They are one step away from getting a multimillion-dollar, federally funded community health center that will treat patients on a sliding scale payment basis.
The Mingo County Diabetes Coalition got $50,000 a year through Marshall Medical School to stir up diabetes prevention efforts.
Those efforts include monthly Williamson-area 5Ks, organized with the Tug Valley Road Runners and the city.
The Redevelopment Authority broke ground on a recreation/lodging complex on the Hatfield-McCoy trail that will generate dollars through cabins, RV camping, and biking/hiking trails.
The schools and Diabetes Coalition created running/walking programs in all middle schools. Each eighth-grader got a pedometer for a 10,000 steps-a-day competition. They held their own 5K. "We aim to spread it to all the schools," Keathley said.
The schools have started new sports programs -- soccer, track, volleyball and golf -- and near-doubled after-school physical activities.
All school cooks are making healthier meals from scratch. Last year, they got training with the help of the state Office of Child Nutrition.
The Diabetes Coalition won a $2.5 million grant through Duke University to canvas the county to find undiagnosed diabetes and come to their homes to teach them how to bring down their blood sugar.
The group is constructing a "smart office" on Main Street, which is slated to be a sustainable technology training and demonstration center for the coalfields.
The farmer's market has grown from one day per month to one day a week and is operating in the black. The city donates space, and the Garden Club and Southern Community College students help. They plan to add days as they grow.
Two new large hoop greenhouses will soon stock the market year-round. This summer, Extension staff will teach anyone who wants to learn how to build one.
Elderly residents are growing corn on city land in community gardens, with the help of Extension, Southern Community College students and the Garden Club.
As the city tears down abandoned buildings, they secured training in salvaging elements that can be sold or incorporated in projects such as the recreation park.
A mountain biking club has started, the Tug Valley Trailblazers. "This is a new activity, so we're mapping trails and getting bikes," said Bruce Curry, Southern West Virginia Community and Technical College staffer.
Southern students are creating a plan to make Williamson a bicycle-friendly city.
A community orchard is producing pick-your-own grapes and apples on two acres of an abandoned strip mine outside town.
Six senior centers and churches ran the "Walk with Ease" exercise program, with the help of the Diabetes Coalition. "We'll do another round this spring," said Jenny Hudson, new Diabetes Coalition director.
Mingo, Wayne and McDowell counties and Pike County, Ky., have formed CASE (Central Appalachia Sustainable Economies), a help-each-other technical assistance cooperative.
As a CASE project, public health graduate students from Appalachian State, WVU, Connecticut Wesleyan and Yale University will come to all four counties this summer to lend expertise and get experience.
A private gym has been rehabbed to Public Employee Insurance Agency specifications so public employees can enroll in PEIA's Weight Management Program.
The USDA designated Williamson a STAR (Small Town Appalachian Revitalization) city, making them eligible for technical assistance from USDA and Appalachian Regional Commission. "It also means they will be a model town for other towns," area director Tracey Rowan said.
The STAR program funded a conference that brought foundation representatives to Williamson to hear about these efforts.
"The Shape We're In" has been supported by a Dennis A. Hunt Fund for Health Journalism fellowship, administered by the California Endowment Health Journalism Fellowships at the University of Southern California's Annenberg School for Communication and Journalism.