Million Extra Years
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joey smith in the garden

A Million Extra Years. 

Health director looks to prolong life in Montgomery County


On sunny afternoons, Joey Smith (’99), director of the Montgomery County Health Department, can occasionally be found on Austin Peay State University’s campus. While most people are there to study or teach, Smith’s motivations are a bit more abstract. He spends his down time at the University’s Clarksville campus because he enjoys watching people who dream big.

“I look around and I see people who truly believe that they’ll do something big when they leave here,” Smith said. “I’ll walk through campus or sit at the coffee shop in the student center and listen to conversations, but I always see people who are doing things to better themselves because they’re moving toward a greater goal.

“That’s what I’m trying to do for my community; I’m trying to help this community move toward something greater.”

For Smith, that “something greater” is a number—a very large number—but one he believes is achievable.

“By the time I retire, I want to be able to say that I helped the people of Clarksville-Montgomery County live a million extra years,” Smith said. “It’s hard to get your mind around that number, but the way our community is growing, we could be at 300,000 people by 2030. If I’m able to help every person live just three extra years, you’re already at 900,000 extra years of life collectively.

“What if you had three more Christmas mornings, or three more birthdays to share with your children or grandchildren? That’s what I hope I can say we accomplished by the end of my career.”

Partnering with APSU

To achieve his goal, Smith has enlisted Austin Peay faculty and students in a number of projects geared at improving lives in this area. For the past five years, he has worked with Dr. Patty Orr, APSU professor of nursing, to address what both saw as an alarming reality. After looking into incidents of breast cancer in the area, Smith and Orr discovered that Montgomery County ranked 88th out of 95 counties in Tennessee for breast cancer incident and mortality rates.

“We surveyed the data, and it was really bad in Montgomery County for underserved populations,” Orr, who also occupies the APSU Lenora C. Reuther Chair of Excellence in Nursing, said. “They were being diagnosed when it had progressed too far.”

Those findings prompted Orr and Smith to submit a grant proposal to the Greater Nashville Affiliate of Susan G. Komen for the Cure to help fund breast health education and services to underserved populations in this community.

For the fifth year in a row, the Nashville Komen affiliate has awarded the grant to the two organizations, providing more than $200,000 in that time for free mammograms and breast exams.

“I met with Dr. Orr because I knew she was very passionate about (breast cancer awareness) and I said that there was a grant out there that I couldn’t apply for, but that Austin Peay’s School of Nursing could because they were a 501C3 non-profit,” Smith said. “We decided Austin Peay would apply for the grant and offer an education component from the school for women, while the county health department would pay for screenings and mammograms for low-income women who came into our clinic with that grant money.”

Drive Your County

Smith was able to study how Montgomery County compares to the rest of the state because of a project he helped spearhead, titled Drive Your County to the Top Ten. The project, developed in 2011, examines the 34 health measures presented in the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute’s County Health Rankings and Roadmaps to identify each county’s areas of strength and weaknesses. The report offers a personalized “at-a-glance” view of both where a county currently stands on issues like smoking, obesity and premature death and the changes needed to be ranked among the Top 10 in the state in each issue.

Smith garnered local support for the project after making presentations to Austin Peay faculty, area health professionals and major providers, including Tennova Healthcare. When he self-published his initial report in 2011, the county ranked 17th out of 95 counties in overall health. In just three years, that ranking was able to move to eighth overall.

Drive Your County to the Top Ten is now a state-wide effort, led by the Tennessee Department of Health. But while Smith has seceded control of that project, he is working with Austin Peay faculty and students from the Department of Mathematics and Computer Science on something much larger.

“The statistics I used for Drive Your County are put out every year for every country in America,” he said. “I’ve got the information for all 3,136 counties in the country, so what if I looked at how you could drive your county to the Top 10 of the nation? I reached out to the math and science people at Austin Peay, and they jumped at the opportunity to crunch that kind of big data.”

Smith partnered with Dr. Sumen Sen, APSU assistant professor of mathematics, and Dr. Samuel Jator, professor of mathematics, to see where Montgomery County ranks among its peers across all 50 states. The county health project then became an APSU class project.

“When our math students are working on math theory all day, it can become difficult to see how the work they’re doing applies to the real world,” Jator said. “So when Joey came to us with this project, we jumped at it. For us and our students, (‘Drive Your County’) is a chance to make a difference and show people how big data can be applied outside of the classroom.”

Healthier Montgomery

In 2015, Smith was one of only 12 individuals named to the Kresge Foundation’s national Emerging Leaders in Public Health program. For 18 months, he and his peers examined the longest-living communities in the nation, in addition to taking courses at the Harvard School of Public Health.

The fruit of this research was Healthier Montgomery, a grassroots initiative aimed at strengthening Montgomery County by providing a roadmap to improving life at the street and neighborhood level. By improving people’s personal communities, Healthier Montgomery will help Clarksville and Montgomery County work toward that million-year milestone.

The first step in Healthier Montgomery is for individuals to create an account for their street or neighborhood at From there, people are given five activities, such as organizing a community garden, leading a neighborhood walking event or establishing a cleanup day. Completing all five goals earns the community a sign that identifies it as a Healthier Street and Neighborhood community.

Austin Peay students play a major role in Healthier Montgomery, with Smith tasking interns from the University’s Department of Health and Human Performance with being the initiative’s people on the street. As many of the department’s interns are health education interns, the hands-on work they do with Healthier Montgomery provides invaluable experience for their careers after college.

“Many of these students we provide are future health educators, so this internship gives them a set of credentials and an understanding of their future careers that set them apart,” Dr. Melissa Gomez, APSU associate professor of health and human performance, said. “Joey’s student interns are going to health fairs and going out into the communities with Healthier Montgomery and that’s what health educators do for a living.”

Though it is a new initiative, Healthier Montgomery has quickly gained traction. Launched on April 3 to coincide with Public Health Week, the movement had registered nearly 50 neighborhoods as of mid-May, with an average of roughly one community a day creating an account to see how it can do its part in making a healthier Montgomery County.

“There are a lot of great neighborhood initiatives going on around the nation, but no one was really trying to actually measure improvement at the community level,” Smith said. “Healthier Montgomery is a way to actually capture the action happening and give people a place they can go to see what they’re really accomplishing.”

A dreamer

When Smith walks on Austin Peay’s campus, he says he sees dreamers. And thanks to his connection with the University, he still considers himself one of them.

“I know that I didn’t get where I am on my own and I won’t get to my goals on my own either,” Smith said. “I started my education at Austin Peay, and all these years later, I’m still at Austin Peay. And it’s good to know that, when I need help, Austin Peay is still here and still excited to help me out with my ideas.”