborhoods participating has grown.

There’s a healthy community in nearly every county so Johnson said the next chapter has to focus on how deep the groups can reach into communities for participation.

It’s not enough, he said, for a group of 15 people to be engaged: the energy and commitment has to spread to more people.

The state’s fight to establish a healthier culture has a long and winding path ahead.

Tennessee ranks among the worst performers for prevalence of chronic disease and behaviors that promote health.

The state’s outsize share of diabetes, hypertension, and cardiovascular disease carries an extra $5.3 billion a year in health care costs, according to the Sycamore Institute.

For comparison, Johnson noted, the state spends $4.7 billion annually on K-12 education, not including federal or local spending.

Changing the culture to instill healthier attitudes — or as Haley said to help people move away from eating biscuits and gravy every single day — will take years and be the byproduct of many local initiatives that currently impact a few. But, leaders hope, that in aggregate will change the course of the state in the coming decade.

Sequatchie County, one of the state’s smallest counties, was celebrated for hosting “Dinner with a Doctor,” hitting high student participation rates in GoNoodle, and finding success for its Facebook page.

What happens in its corner of southeast Tennessee matters.

The “citizen-led movement” across the state is a significant achievement, Johnson said. But the movement needs to gain strength and find ways to reach new people.

Measuring progress is years away, Johnson said in an interview. Some measurements such as rates of activity and smoking could be reflected in stats in five to eight years.

Others, such as rates of disease, could be ten years or more.

Johnson’s remarks to the crowd, who came from across the state, were as much a congratulations as a pep talk.

“It’s the citizens in Tennessee working to make this a healthier Tennessee,” he said. “There’s a long way to go — I know you know that.”•