Health Disparities in Appalachia, a new report issued today by the Appalachian Regional Commission (ARC), the Robert Wood Johnson Foundation (RWJF), and the Foundation for a Healthy Kentucky, documents dramatic disparities in health outcomes and other health-related factors in the Appalachian Region when compared with the nation as a whole, as well as substantial variations in health throughout the region’s 420-county footprint.
The study reviews 41 population and public health indicators to provide a comprehensive overview of the health of the 25 million people living in the Appalachian Region, which spans 13 states from northern Mississippi to New York’s Southern Tier. Key findings include:
- Appalachia has higher mortality rates than the nation in seven of America’s leading causes of death, including heart disease, cancer, chronic obstructive pulmonary disease (COPD), injury, stroke, diabetes, and suicide. These rates are dramatically higher in Appalachia’s rural areas and in counties experiencing economic distress.
- Mortality due to poisoning, which includes drug overdoses, is markedly higher in the region than in the nation as a whole, especially in the region’s rural and economically distressed areas.
- The Appalachian Region has lower supplies of health care professionals per 100,000 population when compared to the nation as a whole. These include primary care physicians, mental health providers, specialty physicians, and dentists. The supply of specialty physicians per 100,000 population is 65 percent lower in Central Appalachia than in the nation as a whole.
- Obesity, smoking, and physical inactivity—risk factors for a number of health issues—are all more prevalent in Appalachia than in the nation overall. Nearly 25 percent of adults in Appalachia’s economically distressed counties are smokers, as compared with roughly 16.3 percent of adults in the nation as a whole.
- In several measures, including incidence of chlamydia, prevalence of HIV, student-teacher ratio, diabetes monitoring among Medicare patients, and the social association rate, Appalachia is doing better than the nation as a whole.
The report also examines 20-year trends for selected indicators. While the region and the country have made improvements on many health measures, the improvements made by the nation overall frequently outpace those made by the region, resulting in widening disparities. For instance:
- During the 1989-1995 period, the cancer mortality rate in Appalachia was only 1 percent higher than the rate in the United States overall, but by 2008-2014, the rate in the region was 10 percent higher than the national rate.
- During the 1989-1995 period, the infant mortality rate in Appalachia was only 4 percent higher than the rate in the United States overall, but by 2008-2014, the rate in the region was 16 percent higher than the national rate.
- In 1995, the household poverty rate in Appalachia was only 0.6 percentage points higher than the rate in the United States overall. By 2014, the poverty rate in the region was 1.6 percentage points higher than the national rate.
Health Disparities in Appalachia is part of Creating a Culture of Health in Appalachia: Disparities and Bright Spots, a multipart health research project conducted by ARC in partnership with the Foundation for a Healthy Kentucky, with funding from the Robert Wood Johnson Foundation. The research team was led by PDA, Inc., of Raleigh, North Carolina, in collaboration with the University of North Carolina’s Cecil G. Sheps Center for Health Services Research and Wake Forest School of Medicine.
Contact: Bonnie J. Hackbarth