Cooperative Extension Evolves Cooperative Extension has been working to advance personal health since its inception. The foci of early programs ranged from safely preserving food and basic sanitation to ensuring water quality for the large number of rural residents who obtained their drinking water from private wells. Nutrition Education Over time, the scope of health-related programming by Cooperative Extension diversified, and its audience expanded. For example, Cooperative Extension’s work to promote the adoption of healthy eating guidelines such as the Daily Food Guide (1956), My Pyramid (1992), and My Plate (2011) was designed to reach into both suburban and urban neighborhoods. In 1969, Extension became responsible for delivering the Expanded Food and Nutrition Program (EFNEP) that has helped low-income families and youth achieve nutritional security wherever they may reside. More recently, Cooperative Extension has become the nation’s largest provider of nutrition education for individuals and families eligible to receive food assistance benefits by serving as an implementing agency for a program called the Supplemental Nutrition Assistance Program - Education (SNAP-Ed) (Yetter and Tripp, 2020).
Expansion of Health Programming
Beyond nutrition education, Cooperative Extension’s portfolio of health-related work has evolved to include efforts related to agricultural safety, physical activity, chronic disease prevention and management, mental health, cardiovascular health, substance misuse prevention, stress management, food security, water quality, skin cancer prevention, radon education, immunization education, and healthy aging. Today, Cooperative Extension is actively engaged in addressing issues related to environmental health, antibiotic resistant bacteria, and the health impacts stemming from the interactions between humans and animals. However, until recently, these activities were not considered or undertaken under a unified banner of “health”. As a result, the magnitude of Cooperative Extension’s work in health is often understated, undervalued, or unnoticed. Health Extension Comes of Age Cooperative Extension’s National Framework for Health and Wellness (2014) greatly accelerated health’s rise to prominence as a priority for Cooperative Extension. More specifically, a review of literature revealed numerous examples of how the framework has raised awareness of key concepts of public health practice and healthcare within the organization including the influence of social systems on human health, the triple bottom line in healthcare, and the notion of building a culture of health (Andress & Fitch, 2016; Parisi et al., 2018; Rodgers & Braun, 2015; Smathers & Lobb, 2017). Particularly noteworthy was a special issue of the Journal of Health Sciences and Extension published in 2018 devoted exclusively to programming and scholarship emanating from implementation of the framework. The framework also sparked an increased focus on six programmatic priorities identified in the original document. Extension Engagement with the Health Care Community Several published works also emphasized the importance of Cooperative Extension establishing closer working relationships with the health care community. New models of health extension 6
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