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WKYT Investigates | The Great Health Divide in Kentucky

Why do health disparities exist in the region, and what’s being done about it?
Published: Jan. 18, 2021 at 4:00 PM EST
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Editor’s Note: Throughout the year WKYT, the Gray D.C. Bureau, InvestigateTV and other Gray Television stations will examine health disparities in the Appalachian region as part of ‘Bridging the Great Health Divide: Mississippi Delta and Appalachia,’ an initiative exploring why disparities exist in those regions and focusing on long-term and sustainable solutions.

HAZARD, Ky. (WKYT) - Among the hills and valleys, the forests and creeks, the character and the natural beauty of this region, there are also signs of struggle. Poverty. Isolation. Disease. All of them, more mountains to climb in Kentucky’s Appalachian counties.

Nearly half of Kentucky counties are in the Appalachian region. Living there, statistics show, often means less access to health care and more reasons to need it.

“Coming out of this, we cannot forget that we still have high rates of diabetes, we still have high rates of heart disease, lung cancer and all the other things that we work on to improve in rural Kentucky,” said Dr. Frances Feltner, director of the University of Kentucky Center of Excellence in Rural Health, based in Hazard.

For 30 years the center has worked to address many health care disparities and other issues not just in the eastern part of the state but across rural Kentucky. And now they believe the pandemic has brought on even more issues.

“The social isolation, the different mental health exacerbations that we have had during this period, we really need to work to come together to find solutions and improve the health and wellbeing,” Dr. Feltner said.

Appalachia already has higher death rates from:

  • Heart disease (17 percent higher than the national rate)
  • Cancer (10 percent higher)
  • COPD (27 percent higher)
  • Injury (33 percent higher; in central Appalachia, double the national rate)
  • Stroke (14 percent higher)
  • Diabetes (11 percent higher; in central Appalachia, 41 percent higher)
  • Suicide (17 percent higher; in central Appalachia, 31 percent higher)

United Health Foundation’s annual report just ranked Kentucky at the bottom - 49th in the country - for people having multiple chronic conditions.

“We know that those individuals with multiple chronic conditions - smokers, and people who have lung disease for example - are more likely to get seriously ill should they become infected with COVID and other infectious diseases, respiratory diseases, for example,” said Dr. Rhonda Randall, chief medical officer for United Healthcare and an adviser for the United Health Foundation.

What many of those conditions add up to: early death. The rate for years of potential life lost is 69 percent higher in the central Appalachian sub-region (mostly made up of Kentucky counties), according to a report from the Appalachian Regional Commission.

“Some of the barriers of course in Appalachia are isolation, the lack of transportation, the health care shortage that was here,” Dr. Feltner said.

The Center of Excellence in Rural Health has helped train health care workers from the area and in the area to get them to stay in the area. But research shows that the problem is not just getting health care, but getting to health care. Transportation is harder - and often farther - for many people, especially those who live in communities without their own hospitals.

And the stakes are higher in the pandemic.

“The needs to access services is even greater during the pandemic,” Dr. Feltner said. “So we have been able to adapt our work with Kentucky Homeplace to continue to provide services to people in the community and also expand the services needed during the pandemic.”

It all shows that there is still work to do - and still work being done - to tear down whatever is blocking people from living healthy lives in the region.

Starting next month UK is hosting a virtual seminar series about rural health and well-being. You can find more information about the seminar series here.

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