This report outlines the policy pursued over the past twenty years by the Mutualité sociale agricole (France’s second-largest social security system) regarding health education and promotion among its members, highlighting the key strategic directions adopted and the initiatives implemented at the local level. Taking into account factors specific to rural areas in terms of demographics, health, and new expectations expressed by the population, priorities were established and local health committees were set up. At the municipal or intermunicipal level, action plans developed based on local social development programs proposed by the central fund rely on a partnership between health and social sector stakeholders and community representatives. Four main types of local social development programs have been implemented: rural revitalization programs (PARM); local programs for children (PLE); programs to combat addiction (PACD); and health education and promotion programs (PEPS). More than four hundred initiatives have been carried out over the past three years, particularly addressing the issue of household and workplace accidents on farms, addiction prevention, the development of social and health services, as well as major themes in health promotion.