Marshall County's elevated rates of cardiovascular disease and diabetes were dubiously achieved over a period of years.
Similarly, it will take years to lower them.
That is why Marshalltown's Healthier Communities Coalition has been working on a regular basis since 2005 to hit disease causes head-on.
Excessive weight coupled with under-activity were two of the chief culprits leading to the elevated rates, HCC found.
The group is comprised of representatives from business, city and county government, education, health care professionals among others.
Carol Hibbs, Marshalltown YMCA-YWCA CEO and Kim Schryver, a volunteer from Marshalltown, co-chair the group.
Attendance at all meetings has remained steady and 2013 brought in a number of new community partners and excitement, Hibbs said.
The group met Monday at the Y to hear updates on work being done in implementing healthy eating and physical activity standards in child care sites, and progress of the Y's Diabetes Prevention Program.
Previously, the group designed the Eat Smart, Move More, Live Well! initiative for county residents in August, 2010.
The effort promotes healthy eating habits coupled with physical activity. A website - livewellmarshallcounty.com encourages participation.
Additionally, HCC has partnered with Governor Terry Branstad's Healthiest State Initiative - an effort established in 2011 to make Iowa the healthiest state in the nation in five years.
The state effort is a privately led, public enterprise that engages Iowans and communities throughout the state.
Hundreds of Marshalltown-area residents participated in two "Start Somewhere" activities sponsored by the program in 2011 and 2012.
A centerpiece of the governor's program is the Blue Zone Project.
A Blue Zone is a geographical defined area where people live measurably longer, healthier lives as described by author Dan Buettner - who helped pioneer the concept.
Wellmark - Blue Cross/Blue Shield of West Des Moines invested $25 million in the project, which provides hands-on assistance to communities to assist residents attain the healthier lifestyles.
Marshalltown's preliminary application was approved in 2012 but it was unsuccessful next round.
Cedar Falls, Mason City, Spencer and Waterloo did succeed.
Yesterday they were joined by Cedar Rapids, Iowa City, Marion, Muscatine, Oskaloosa and Sioux City.
Hibbs said the coalition may consider submitting another Blue Zones application, but currently the group is busy with other endeavors.
"At the appropriate time we will evaluate the Blue Zone application and make a decision then," she said. "The program offers much in the way of assistance, so I know our team will be diligent."
Since the Blue Zones application was turned down, the coalition has submitted applications to other entities in ongoing efforts to reduce obesity and prevent diabetes.
Hibbs said the coalition expects word on one application "in the next few days."