Social and Behavioral Sciences Commons^™

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.

The Landscape Of Connected Cancer Symptom Management In Rural America: A Narrative Review Of Opportunities For Launching Connected Health Interventions, Ming-Yuan Chih, Anna Mccowan, Sadie Whittaker, Melinda Krakow, David K. Ahern, Eliah Aronoff-Spencer, Bradford W. Hesse, Timothy W. Mullett, Robin C. Vanderpool

Journal of Appalachian Health

Background: The 2016 President’s Cancer Panel called for projects focusing on improving cancer symptom management using connected health technologies (broadband and telecommunications). However, rural communities, like those in Appalachia, may experience a “double burden” of high cancer rates and lower rates of broadband access and adoption necessary for connected health solutions.

Purpose: To better understand the current landscape of connected health in the management of cancer symptoms in rural America.

Methods: A literature search was conducted using four academic databases (PubMed, CINAHL, MEDLINE, and PsycINFO) to locate articles published from 2010 to 2019 relevant to connected cancer symptom management in …

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.

The Model Area In Successful Lean Transformation And Scale Modeling, William Cooper, M. Abbot Maginnis, David Parsley, Kozo Saito

Progress in Scale Modeling, an International Journal

The True Lean System Program at the University of Kentucky was created in 1994 to study how the development of the Toyota Production System (TPS) contributes to Toyota’s success. This increased understanding of Toyota’s experience would provide useful guidance to Western companies taking on the challenges of replicating Toyota’s success within their own organizations. The common struggle point shared by the companies who come to us is their inability to establish sustainable TPS-based Lean transformations throughout their organizations. Our work with these companies along with our study of Toyota’s own experience in bringing TPS to its own American operations has …

The Health Wagon Partners With The Virginia Department Of Health To Provide Covid-19 Testing In Rural Southwest Virginia, Tauna Gulley, Teresa Tyson, Ethan Collins, Rachel Helton, Paula Hill-Collins, Nicole France, Sarah Hubbard

Journal of Appalachian Health

The Health Wagon has been providing care for the rural population of southwest Virginia for the past 40 years. The mission of the Health Wagon is to provide quality health care to the medically underserved people in the mountains of Appalachia. It has expanded to two stationary clinics, three mobile units, and a mobile dental unit, logging over 19,000 patients encounters in the past year.

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.

Responding To Appalachian Voices: Steps In Developing Substance-Use Recovery Ecosystems, Bruce Behringer

Journal of Appalachian Health

A description is presented of the four-step process used by the Appalachian Regional Commission to develop a new Recovery to Work initiative. The Commission identified, defined, and described issues facing individuals who complete substance abuse disorder treatment and who seek reentry into the workforce. Key elements were identified for resources and supports to develop and maintain community-based substance abuse recovery ecosystems. The steps included conceptualization, data collection, analysis, and review to formulate recommendations for program and policy development. The full process of development was accomplished in twelve months.

Experiencing Cancer In Appalachian Kentucky, Melanie Mccomsey, David Ahern, Robin C. Vanderpool, Timothy W. Mullett, Ming-Yuan Chih, Meghan Johnson, Michele Ellison, Karen Onyeije, Bradford W. Hesse, Eliah Aronoff-Spencer

Journal of Appalachian Health

Nothing tells the story of people working together better than a community quilt. A diversity of talents, colors, and materials brought together through skill and shared purpose. Perhaps never before have we as Americans needed a stronger reminder that many hands make short work of big problems. The work presented here by the L.A.U.N.C.H. Collaborative offers a new framework for health care that could be compared to a digital quilt, powered by community-based participatory design, with lived expertise and the newest advances in broadband-enabled connected health solutions. This work demonstrates the value and need to engage local communities and what …

Preface: Experiencing Cancer In Appalachian Kentucky, Michele Ellison, Robin C. Vanderpool

Journal of Appalachian Health

Connected cancer care is of increasing importance in light of the COVID-19 pandemic. The Linking & Amplifying User-Centered Networks through Connected Health (L.A.U.N.C.H.) Collaborative in Appalachian Kentucky has pioneered a new roadmap for equipping communities with the transformative power of broadband to innovate around the future of cancer care and to better scale their ideas. The roadmap involves reaching across disciplines, including public health, anthropology, telecommunications, and user-centered design. The goal is to leverage connectivity and cancer communication research and practice to make a real difference for patients and families.

