Missouri High Obesity Project - The proposed project addresses obesity and related chronic disease in 10 counties in South Central and South East Missouri: New Madrid, Mississippi, Scott, Stoddard, Ripley, Wayne, Howell, Wright, Crawford, and Washington. All identified counties have obesity rates ≥40%, and have high rates of physical inactivity, limited access to healthy foods, consistently rank in the lowest-quartile of health rankings, and are frequently identified as counties of highest need around the state. This project will implement evidence-based policy, systems, and environmental change strategies to improve nutrition and physical activity participation in targeted communities. The project will promote food service and nutrition guidelines, coordinate the expansion of existing produce voucher and prescription programs, and implement activities that advance farm to ece. Supported by a strong network of partners, regional and state Extension Specialists, and project coordinators, targeted communities will go through training, coalition building, and needs assessments before developing a strategic plan to improve healthy food access, and create safe places for people to be physically active, and connect residents to every day destinations. These sustainable, community-led approaches will reduce health disparities by improve eating patterns, increasing physical activity levels, and leading to overall increases in healthy behaviors and reduction of obesity rates.