Regional Economics Commons^™

Harlan County, Kentucky In A Post-Coal America: A Case Study, Karli Bryn Ailshie

Chancellor’s Honors Program Projects

No abstract provided.

The U.S. Coal Industry: Market Structure & Implications, Sara Elizabeth Guffey

Graduate Theses, Dissertations, and Problem Reports

The U.S. coal mining industry was once a booming industry which created and defined communities, particularly in Appalachia. The industry has, however, transformed significantly in the last couple of decades with the passage of environmental policies, with competition from the Shale Revolution, from changes in company ownership, and from mine safety regulation. Overall, the coal industry during this time has experienced a massive decline in production and employment. This dissertation is composed of three papers that investigate these mechanisms and their role in understanding market structure, coal transactions and prices, and mine safety outcomes. Motivated by the shutdowns of U.S. …

Comparisons Of Cooking, Dietary, And Food Safety Characteristics Of Food Secure And Food Insecure Sophomores At A University In Appalachia, Hannah Boone, Melissa D. Gutschall, Alisha Farris, Kimberly Fasczewski, Don Holbert, Laura Mcarthur

Journal of Appalachian Health

Introduction: Food insecurity means lacking access to adequate, nutritious, and safe food. Collegiate food insecurity rates at ten Appalachian campuses range from 22.4% to 51.8%, and have been associated with unfavorable health and academic outcomes.

Purpose: This study compared cooking, dietary, and food safety characteristics of food secure (FS) and food insecure (FI) sophomores at a university in Appalachia in the context of the USDA definition of food security.

Methods: Data were collected using an online questionnaire. Descriptive and inferential procedures compared FS and FI sophomores (p < 0.05).

Results: Participants (n = 226) were 65.0% females, 76.1% …

Access To And Use Of Technology For Health: Comparisons Between Appalachian Kentuckians And The General U.S. Population, Robin C. Vanderpool, Lindsay R. Stradtman, Anna Gaysynsky, Quan Chen, Meghan Johnson, Bin Huang

Journal of Appalachian Health

Introduction: Technology may increase the availability of health information and enable health promoting behaviors. However, lack of access to and use of technology may also exacerbate disparities, particularly in rural communities with limited Internet access.

Purpose: The purpose of this study was to compare Internet access, device ownership, and use of technology for health between Appalachian Kentuckians and the general U.S. population.
Methods: Findings from the 2017 Assessing the Health Status of Kentucky (ASK) survey were compared to national estimates from the Health Information National Trends Survey (HINTS) 5, Cycle 1 (2017), with a particular focus on degree of rurality. …

Risk Factors Associated With Passenger Vehicle Fatal Rollover Crashes In West Virginia, 2001-2018, Yuni Tang, Toni Marie Rudisill, Ruchi Bhandari

Journal of Appalachian Health

Background: Rollover crashes cause more injuries and fatalities than other types of motor vehicle crashes. West Virginia (WV) has high rates of drug overdose deaths and motor vehicle crash fatality. However, no studies have investigated risk factors associated with fatal rollover crashes in WV.

Purpose: The objective of this study is to evaluate whether drug use and other risk factors are associated with fatal rollover crash fatalities in WV.

Methods: This cross-sectional study utilized the Fatality Analysis Reporting System dataset from passenger vehicle crashes involving WV drivers ≥ 16 years of age with known drug test results who died within …

Perceived Hearing Loss And Availability Of Audiologists In Appalachia, Charles B. Pudrith, Ellyn Grider, Blythe Kitner

Journal of Appalachian Health

Introduction: There is a high demand for audiologists throughout the United States. Previous research has supported an additional demand for these providers within Appalachia.

Purpose: The purpose of the study was to determine if Appalachia has a disproportionally high demand for audiologists compared to the rest of the United States.

