The Missouri Foundation for Health is one of only 11 groups nationally to win grants under a new federal initiative -- the Social Innovation Fund. The foundation got $2 million of the $50 million that the fund distributed Thursday. All recipients are charged with helping local communities develop better outcomes to persistent problems confronting the poor, ranging from struggling with financial issues to coping with AIDS.

Dr. James Kimmey (right), president and CEO of the Missouri Foundation, says the $2 million grant will help his group do more to fight obesity and tobacco use in Missouri. Controlling these twin problems, the foundation says, can help reduce the prevalence of chronic disease and avoidable deaths associated with them.

Nearly 25 percent of Missouri adults smoke, the fourth highest rate in the nation. Each year, nearly 10,000 Missourians die from tobacco-related diseases, while at least $2 billion is spent to treat smoking-related illnesses. Missouri has the nation's 13th highest rate of adult obesity, with more than 28 percent of its residents overweight. The state also ranks 23rd highest in overweight youths between 10 and 17, meaning 31 percent of Missouri youngsters in this age category are overweight.

Kimmey and others describe the national initiatives as a new way of tackling problems. Recipients will be required to show that their solutions actually solve problems; the 11 organizations were chosen partly because of their evidence-based approach to problems. Recipients must also rely on communities to help identify and drive the solutions -- in other words a shift away from a Washington-based, top-down approach.

The funding system in Missouri will work this way: The foundation will supplement the $2 million grant with a like amount of its own money. The $4 million will then be turned into as many as 20 grants for obesity and tobacco prevention programs in poor communities across the state. Those receiving the grants will be required to match them with money from local organizations, foundations, businesses and other investors. In the end, the $2 million grant to the foundation will generate $8 million for community projects.

"We are proud to be included among this first, select group of funders from across the country that have been recognized at the national level as innovators in tackling social challenges," Kimmey said.

He notes that his agency already is funding tobacco prevention and smoking cessation programs in predominantly black neighborhoods in St. Louis and in 50 other communities across Missouri. The additional funding, he said, will expand the foundation's reach to more communities "by replicating proven, effective models of prevention on obesity and tobacco control."

Intermediate effects of the additional anti-smoking and anti-obesity programs, the foundation says, will include drops in tobacco-use rates, a rise in physical activity and higher consumption of fruits and vegetables to improve health. In the long run, the foundation says it expects the targeted communities to see decreases in illnesses associated with smoking and obesity, including diabetes, asthma and high blood pressure.

Adding to the urgency of addressing the problem, one foundation spokesperson notes, is research pointing to higher smoking rates among poor people. African-Americans have higher smoking rates than the general public.

"So to be black and low-income does significantly increase the chance that you smoke," the spokesperson said. "And we know that both of those groups also have a lower than average rate of access to health care or are less likely to seek preventive health care or engage in preventive health choices. So that means these groups are often sicker because their health problems, triggered by the smoking, go untreated longer."

All but three of the 11 awards went to groups in New York, Washington and California. Kimmey said that speaks well of the foundation's work and what it has learned about addressing health problems. He says the focus of the new projects, which are expected to be funded next year, will be on a "model of change that's not just for one small population but change a community."

The Social Innovation Fund is part of the Corporation for National and Community Service, which is taking the lead in President Barack Obama's United We Serve program through AmeriCorps and other initiatives. Patrick Corvington, head of the Corporation for National and Community Service, praised the 11 winning organizations as the "cream of the crop" with "demonstrated track records of making a difference in the lives of people." He said the 11 represented a "collection of extraordinary organizations with an unparalleled body of knowledge and expertise on growing what works."

The awards themselves, he said, marked a "birthing moment. This is a new way of doing business, a different way to community solutions. The best solutions come from communities; problems are solved by people closest to them."