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12 municipalities near St. Louis went all-in on health. Here’s what happened.

This feature was produced by Robert Wood Johnson Foundation, and does not reflect the opinions or point of view of Vox Media or Vox Creative. Vox Media editorial staff was not involved in the creation or production of this content.

On a map, 24 contiguous municipalities just northwest of St. Louis resemble nothing more than a crazy quilt. And for decades, their governance and services were a patchwork, too. Each municipality — from the tiny, two-street Village of Glen Echo Park, population 160, to the neighborhood-sized City of Normandy, population 5,008 — has its own government. That's two dozen mayors and city councils and about as many police departments in an area that spans almost 11 square miles, is home to 36,250 people, and is served by one school district.

Over half a decade ago, city leaders rose above their individual municipal identities and city charters, embracing an "all-for-one" approach. Calling themselves "24:1," they first came together in the midst of the nationwide mortgage foreclosure crisis that threatened the health of individuals, families, neighborhoods, and entire communities. Today, the 24:1 municipalities strive to realize a unified vision: strong communities, engaged families, and successful children. Explore the links throughout this story to learn more about 24:1's work.

Daycare provider Tina Mosley reads to Londyn Kennell, 2, at Our Daycare, in the 24:1 Community.

[Now showing in Pagedale, MO: Hope]

"If one community fails, we all fail," says James W. McGee, mayor of the City of Vinita Park on the western edge of the 24:1 footprint. "To start healing the community, you have to have everybody involved. If everybody takes ownership, then you're going to have a healthier community."

For this unique spirit of collaboration and healing, the 24:1 Community has been honored with the RWJF Culture of Health Prize.

The 24:1 municipalities, whose total populations are 80 percent black, are tackling deep challenges to health and well-being. More than nine in 10 of their public school students qualify for free or reduced-price lunch. The unemployment rate is three times the county norm. People in the area live, on average, 15 fewer years than residents of Clayton, a more affluent community just three miles away. To cap it all off, four years ago the school district lost its state accreditation after 18 years of struggling under "provisional accreditation."

Samijah Robinson, 3, cools down during "Beyond the Backpack," a back-to-school event at Normandy High School.

[Mayors — working together — set agenda for change]

Shared concern about the community's ills brought the municipalities together in 2008, when more than half of their mayors first gathered. They were convened by Beyond Housing, a neighborhood development organization that was already building and maintaining affordable housing with supportive social services in the City of Pagedale. With the foreclosure crisis eroding some of Pagedale's success in increasing property values and improving children's school performance, Chris Krehmeyer, Beyond Housing's president and CEO, wanted to spark a wide-ranging conversation: How do we make the community better? How do we make it whole?

The answer was to collaborate. "At the end of the day, housing alone won't fix our community," Krehmeyer says. "Education alone won't fix our community. Jobs alone, health alone, economic development alone won't help our community, but we think having all of them together and intentionally integrating them to make the fabric of a place healthy is going to give us long-term economic success."

[A school district stripped of accreditation fights to do right by students]

So, in 24:1 they're trying to do it all—together. Superintendent Charles Pearson of the Normandy Schools Collaborative, the reorganized and state-controlled school district, meets regularly with the mayors to update them on the quest for reaccreditation and to enlist their help spreading the word about priorities and accomplishments. The municipalities and Beyond Housing also have taken steps to spur economic development, particularly in Pagedale, and to bring a new health clinic to the community. To keep some of the most devoted residents of 24:1 — the older generation — from moving away, Beyond Housing worked with two municipalities to build senior living centers. Residents of one of the two complexes, erected on the site of an abandoned liquor store, will tutor and mentor students at the elementary school across the street.

[Eight years after the housing crisis, a community works to regain its footing]

Other resources meant to improve health for residents of various ages have sprouted up across 24:1, including free fitness classes, a free summer youth softball league, and a planned expansion of the seven-mile St. Vincent's Greenway walking and biking trail. Once completed, the trail will diagonally connect one corner of 24:1 to the other, from the City of Wellston to the Village of Bel-Ridge. A project to convert many of the area's potholed, unappealing streets into walkable, well-lit, tree-lined boulevards is also slowly coming to fruition.

Though challenges remain, Krehmeyer says one of the biggest transformations in 24:1 is an invisible one: a shift from resignation to hope.

[How to help in-home childcare providers give kids a quality start]

"I think people now have a sense of ‘Wow, we really may have a community that's going to be exciting, that's going to be vibrant,'" he says. "‘And it's going to be ours, and we can feel proud about where we live day in and day out.'"

Share this story with a friend or colleague who cares about health in America.

This feature was produced by Robert Wood Johnson Foundation, and does not reflect the opinions or point of view of Vox Media or Vox Creative. Vox Media editorial staff was not involved in the creation or production of this content.


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