Methods: A cross-sectional retrospective study was performed with population data from the Appalachian Regional Commission, the American Academy of Audiology, and the United States Census Bureau. County-level population-weighted averages of individuals with perceived hearing loss and number of audiologists per capita were compared between Appalachian and non-Appalachian counties. …

Review Of: Appalachians For Medicaid Website, Kendra Barker Dnp

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relates to contemporary concepts affecting the health of Appalachia. Access to care and the health disparities we face have a direct effect on our experience of illness. Dr. Kendra Barker reviews the website: Appalachians for Medicaid.

Geospatial Analysis Of Rurality And Food Banks In Appalachian Ohio, Cooper T. Johnson, Rebecca Fischbein, Kristin Baughman

Journal of Appalachian Health

Introduction: Food insecurity is a problem for individuals across Ohio, including those living in Appalachia. Adequate access to resources that help combat food insecurity is important for these populations.

Purpose: To examine how rurality relates to food insecurity and need for food resources, as well as availability of those resources including food pantries and soup kitchens, in 15 northern Ohio Appalachian counties.

Methods: A cross-sectional study with a geographical analysis was conducted using data from the American Community Survey census data, County Health Rankings data, and regional foodbank websites.

Results: Rural counties had a higher ratio of potential clients per …

Triple Negative Breast Cancer In An Appalachian Region: Exponential Tumor Grade Increase With Age Of Diagnosis, Gina Sizemore, Toni Marie Rudisill

Journal of Appalachian Health

Introduction: Triple negative breast cancer is an aggressive breast cancer with decreased five-year survival, increased risk for recurrence, and higher risk for metastases. Unlike other breast cancers, it has no targeted treatment and has heterogeneous genetics which make classification and treatment difficult.

Purpose: The purpose of our research was to compare triple negative breast cancer to non-triple negative breast cancer to identify key epidemiologic factors that might lead to improved basic science directives for biomarkers, treatments, and classification.

Methods: The state cancer registry was used to provide the first West Virginia state-wide population evaluation of triple negative breast cancer.

Results: …

Addressing Diabetes Distress In Self-Management Programs: Results Of A Randomized Feasibility Study, Ranjita Misra, Samantha Shawley-Brzoska, Raihan Khan, Brenna O. Kirk, Sijin Wen, Usha Sambamoorthi

Journal of Appalachian Health

Background: West Virginia ranks 1st nationally in the prevalence of hypertension (HTN; 43.8%) and diabetes (16.2%). Patients with type 2 diabetes mellitus (T2DM) are distressed over physical and psychological burden of disease self-management.

Methods: This study investigated the effectiveness of an intervention to reduce diabetes distress and outcomes [glycemic control, blood pressure (BP)] among T2DM adults with comorbid HTN. Participants were randomized to a 12-week diabetes and hypertension self-management program versus a 3-month wait-listed control group. Trained health coaches and experts implemented the lifestyle program in a faith-based setting using an adapted evidence-based curriculum. Twenty adults with T2DM and HTN …

Establishing Peer Recovery Support Services To Address The Central Appalachian Opioid Epidemic: The West Virginia Peers Enhancing Education, Recovery, And Survival (Wv Peers) Pilot Program, Stephen M. Davis, Amanda Stover, Herb Linn, Jon Dower, Dan Mccawley, Erin Winstanley, Judith Feinberg

Journal of Appalachian Health

Introduction: Central Appalachia has been disproportionately affected by the opioid epidemic and overdose fatalities. We developed West Virginia Peers Enhancing Education, Recovery, and Survival (WV PEERS), a program based on peer recovery support, to engage individuals using opioids and link them with a range of services.

