Sociology Commons^™

A Virginia Mountain City Responds To The Challenge Of Improving Health Outcomes, Robert S. Cowell Jr.

Journal of Appalachian Health

In 2012, Roanoke Virginia was becoming a city of haves and have-nots, a place where many were benefitting from revitalization underway but too many were seeing their situation grow worse and becoming even more entrenched. Poverty with levels as high as 50% in some neighborhoods; life expectancy sometimes 14 years shorter than those living just one or two neighborhoods over; and lack of access to fresh food, medical care, and economic opportunities—all within view of the largest hospital in the region was unacceptable.

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Roanoke's Collective Public Health Activities, Michael Lytton

Journal of Appalachian Health

Roanoke is addressing problems that confront many small and medium sized cities in the U.S., especially disparities in health and life expectancy between neighborhoods. These disparities are often legacies of decades of racial and economic segregation, resulting in low-income or disinvested communities. Typically, such neighborhoods have fewer parks, higher vacancy rates and less stable affordable housing stock, inadequate public transit systems, too few clinics, too many fast food restaurants and insufficient access to high quality schools. In Roanoke these are the northwest and southeast quadrants, both federally designated Medically Underserved Areas, and characterized by a large proportion of the city’s …

A Legacy Of Disease, Arthur L. Frank

Journal of Appalachian Health

In Appalachia, like much of America, there are important health issues that have not always been appropriately predicted or dealt with when they occur. Lifestyle issues in Appalachia lead to obesity and heart disease, not surprisingly due to extensive use of sugary drinks. The current opioid crisis could have been better predicted given the trauma of mining and the past abuse of less-potent narcotics. A continuing major problem in the whole country is inadequate support for preventive health activities.

Improving Access To Addiction Recovery Care In Central Appalachia Through Organizational Collaboration, Katy Stigers

Journal of Appalachian Health

Fahe, a Network of 50+ members throughout Appalachia based in Berea KY, has brought together a coalition to finance, build, and manage several addiction recovery care centers across Kentucky and West Virginia, increase access to employment, and deploy vouchers for supportive services.

Disparities In Quality Of Life By Appalachian-Designation Among Women With Breast Cancer, Robin C. Vanderpool, Ann L. Coker, Heather M. Bush, Sarah E. Cprek

Journal of Appalachian Health

Introduction: Few studies have examined the association of geography and quality of life (QOL) among breast cancer patients, particularly differences between Appalachian and non-Appalachian Kentucky women, which is important given the cancer and socioeconomic disparities present in Appalachia.

Purpose: The purpose of this study was to determine whether women with breast cancer residing in Appalachian Kentucky experience poorer health outcomes in regards to depression, stress, QOL, and spiritual wellbeing, relative to those living in non-Appalachian Kentucky after adjusting for demographic, socioeconomic, and health-related factors.

Methods: Women, aged 18–79, recruited from the Kentucky Cancer Registry between 2009 and 2013 with an …

Investigating The Impact Of The Diseases Of Despair In Appalachia, Michael Meit, Megan Heffernan, Erin Tanenbaum

Journal of Appalachian Health

Introduction: Appalachia is one of the regions most significantly impacted by the opioid crisis. This study investigated mortality due to diseases of despair within the Appalachian Region, with an additional focus on deaths attributable to opioid overdose.

Methods: Diseases of despair include: alcohol, prescription drug and illegal drug overdose, suicide, and alcoholic liver disease/cirrhosis of the liver. Mortality data from the National Center for Health Statistics (NCHS) National Vital Statistics System (NVSS) Multiple Cause of Death database were analyzed for this study, focusing on individuals aged 15–64.

Results: Over the past two decades, the mortality rate due to diseases of …

Root Causes Of Appalachia’S Deaths Of Despair, F. Douglas Scutchfield Md

Journal of Appalachian Health

The U.S. is experiencing a decline in life expectancy, particularly among rural white males in their most productive years. Appalachia is disproportionally represented in mortality rates, accounting for 30% of the U.S. population, but 50% of the excess mortality attributed to the “deaths of despair”: drug overdose, suicide, and alcoholic cirrhosis. A substantial proportion of that excess mortality is related to the current opioid crisis we are experiencing. We have data on evidence-based solutions to the treatment of addiction, but little information on prevention of addiction as well as the other deaths of despair, likely with the same etiologic agent. …

Dusty Shoes: Appalachia Wisdom Fertilizing The Future Of Religious Leadership, Jill Crainshaw

Journal of Appalachian Health

Dust from their journeys through the hills and hollows of Appalachia clings to their shoes and has forever shaped their vocational journeys. This is a refrain I have distilled from the reflections of students who have participated in Wake Forest University School of Divinity’s multicultural contexts course that includes a 10-day sojourn in the mountains of North Carolina.

