Great Health Divide | ‘Nowhere to go’: Insufficient medical access source of constant concern for some eastern Kentuckians

Editor’s Note: This story is another installment in WKYT’s year-long effort to examine how health disparities in the Appalachian region are being addressed, as part of Gray Television’s ‘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.

BOONEVILLE, Ky. (WKYT) - Downtown Booneville has a number of amenities, businesses and conveniences: Family Dollar and Dollar General, a courthouse right in the middle of the square, a bank, gas station, diner, dentist and some other places right on the same block. Not bad, really, for a tiny town (population less than 200) in a small county (population roughly 4,400).

But far more consequential is what you will not find here.

Owsley County is one of several dozen Kentucky counties without its own hospital.

“If you’re sick and there’s nothing around, you just have to turn to whatever’s out there,” said Brenda Sizemore.

Sizemore lives in the rural community of Ricetown, a good 12 minutes or so outside of Booneville. Her husband has dealt with multiple heart attacks and is now fighting cancer, she said, making it hard for them to find the health care their family needs close to home.

[MORE: BRIDGING THE GREAT HEALTH DIVIDE IN APPALACHIAN KENTUCKY]

“He said, ‘I know I’m having a heart attack,’” Sizemore said, telling the story of her husband’s first heart attack. “And he did have a heart attack. But we took him in our own vehicle. Two hours.”

Two hours for her husband to be treated closer to his heart doctor in Lexington, a terrifying reality for Sizemore, who says they have nowhere to go much closer that can provide the care they need. That worry - and her husband’s pain - keeps them up at night, Sizemore said, not knowing what to do or where to go if something happens.

A WKYT Investigates analysis found that several communities in Owsley County have among the longest drives in the state to get to a hospital. Even from Booneville proper, according to Google Maps, it is:

• 35 minutes to the closest one, Kentucky River Medical Center, a small hospital in Jackson;
• 48 minutes to AdventHealth Manchester;
• 52 minutes to Mercy Health Marcum and Wallace Hospital in Irvine;
• 57 minutes to CHI St. Joseph in London;
• 58 minutes to Hazard ARH Regional Medical Center.

Anywhere else - such as Mary Breckinridge ARH in Hyden or Rockcastle Regional Hospital in Mt. Vernon - is more than an hour away, estimates show, when mere minutes can matter when it comes to emergencies such as heart attacks or strokes.

“Mean the difference between life and death or being crippled for the rest of your life,” said Cale Turner, Owsley County Judge-Executive. “It can really make a big impact on the quality of your life if you survive it.”

County leaders say the lack of access - along with other factors - clearly hurts the health of folks living there. Owsley County has had the lowest average life expectancy of any county in Kentucky, federal statistics show.

“It’s very concerning,” Judge Turner told WKYT’s Garrett Wymer. “These are people I know and love...”

Turner trailed off as he became choked up with emotion, taking a moment to gather himself before continuing on.

It is a tough subject for the judge-executive to talk about as he serves his fourth term in office. He described seeing cancer, drug addiction and poverty take far too many of his constituents too early.

[INTERACTIVE: TRACK THE AVERAGE LIFE EXPECTANCY WHERE YOU LIVE]

Owsley County has been considered medically underserved for decades, first receiving that designation in 1978. That means the health gap there is not just a passing trend; it is generational.

The same can be said of many counties across Appalachia.

More than one third of Kentucky counties - 43 of them - do not have an acute care or critical access hospital, according to a Kentucky Cabinet for Health and Family Services hospital directory. Twenty of 54 Appalachian Kentucky counties do not have one of those hospitals.

“One of the reasons that this area has had such health disparities is because it’s been largely forgotten,” said Dr. Mark Dignan, a professor with the UK College of Medicine and Markey Cancer Center researcher. “And I think we need to work back toward bringing the area into public focus.”

Experts say that these communities continue to deal with a perfect storm of higher risk and less access to care.

All of Kentucky’s Appalachian counties have lower life expectancies than the national average (78.7 years). Most are even below the state’s average (75.9).

“We don’t have mass transit, interstate highways don’t often go into these areas,” Dr. Dignan said. “So people just turn out to be isolated.”

Judge Turner hopes the completed final stretch of the new Kentucky 30 will help, providing a shorter - and much straighter - route to London.

“You’re going to have a lot more specialists once you get to London,” Turner explained. “You’ve still got a little farther distance to travel than we would hope for, but that’s going to be a big improvement.”

But it is little solace - or even much convenience - for folks like the Sizemores living out in rural Ricetown, isolated but far from alone - several of them, Sizemore said, making long drives (even daily) to meet specialists or for treatments.

“Right now,” she said, “I know of four friends and neighbors that are dealing with the same thing. And they’re going back and forth.”

[MORE: WKYT INVESTIGATES]

Sizemore even says that they have found in some cases it can be quicker to drive those windy roads themselves in an emergency than to wait on an ambulance to reach them and take them back out.

They know it is a risk.

“You just take a chance,” Sizemore said.

But she has come to realize that the twists and turns, and so much of life out there, is just out of their hands.

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