Methods: Community partners providing services to individuals with opioid use disorder (OUD) were identified and collaborations were formalized using a standardized memorandum of understanding. The program was structured to offer ongoing peer recovery support specialist (PRSS) services, not just a one-time referral. A website and cards describing the WV PEERS program were developed and …

Effects Of Sleep Duration On Falls In A West Virginia Population-Based Study, Brfss, 2018, R. Constance Wiener, Christopher Waters

Journal of Appalachian Health

Introduction: West Virginia is a state in which most counties are rural, as well as a state with multiple health disparities among its population. The purpose of this study was to determine the association of sleep duration and falls for non-institutionalized West Virginia adults, aged 40 years and above, using the National Sleep Foundation’s definition of “may be appropriate” and “not recommended” sleep durations for specific ages.

Methods: Behavior Risk Factor Surveillance System (BRFSS) 2018 data concerning West Virginia residents were extracted for sleep duration and number of falls within the previous year. Data were analyzed with Chi square and …

Diseases Of Despair: A Commentary, Andrew Howard

Journal of Appalachian Health

Across the nation, and within Appalachia, communities that struggle economically experience greater health challenges, with disparities observed across leading causes of death. Within our region, these disparities are particularly notable across diseases of despair.

Poll Finds Rural Residents More Hesitant To Get Vaccinated, Tim Marema

Journal of Appalachian Health

Rural residents are more hesitant than their metropolitan counterparts to get a Covid-19 vaccination, even though rural areas have higher rates of infections and deaths from the coronavirus.

Review Of: Ailing In Place: Environmental Inequities And Health Disparities In Appalachia, Jerome A. Paulson Md, Faap, Jennifer A. Mallow Phd

Journal of Appalachian Health

The Journal of Appalachian Health is committed to reviewing published media that relate to contemporary concepts affecting the health of Appalachia. The Appalachian environmental inequities and the health disparities we face have a direct effect on our experience of illness. Dr. Jerome Paulson reviews the book Ailing in Place: Environmental Inequities and Health Disparities in Appalachia.

Impact Of The Covid-19 Shutdown On Mental Health In Appalachia By Working Status, Erin N. Haynes, Timothy J. Hilbert, Susan C. Westneat, Kate Leger, Katie Keynton, Heather M. Bush

Journal of Appalachian Health

Introduction: To slow the spread of COVID-19 in the United States, businesses shutdown in Spring 2020. Research has indicated the impact on frontline workers, yet little is known about the impact on those who were not working outside the home or switched to working remotely.

Purpose: The purpose of this report is to identify the financial and healthcare issues and mental health impact of the COVID-19 shutdown on Appalachians by worker categories.

Methods: An online survey was administered from May 8 – June 6, 2020 to a convenience sample of previous research participants and shared through social …

Students, Research, And The Health Of Appalachia, F. Douglas Scutchfield Md

Journal of Appalachian Health

The notion of publication in the peer-reviewed literature out of your doctoral or master’s thesis/dissertation or capstone is a characteristic of those who choose a career in the academy. This paper illustrates my pleasure by reflecting a student taking the additional step in research achievement by publishing results that contribute new knowledge to evidence-driven research and practice.

Economic Structure In Appalachia’S Urban Regions: Clustering And Diversification Strategies, Randall W. Jackson, Peter Jarosi, Gi-Eu Lee, Sara Farhangdoost

Cluster Analyses

In support of economic development practitioners’ efforts to devise strategies that can align with both industrial clustering and industrial diversification, this report provides a wide range of relevant measures and metrics. In addition to standard regional analysis tools like coefficients of specialization, location quotients, and growth rates, we introduce two fundamentally new measures for understanding the nature of regional clusters. These measures focus on the industries that anchor the clusters and characterize their strength and regional dominance. The former measures the share of the anchor industry’s direct and indirect requirements that could be satisfied by regional industries, and the latter …

Economic Structure In Appalachia’S Urban Regions: Clustering And Diversification Strategies Supplement 3, Regions 61-90, Randall W. Jackson, Peter Jarosi, Gi-Eu Lee, Sara Farhangdoost

