Drs. Robert L. Ludke and Phillip J. Obermiller, the co-editors of the forthcoming volume “Appalachian Health and Well-Being,” presented the plenary session address at the annual Appalachian Regional Commission conference on September 8 in Prestonsburg, Kentucky. ARC is a federal-state partnership that works for sustainable community and economic development in Appalachia. The theme of this year’s ARC conference was “Healthy Families, Healthy Future,” and the goal of the gathering was to bring together health experts, community leaders, and policy makers to examine key health issues and highlight successful healthcare programs in Appalachia, with a special focus on children and families.
Drs. Ludke and Obermiller presented findings from their new book, “Appalachian Health and Well-Being,” to be published by UPK in March 2012. This volume represents the first comprehensive, book-length synthesis of research on the health status of Appalachians since 1973 and includes chapters from 39 contributors.
Below are highlights from Drs. Ludke and Obermiller’s plenary session; for a comprehensive overview of their session and to sign up to receive notification of when this book becomes available, click here.
- Appalachians are at greater risk for cardiovascular diseases, diabetes, obesity, cancer, and possibly chronic kidney disease than people in the rest of the country.
- Nearly 15 percent of hospitalizations in Appalachia are due to heart disease, exceeding the percent of hospitalizations due to chronic obstructive pulmonary disorders, all cancers, stroke, and diabetes combined.
- Appalachians constitute a health disparity population. They experience higher rates of chronic illness and mortality from the major causes of death when compared to the rest of the country. Most troubling is the high premature mortality in the 35-64 age group. Moreover, health disparities exist within Appalachia across the subregions and between the urban and rural areas.
- The available literature does not substantiate the long-held belief that there is a higher rate of abnormal genetic conditions in Appalachia due to inbreeding.
- People in Appalachia experience higher riskscape exposures across the spectrum of behavioral, socioeconomic, and environmental threats.
- Appalachian culture is frequently used as a nebulous explanatory variable in the region’s health, but the available science does not support this conclusion.
- Suggesting that health disparities are due to a lifestyle characterized as uniquely “Appalachian” is not supported by existing research.
- The underlying cause of the region’s poor health outcomes is the general absence of community-linked and community-responsive systems of healthcare across the region.
- Trauma care in Appalachia is unevenly distributed and generally underdeveloped, unorganized, fragmented, understaffed, and underfunded.
- Rural Appalachians derive little benefit from available mental health services. This may be due to the lack of affordable mental health care, or because the organization and delivery of available mental health services may discourage service utilization.
- The growing abuse of many legal and illegal substances is having devastating effects on Appalachian individuals, families, and communities.
- Appalachians historically have been affected more by caries and other oral diseases than other groups in the nation.
The book goes beyond documenting Appalachian health inequalities; it examines some of the more effective programs for dealing with them. Case studies highlight the key role of local communities in defining needs and promoting health care services. The volume also contains recommendations for improvement in health policies, and indicates where data are lacking for program design and how they might be obtained.
What aspects of these research findings surprise or shock you? What findings ring true with your own experiences?