Geographic Variation In The Structure Of Kentucky’S Population Health Systems: An Urban, Rural, And Appalachian Comparison, Rachel Hogg-Graham, Angela Carman, Glen P. Mays, Pierre Martin Dominique Zephyr

Journal of Appalachian Health

Introduction: Research examining geographic variation in the structure of population health systems is continuing to emerge, and most of the evidence that currently exists divides systems by urban and rural designation. Very little is understood about how being rural and Appalachian impacts population health system structure and strength.

Purpose: This study examines geographic differences in key characteristics of population health systems in urban, rural non-Appalachian, and rural Appalachian regions of Kentucky.

Methods: Data from a 2018 statewide survey of community networks was used to examine population health system characteristics. Descriptive statistics were generated to examine variation across geographic regions in …

Appalachian Regional Commission Recovery Ecosystem Background And Overview, Kostas Skordas, Andrew Howard

Journal of Appalachian Health

The Appalachian Regional Commission (ARC) has long addressed issues of substance abuse through funded community-based interventions, research, and sponsored conferences. Recently, the opioid crisis created a new urgency for cross-sector collaboration among various partners and funders dealing with this issue. This commentary provides an overview of recent efforts by the ARC to convene stakeholders to focus on assisting individuals with substance abuse disorder to access recovery services while pursuing education and training necessary to reenter the workforce and gain employment. Two papers have been prepared to describe this year-long effort. One paper focuses on the participatory methods used to gather …

Perspective On Substance-Abuse Recovery Ecosystem From The Appalachian Regional Commission Federal Co-Chair, Tim Thomas

Journal of Appalachian Health

The Appalachian Regional Commission (ARC) is a local, state, and federal partnership focused on economic development in the communities of the Appalachian Region. ARC Federal Co-Chairman Tim Thomas provides his perspective on how an economic development entity, such as ARC, can support efforts to address the Region’s drug crisis in a way that both saves lives and strengthens economic opportunity in communities throughout Appalachia.

Fiscal Challenges And Anticipated Changes To Kentucky's Population Health System, Jeffrey Howard

Journal of Appalachian Health

The hallmark of public health is population-level intervention. However, current public health funding in Kentucky is largely programmatic or disease-based. As a result, public health leaders are not able to appropriately utilize present resources to pursue population health endeavors. However, a recent transformation of the public health system has emphasized multisector partnerships and efficient funding mechanisms that may increase resources to pursue population-level health interventions based on community health assessments.

Social Solidarity And The Ontological Foundations Of Exclusionary Nationalism: Durkheim And Levinas On The Historical Manifestations Of Authoritarian Populism, C. J. Eland, Nicole L. M. T. De Pontes

disClosure: A Journal of Social Theory

This paper seeks to explore the dynamics of contemporary authoritarian populism from a historical perspective, relying on the approaches of Durkheim’s experimental sociology and Levinas’s ethical phenomenology. By reading the works of these two thinkers in concert, a pathology is exposed within this particular form of politics in that the State must necessarily close itself off to the critique of exteriority. Our reading of Durkheim explores the social pathology of nationalism while our reading of Levinas demonstrates the philosophical dimension of this pathology as the inevitable outcome of any philosophical thinking which privileges ontology above all else. The way these …

The 2016 Bernie Sanders Campaign: American Socialist Populism, Judson C. Abraham

disClosure: A Journal of Social Theory

Some socialists criticize Bernie Sanders’s 2016 presidential campaign, taking issue with the senator’s nationalism, vague presentation of socialism and revolution, and seeming preoccupation with class at the expense of attention to racism. This article draws from Ernesto Laclau and Chantal Mouffe’s theorization of populism to depict Sanders’s campaign as a legitimately socialist project. Laclau and Mouffe claim that left populism may evolve into socialism under certain conditions. One may expect Sanders’s populism to empower previously uncommitted people to make socialist demands.

