This proposal addresses persistent unemployment and limited access to living-wage employment in Vance County, North Carolina, using a systems-level public health approach grounded in the Vital Condition of Meaningful Work and Wealth. Economic stability is a key driver of health, yet structural barriers such as misaligned workforce training, transportation challenges, fragmented data systems, and policy constraints continue to limit opportunity. Using an integrated framework that incorporates leadership, policy analysis, continuous quality improvement, and systems thinking, this proposal outlines strategies to improve employment access and economic mobility for working-age adults. Recommendations include strengthening cross-sector governance, expanding workforce development pathways, and improving data infrastructure through a public dashboard. Findings indicate workforce training offers the most sustainable long-term impact, while transportation improvements and unemployment insurance reform provide more limited support. Overall, this proposal highlights the importance of coordinated, data-driven, and equity-focused strategies to improve economic opportunity and population health outcomes in Vance County
White et al. (2026) studied this question.