Mitchell County is a rural county with a population 15,579 (95.3% white, 0.4% Black, 4.1% Hispanic). It is located in the Blue Ridge Mountains in Western North Carolina and faces a crisis in the burden of chronic disease. According to the North Carolina State Center for Health Statistics, the rates of heart disease, cancer and respiratory disease are higher for Mitchell County than for the State. Additionally, there is a high prevalence of the risk factors linked to these diseases. According to Western NC regional data 61% of adults are overweight or obese; 56% do not meet national recommendations for physical activity; 71% consume less than 5 servings of fruit and vegetables daily; and 22% of adults currently smoke, a rate higher than the state. These issues are also affecting the county’s children. According to the NC Nutrition and Physical Activity Surveillance System, rates of childhood overweight/obesity for children ages 2 to 4 are significantly high (27.4% vs. 29.4% for the state). Additionally, Mitchell County has a rapidly growing older population; currently at 20.9%. By 2030, projections estimate that there will be more than 26%, which is almost 4,000 people 65+ that will be living in the area.