Volume 29: Populism, Aimee Imlay, Matthew Wentz

disClosure: A Journal of Social Theory

The 2019-2020 disClosure collective is thrilled to present the 29th volume of disClosure: A Journal of Social Theory. This volume focuses on theories of populism and brings together a wide range of perspectives relating to the phenomenon, experience, and study of populism. The recent uptick in populism signals political, economic, and/or social unrest across the globe, yet, populism remains a phenomenon that is difficult to define. Our goal with this volume was not to define populism. Instead, this issue engages conversations about the various types and origins of populisms, as it is our belief that the development and definition …

Nationalpopulism, Right And Left: The Social-National Synthesis Today, Daniel Rueda

disClosure: A Journal of Social Theory

For most of the postwar period the idea of merging socialist (or popular) and nationalist elements was marginal in Europe. But in the last two decades we have been witnessing a new form of social-national synthesis: nationalpopulism. This article examines this resurgence by comparing right-wing nationalpopulism and left-wing nationalpopulism. In order to do so, it focuses on four European countries: France, Italy, Greece and Spain. While there are both policy and discursive similarities between these two forms of nationalpopulism, this article argues that they are fundamentally different and belong to antagonistic ideological factions.

Reactionary Populism And The Historical Erosion Of Democracy In America. An Interview With Nancy Maclean, Duke University, Nancy Maclean, Aimee Imlay, Matthew Wentz

disClosure: A Journal of Social Theory

Nancy MacLean is the William H. Chafe Professor of History and Public Policy at Duke University, and the award-winning author of several books, including Behind the Mask of Chivalry: The Making of the Second Ku Klux Klan; Freedom is Not Enough: The Opening of the American Workplace; The American Women’s Movement, 1945-2000: A Brief History with Documents; and Debating the American Conservative Movement: 1945 to the Present. She also served the editor of Scalawag: A White Southerner’s Journey through Segregation to Human Rights Activism.

Her scholarship has received more than a dozen major prizes and …

Understanding Populism Through Difference: The Significance Of Economic And Social Axes. An Interview With Kenneth Roberts, Cornell University, Kenneth Roberts, Kayla Bohannon, Alina Hechler

disClosure: A Journal of Social Theory

Kenneth M. Roberts is the Richard J. Schwartz Professor of Government and Binenkorb Director of Latin American Studies at Cornell University. His research and teaching interests focus on party systems, populism, social movements, and the politics of inequality in Latin America and beyond. He is the author of Changing Course in Latin America: Party Systems in the Neoliberal Era (Cambridge University Press) and Deepening Democracy? The Modern Left and Social Movements in Chile and Peru (Stanford University Press). He is also the co-editor of The Resurgence of the Latin American Left (Johns Hopkins University Press), The Diffusion of Social Movements …

Editor’S Preface And Acknowledgements, Aimee Imlay, Matthew Wentz

disClosure: A Journal of Social Theory

The 2019-2020 disClosure collective is thrilled to present the 29th volume of disClosure: A Journal of Social Theory. This volume focuses on theories of populism and brings together a wide range of perspectives relating to the phenomenon, experience, and study of populism.

Adorno’S Critique Of The New Right-Wing Extremism: How (Not) To Face The Past, Present, And Future, Harry F. Dahms

disClosure: A Journal of Social Theory

This paper serves three purposes relating to a lecture Adorno gave in 1967 on “the new right-wing extremism” that was on the rise then in West Germany; in 2019, the lecture was published in print for the first time in German, to wide acclaim, followed by an English translation that appeared in 2020. First, it is important to situate the lecture in its historical and political context, and to relate it to Adorno’s status as a critical theorist in West Germany. Secondly, Adorno’s diagnosis of the new right-wing extremism (and related forms of populism) and his conclusions about how to …

