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On a warm summer evening in Alamance County, veterans and community members gathered for an unexpected public health event: an art show. The walls displayed paintings, photography, and mixed-media pieces, each one telling a unique story. As veterans stood beside their work, talking with visitors about what inspired them, the atmosphere was alive with connection — a reminder that feeling seen, supported, and part of a community is essential for our well-being.

This art show was the product of a UNC-Chapel Hill initiative called the Healthy Vets Community Project, led by Vaughn Upshaw and Aimee McHale, professors in the Gillings School of Global Public Health.

The idea began in 2018, when Upshaw met Paul Crews, director of the Durham Veterans Affairs Health Care System, at a UNC-Chapel Hill public workforce conference. Their conversation highlighted a key challenge: the difficulty of connecting veterans with community-based mental health services. Upshaw quickly saw this wasn’t just a clinical issue; it was a public health one.

Veterans face distinct health challenges shaped by their service, transition to civilian life, and the communities they return to. Many experience higher rates of post-traumatic stress disorder, depression, anxiety, physical injuries, chronic pain, and exposure to environmental hazards. Some also grapple with deep psychological distress from actions during service that conflict with their personal values.

In rural counties, where many veterans live, limited public transit can make it difficult to attend medical appointments or social programs. Upshaw saw an opportunity to apply public health tools to address these barriers.

Today, that conversation has grown into a larger project. With McHale, Upshaw has developed the Healthy Vets Community Project into a phased initiative that partners with communities across North Carolina to strengthen the resources, networks, and conditions that affect veteran health.

The project’s early days were experimental. Upshaw and McHale didn’t begin with fixed goals, just a shared commitment to making a difference. They recruited Gillings students with military connections, using their lived experiences to help shape the initiative.

So far, these efforts have resulted in reduced bus fares in Rocky Mount, eastern North Carolina’s first veteran resource fair, the creation of all-in-one support service centers, and improved mental health hotline screening in Alamance County.

“The public health approach means you’re guided by the evidence,” McHale says. “From the beginning, it was: ‘Let’s start digging and see what we find.’”

A paradigm shift

Health is shaped by more than doctor visits. It’s influenced by housing, transportation, food access, and social support. That’s where public health comes in: strengthening the systems that keep communities healthy.

The Healthy Vets Community Project uses the vital conditions framework to examine these broader forces.  

“We’re not working with veterans directly, but with the people who serve them,” Upshaw explains. “Our project is elevating their visibility.”

The project began with a comprehensive literature review exploring how social and structural determinants like housing stability, food access, and social support impact veteran health. This research helped ground the project in evidence, revealing where communities could intervene most effectively.

Then, they began creating visual resource maps by overlaying where veterans live with the presence, or absence, of resources to highlight community strengths and gaps.

Armed with data, the team partnered with three pilot communities — Alamance County, Rocky Mount, and Wake County — to build relationships, identify assets, align priorities, and launch community-led initiatives to address real, lived issues.

 “You don’t have to be a psychologist or a psychiatrist to be able to help veterans and move people away from the cliff of mental health crisis,” Upshaw says. “People want to be seen, people want to be helped, and everybody wants to be a part of that picture.”

Insights to impact

With a $6.8 million grant from the Veterans Health Administration, the Healthy Vets Community Project is entering phase two, turning knowledge into action with four ambitious aims.

The first is to create a veteran registry guide, a practical tool to align referral systems and simplify access to services. The second will expand their resource maps to cover all 100 N.C. counties, giving leaders a clear picture of where veterans live and where resources are lacking.

The third goal, ecosystem mapping, paints a broader view to show how organizations, policies, and institutions interact. And the fourth will develop scalable tools to empower communities to build veteran-friendly environments and recognize sustainable efforts.

McHale now represents Gillings on the North Carolina Institute of Medicine’s new veteran health task force. The hope is that the project’s insights will inform not only local programs but also state-level policy decisions.

“The beauty of this project is it’s the kind of thing that can pull communities together, where people can work across partisan lines to serve the people who have served us,” McHale says.