Identifying Priority And “Bright-Spot” Counties For Diabetes Preventive Care In Appalachia: An Exploratory Analysis, Peter J. Mallow, Michael Topmiller, Jennifer Rankin, Jene Grandmont, David Grolling, Jessica L. Mccann, Mark Carrozza

Journal of Appalachian Health

Introduction: Type 2 diabetes mellitus (T2DM) prevalence and mortality in Appalachian counties is substantially higher when compared to non-Appalachian counties, although there is significant variation within Appalachia.

Purpose: The objectives of this research were to identify low-performing (priority) and high-performing (bright spot) counties with respect to improving T2DM preventive care.

Methods: Using data from the Centers for Medicare and Medicaid (CMS), the Dartmouth Atlas of Health Care, and the Appalachia Regional Commission, conditional maps were created using county-level estimates for T2DM prevalence, mortality, and annual hemoglobin A1c (HbA1c) testing rates. Priority counties were identified using the following criteria: top 33rd …

Serum Cotinine Versus Parent Reported Measures Of Secondhand Smoke Exposure In Rural Appalachian Children, Samrat Yeramaneni, Kimberly Yolton, Kurunthachalam Kannan, Kim N. Dietrich, Erin N. Haynes

Journal of Appalachian Health

Background: Secondhand smoke (SHS) exposure in Appalachian children and associated adverse effects is understudied and not well documented. This study assessed the prevalence of SHS exposure in Appalachian children by parental self-report and internal biological measure.

Methods: SHS exposure was determined in children residing in rural Appalachian communities during their participation in the Communities Actively Researching Exposure Study between 2009 and 2013. Parents reported the number of smokers in the household and number of cigarettes smoked/day. Children ages 7-9 provided a serum sample for cotinine analysis. Parent reported measures and child serum cotinine measures of SHS exposure were compared with …

The Social Determinants Of Health And The Decline In U.S. Life Expectancy: Implications For Appalachia, Steven H. Woolf, Heidi Schoomaker, Latoya Hill, Christine M. Orndahl

Journal of Appalachian Health

For the past century, life expectancy in industrialized countries has increased, and the U.S. has shared in that progress. However, beginning in the 1980s, advances in U.S. life expectancy began to lose pace with peer countries. By 1998, U.S. life expectancy had fallen below the average for Organisation for Economic Cooperation and Development nations. U.S. life expectancy peaked in 2014 and has been decreasing for three consecutive years, a trend not been seen since the influenza pandemic a century ago. Put simply, U.S. health is in decline.

Delivering Health Knowledge And Wisdom From The Hills And Hollows Of Appalachia, F. Douglas Scutchfield Md, Erin N. Haynes, Robert M. Shapiro Ii, Charlotte S. Seidman

Journal of Appalachian Health

There is knowledge in the pages of Appalachia’s hills. This journal is positioned to find and publish those translations. It grows from a need to provide an outlet for scholarship about Appalachia’s health so that knowledge, and occasionally wisdom, is shared with those who care about and are committed to improving the region’s health.

The Digital Knowledge Economy Index: Mapping Content Production, Sanna Ojanperä, Mark Graham, Matthew Zook

Geography Faculty Publications

We propose the construction of a Digital Knowledge Economy Index, quantified by way of measuring content creation and participation through digital platforms, namely the code sharing platform GitHub, the crowdsourced encyclopaedia Wikipedia, and Internet domain registrations and estimating a fifth sub-index for the World Bank Knowledge Economy Index for year 2012. This approach complements conventional data sources such as national statistics and expert surveys and helps reflect the underlying digital content creation, capacities, and skills of the population. An index that combines traditional and novel data sources can provide a more revealing view of the status of the world’s digital …

Gay Men And Satisfaction With Health Care Interactions, Michael Huggins

Theses and Dissertations--Nursing

The purpose of this research was to determine relationships among depression, anxiety, self-rated physical and mental health, self-advocacy, internalized homophobia, and quality of patient-provider communication to satisfaction with health care interactions. These were measured while controlling for select demographic variables: age; ethnicity; urban or rural domicile; relationship status; household income; highest educational attainment; health insurance; disclosure to health care provider as a gay man; reason for last healthcare visit; and, general health self-rating. The specific aims of this study were to: 1) identify general characteristics of gay men in this sample; 2) examine how levels of satisfaction with health care …

Women Into Advanced Manufacturing: Can Community College Open This Door?, Carissa Bradley Schutzman

Theses and Dissertations--Educational Policy Studies and Evaluation

Women still rarely choose to seek employment in advanced manufacturing. Lack of familiarity with manufacturing jobs and education programs, lack of role models, and too few experiential opportunities contribute to women not choosing manufacturing jobs as well as other jobs traditionally held by men (Reha, Lufkin, & Harrison, 2009; St. Rose & Hill, 2013; Starobin & Laanan, 2008). Nontraditional jobs for women often provide higher wages and more opportunity for advancement than traditional jobs for women. This study is a qualitative thematic narrative analysis of factors that influenced women who chose an advanced manufacturing program at a community college to …