Reflections From A Lifetime Of Activism. An Interview With Chip Berlet, Chip Berlet, Kendall Sewell, Matthew Wentz, Austin Zinkle

disClosure: A Journal of Social Theory

Chip Berlet is a widely published independent scholar who studies right-wing movements in the United States and Europe, as well as the global spread of conspiracy theories. He is an award-winning investigative journalist and photographer. Since the 1995 Oklahoma bombing, Berlet has appeared frequently in the media to discuss these issues. For over twenty years, Berlet was a senior analyst at Political Research Associates (PRA), a non-profit think tank in the United States that tracks right-wing networks. Berlet is co-author (with Matthew N. Lyons) of Right-Wing Populism in America: Too Close for Comfort (Guilford 2000) and more recently editor of …

Making The People. An Interview With Paulina Ochoa Espejo, Haverford College, Paulina Ochoa Espejo, David Cortés Ferrández, Sandra Nava Nieto

disClosure: A Journal of Social Theory

Paulina Ochoa Espejo is an Associate Professor of political science at Haverford College. She is the author of On Borders: Territories, Legitimacy and the Rights of Place (OUP, 2020), The Time of Popular Sovereignty: Process and the Democratic State (PSUP, 2011) and co–editor of the Oxford Handbook of Populism (2017).

We Are Right, They Are Wrong: The Antagonistic Relationship Between Populism And Discourses Of (Un)Truthfulness, Michael Hameleers

disClosure: A Journal of Social Theory

Populism maintains a specific relationship with discourses of (un)truthfulness. Yet, although a growing body of research has explored the nature and effects of populist rhetoric, populism’s cultivation of reality and dishonesty has been under-theorized. In this paper, we explore three relationships between populism and (un)truthfulness: (1) the cultivation of a conspiracy theory in populist discourse; (2) populism’s denial or discrediting of expert knowledge or empirical information, and the legitimacy of journalism and mainstream sources of knowledge and (3) populist constructions of alternative truths that resonate with common sense and the experiences of the ordinary people. We further explore the effects …

Seeking Care At Free Episodic Health Care Clinics In Appalachia, Malerie Lazar, Sandra Thomas, Lisa Davenport

Journal of Appalachian Health

Background: People who live in rural Appalachia experience a wide variety of problems when seeking access to health care. Health care disparities continue to be one of the most complex and prevalent problems, and many barriers exist for impoverished men and women such as a lack of education, complications with health insurance, and personal distrust of healthcare providers.

Purpose: A critical gap in the literature is the unheard voice of persons in rural underserved areas. The purpose of this study was to explore the perspectives of persons in rural Appalachia who seek healthcare services at free episodic health care clinics, …

Skin Cancer And Uv Exposure-Related Behaviors Among Appalachian And Non-Appalachian Adults, Minal Patel, Katrina Serrano, Elise Rice, Chan Thai, Kelly Blake, Robin C. Vanderpool

Journal of Appalachian Health

Introduction: Appalachian communities experience elevated rates of cancer incidence and mortality relative to other regions in the U.S. Specifically, melanoma mortality rates are higher in Appalachia compared to the national average, despite comparable incidence rates.

Purpose: To examine differences in self-reported history of skin cancer and prevalence of two UV exposure behaviors between Appalachian and non-Appalachian adults in a nationally representative sample.

Methods: Data are from four cross-sectional cycles of the Health Information National Trends Survey (2011–2014) (N=14,451). We examined sunscreen use and tanning bed use, and self-reported history of melanoma and non-melanoma skin cancer. Descriptive and weighted …

Impact Of The Affordable Care Act On Referral To Care For People Living With Hiv In Appalachia, Cameron A. Wade, Timothy N. Crawford, Nicole Leedy, Alice C. Thornton

Journal of Appalachian Health

Introduction: The Affordable Care Act (ACA) enacted on March 23, 2010 significantly impacted access to healthcare for people living with HIV (PLWH). Expansion of care was accomplished in three areas: eliminating exclusions for pre-existing conditions, elimination of lifetime caps on healthcare expenditures, and expansion of Medicaid eligibility.

Purpose: This study evaluated the impact of state implementation of the ACA Medicaid expansion on referral to HIV care at a Ryan White federally funded clinic in Kentucky (University of Kentucky Bluegrass Care Clinic [UK BCC]).

Methods: Retrospective chart review of all newly enrolled patients at the UK BCC between March 2010 and …