Cluster Analyses

In support of economic development practitioners’ efforts to devise strategies that can align with both industrial clustering and industrial diversification, this report provides a wide range of relevant measures and metrics. In addition to standard regional analysis tools like coefficients of specialization, location quotients, and growth rates, we introduce two fundamentally new measures for understanding the nature of regional clusters. These measures focus on the industries that anchor the clusters and characterize their strength and regional dominance. The former measures the share of the anchor industry’s direct and indirect requirements that could be satisfied by regional industries, and the latter …

Economic Structure In Appalachia’S Urban Regions: Clustering And Diversification Strategies Supplement 4, Regions 91-120, Randall W. Jackson, Peter Jarosi, Gi-Eu Lee, Sara Farhangdoost

Cluster Analyses

In support of economic development practitioners’ efforts to devise strategies that can align with both industrial clustering and industrial diversification, this report provides a wide range of relevant measures and metrics. In addition to standard regional analysis tools like coefficients of specialization, location quotients, and growth rates, we introduce two fundamentally new measures for understanding the nature of regional clusters. These measures focus on the industries that anchor the clusters and characterize their strength and regional dominance. The former measures the share of the anchor industry’s direct and indirect requirements that could be satisfied by regional industries, and the latter …

Economic Structure In Appalachia’S Urban Regions: Clustering And Diversification Strategies Supplement 1, Regions 1-30, Randall W. Jackson, Peter Jarosi, Gi-Eu Lee, Sara Farhangdoost

Cluster Analyses

In support of economic development practitioners’ efforts to devise strategies that can align with both industrial clustering and industrial diversification, this report provides a wide range of relevant measures and metrics. In addition to standard regional analysis tools like coefficients of specialization, location quotients, and growth rates, we introduce two fundamentally new measures for understanding the nature of regional clusters. These measures focus on the industries that anchor the clusters and characterize their strength and regional dominance. The former measures the share of the anchor industry’s direct and indirect requirements that could be satisfied by regional industries, and the latter …

Economic Structure In Appalachia’S Urban Regions: Clustering And Diversification Strategies Supplement 2, Regions 31-60, Randall W. Jackson, Peter Jarosi, Gi-Eu Lee, Sara Farhangdoost

Cluster Analyses

In support of economic development practitioners’ efforts to devise strategies that can align with both industrial clustering and industrial diversification, this report provides a wide range of relevant measures and metrics. In addition to standard regional analysis tools like coefficients of specialization, location quotients, and growth rates, we introduce two fundamentally new measures for understanding the nature of regional clusters. These measures focus on the industries that anchor the clusters and characterize their strength and regional dominance. The former measures the share of the anchor industry’s direct and indirect requirements that could be satisfied by regional industries, and the latter …

An Economic Analysis Of Appalachian Power Industry Ecosystems County-Level Pie Supply Chain Analysis, Randall Jackson, Péter Járosi

Power Industry Ecosystem

This report describes an effort to provide for the Appalachian Region a clearer picture of the implications for the Power Industry Ecosystem (PIE) of power generating technology transitions and the geographical variations in PIE impacts. We develop and implement three measures that reveal meaningful characteristics of the PIE at the county level in terms of industry and place-based PIE dependence, changes in PIE-dependent employment, and susceptibility to impacts from a continued energy sector transition. We then use these three measures—Dependence, Impact, and Risk—to form a typology that we apply to identify and focus on counties in three identifiable categories: Hardship …

An Evaluation Of Databases Drawn From The National Survey Of Substance Abuse Treatment Services (N-Ssats), Brian Cushing, Elham Erfanian

Other

Appalachia has been at the center of the drug crisis that has now exploded across the United States, wreaking havoc on communities and destroying lives. Other than a brief, hopeful leveling off in 2018, drug use and overdose deaths have continued to accelerate. One key focus of policies aimed at dealing with the crisis has been treatment and recovery resources, which provide critical support for those struggling with addiction. The Appalachian Regional Commission wishes to document the distribution of treatment and recovery resources within Appalachia, which is critical to assessing unmet needs. The following report describes, reviews, and evaluates the …

