Study to Assess Health Care Disparities Among Residents in Appalachian Region

The Appalachian Regional Commission will conduct a "major" study of health care in the Appalachian region to determine what risk behaviors and socioeconomic disparities could be affecting the health of local residents, the Richmond Times-Dispatch reports. The commission, composed of federal and state officials, was founded in 1965 to "improv[e] life in the ... hardscrabble Appalachian Mountains." The commission has never undertaken a health study of the entire region, which stretches along the Appalachian Mountains from northern Mississippi to southern New York and includes regions of Virginia, Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and West Virginia. The commission will hire researchers to examine the disease and mortality rates of Appalachians to determine "what behaviors might be worsening their health, their accessibility to health care providers and insurance and any relevant socioeconomic factors." The commission is asking for the study to be completed by September 2002. "[G]rowing evidence" has shown that the region's residents have a higher incidence of health problems than those in other areas of the United States. A study conducted in Virginia last year, for example, found that people in the Appalachian region are 50% more likely to die of chronic obstructive pulmonary disease, 26% more likely to die of heart disease, 53% more likely to die of pneumonia or the flu and 60% more likely to commit suicide in than those in other areas. In addition, studies have shown that white women in the region have a higher rate of cervical cancer than women elsewhere, and local white men have a higher incidence of lung cancer.

Barriers to Care
Health care professionals say that "a big part of the problem" with the region's health is a "lack of doctors." Federal statistics show that the Appalachian region contained 121 counties designated as Health Professional Shortage Areas in 1996; since then, 175 additional areas have been labeled "partial" shortage areas. The commission hopes that the study will result in a regionwide database that local, state and federal lawmakers can use to develop health care spending, research and education strategies for the region. In tandem with the report on health disparities, the commission also will launch a study on financial conditions of the region's health systems "to identify those hospitals, clinics and nursing homes that are financially at risk of cutbacks in service" (Bowman, Richmond Times-Dispatch, 7/6).