Rural Appalachia Battling The Intersection Of Two Crises: Covid-19 And Substance Use Disorders, Margaret Miller, Rebekah Rollston, Kate E. Beatty, Michael Meit

Journal of Appalachian Health

During the COVID-19 pandemic, rural Appalachia is at great risk of unforeseen side effects including increased mortality from substance use disorders (SUDs). People living with SUDs are at increased risk for both exposure to and poor outcomes from COVID infection. The economic impacts of COVID-19 must also be considered. As rural Appalachia combats the substance use crisis amidst the COVID-19 pandemic, the geographic economic, health and social inequities within our region must be considered. As a national recovery is sought, we should reimagine federal policies that center the economic and public health of rural Appalachia addressing the two crises.

Review Of: From The Front Lines Of The Appalachian Addiction Crisis Healthcare Providers Discuss Opioids, Meth And Recovery, Carl G. Leukefeld

Journal of Appalachian Health

The Journal of Appalachian Health is dedicated to reviewing various types of media related to contemporary concepts that affect the health of Appalachia. As the opioid-related overdose deaths ravish Appalachia, now more than ever, we each must devote energy to understanding addiction and pathways to recovery. Dr. Carl Leukefeld reviews the book From the Front Lines of the Appalachian Addiction Crisis: Healthcare Providers Discuss Opioids, Meth and Recovery.

In Their Own Words: How Opioids Have Impacted The Lives Of “Everyday” People Living In Appalachia, Patricia Nola Eugene Roberson, Gina Cortez, Laura H. Trull, Katherine Allison Lenger

Journal of Appalachian Health

Introduction: The opioid epidemic is ravaging people, families, and communities in Appalachia. However, limited research has examined how “everyday” people (e.g., not chronic pain patients, not medical professionals) living in these communities how opioids have impacted their lives.

Objective: Identify the perception of the opioid epidemic on individuals, families, and communities from people living in region most impacted regions.

Methods: Patients were recruited at Remote Area Medical clinics throughout Central and Southern Appalachia to complete interviews online (N = 169) or over the phone (N = 26), including one open-ended question about how opioids have impacted their lives.

Results: Using …

Improving Access To Treatment For Opioid Use Disorder In High-Need Areas: The Role Of Hrsa Health Centers, Michael Topmiller, Jennifer Rankin, Jessica L. Mccann, Jene Grandmont, David Grolling, Mark Carrozza, Hank Hoang, Josh Bolton, Alek Sripipatana

Journal of Appalachian Health

Introduction: Despite the opioid epidemic adversely affecting areas across the U.S. for more than two decades and increasing evidence that medication-assisted treatment (MAT) is effective for patients with opioid use disorder (OUD), access to treatment is still limited. The limited access to treatment holds true in the Appalachia region despite being disproportionately affected by the crisis, particularly in rural, central Appalachia.

Purpose: This research identifies opportunities for health centers located in high-need areas based on drug poisoning mortality to better meet MAT care gaps. We also provide an in-depth look at health center MAT capacity relative to need …

Rural Community Toolbox To Help Battle Opioid Epidemic, Liz Carey

Journal of Appalachian Health

An online data repository and toolbox created by the Office of National Drug Control Policy is designed to provide communities with knowledge and resources to fight the opioid epidemic according to their unique needs.

Listening To Voices In Appalachia: Gathering Wisdom From The Field About Substance-Abuse Recovery Ecosystems, Bruce Behringer

Journal of Appalachian Health

New qualitative data collected through six regional community-based listening sessions and community meetings are presented that describe elements of the Appalachian Regional Commission’s Recovery Ecosystem Model. These data informed the Model, which was used in formulating the new ARC Recovery-to-Work initiative. Input was intentionally solicited from multiple sectors, including persons recovering from substance abuse disorder, treatment and recovery service providers, workforce development agencies, employers, and community advocacy groups.