Regional Sociology Commons^™

Adult Food Security And The Relationship With Adverse Childhood Experiences Among Residents Of Appalachian North Carolina, Manan Roy, Erin Bouldin, Maggie Bennett, Adam Hege

Journal of Appalachian Health

Introduction: The Appalachian region has worse health outcomes than the remainder of the United States. These disparities are often linked to the underlying social and environmental determinants of health. Adverse childhood experiences (ACEs) are associated with poor health outcomes across the lifespan and have a significant impact on future social determinants as an adult, including food security status.

Purpose: To explore the relationships between ACEs and food security among adults in the Appalachian counties of North Carolina and make comparisons with the rest of the state.

Methods: Researchers used North Carolina’s 2012 Behavioral Risk Factor Surveillance System data; namely, …

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.

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 …

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.

Weathered Mountains: A Qualitative Study Of West Virginia Women And Their Perceptions Of Strength, Land, And Womanhood, Danielle Renee Mullins

Theses, Dissertations and Capstones

Appalachia and those living within the region have been discussed, examined, critiqued, and defined primarily by those living outside of the area, particularly following the 2016 Election. The main narratives of Appalachia form a dichotomous view of the land and its people: beautiful landscapes threatened by resource extraction and a people wrecked by the symptoms of longterm poverty and economic stagnation. Simultaneously, the Appalachian identity has been constructed around a rugged or blue-collar male identity that excludes and makes invisible the female experience. This study seeks to break through the landscape and poverty binary, as well as the male-archetype, to …

Moving Mountains : A Study Examining Long-Term Impacts Of Mountaintop Removal Coal Mining On Mortality In The Appalachian Region Using Geographic Information Sciences Techniques., James Howard Kent Pugh

Electronic Theses and Dissertations

Over the last hundred years, the Appalachian region has been dominated by the coal industry. It has also been and currently is one of the unhealthiest regions in the United States. Recent scholarship has examined the relationship between coal mining and health and mortality rates in the Appalachian region. The first study incorporates air quality and pollution data to examine if coal mining counties have higher levels of pollution and if this pollution contributes to mortality disadvantage. In the second study, I construct a population-based coal-exposure measure to better evaluate the relationship between coal mining and health I find that …

The Devil Is In The Details: Representations Of The Rural Appalachian Deviant, Stephen T. Young

Sociology & Criminal Justice Theses & Dissertations

Every year, it seems, a new film makes its way through theaters across America demonstrating a new variant of the rural Appalachian deviant. These films play a major role in continuing to shape societal perceptions of rural white populations in Appalachia. Drawing on theoretical insights of Cohen, Hunt, Simon, and Lupton this dissertation examines how film depictions of the rural white Appalachians supports the continued construction of the rural Appalachian deviant. This study finds that films support said construction by demonstrating this population through themes about tainted blood, intimate partner violence, and drug addiction. Moreover, these films camouflage the facts …

Rural Reality: How Reality Television Portrayals Of Appalachian People Impact Their View Of Their Culture, Ivy Jude Elise Brashear

Theses and Dissertations--Community & Leadership Development

Appalachian people have faced stereotyping of their culture and region in popular culture, news media, and art for generations. For more than 150 years, images of the region have been extracted by outside media makers and disseminated widely, solidifying the “hillbilly” stereotype in the national lexicon. This study focuses on such images in reality television shows about Appalachia, and seeks to determine whether or not those images, and the proliferation of them, has an impact on the ways in which Appalachian people understand and accept their own culture.

O Brother, Where Art Thou? Understanding Culturally-Produced Limitations On Gay Male Community Formation In South Central Appalachia, Michael Brandon Brewer

Electronic Theses and Dissertations

This research examines limitations presented to gay men living in south central Appalachia that are produced by Appalachian culture itself, in regard to community formation. This qualitative study intersects existing scholarship on rural sexualities, gay communities and Appalachian culture in order to gain insight into the complexities that effect men in the region. The data is synthesized through a contextual dialectics framework in order to position both the Appalachian culture in its entirety, and gay men residing in the region, as agentic actors that are simultaneously informed by and produce tensions between the two. This study explores ways in which …

Capitalizing On Distinctiveness: Creating West Virginia For A New Economy, Brian A. Hoey

Sociology and Anthropology Faculty Research

This paper explores use of images and ideas of place to promote particular social and economic agendas within the regional context of Appalachia. Despite prevailing imageries of backwardness and isolation that adhere to the region, as well as recent history of often-bleak economic conditions, communities such as Huntington, West Virginia, are ideal places to observe inventive forms of community-building, place-making, and place-marketing that borrow from emerging cultural and economic models and stand in sharp contrast to a once-dominant paradigm that encouraged capital investment by relying simply on tax breaks and the provision of cheap land and labor to attract large, …

The Geography Of Stuck: Exceptions To Brain Drain In West Virginia, Lindsay Heinemann

Theses, Dissertations and Capstones

Brain drain, also known as “human capital flight,” can be defined as “the mass emigration of technically skilled people from one country to another country” (Weeks, 2008, p. 250) or one state to another state. This theory surmises that highly skilled people or those with high education levels are more likely to migrate from places with little to no economic opportunities to places with better economic and job opportunities. West Virginia has largely been a state with few high paying or prestigious job opportunities. So why do highly educated people stay in West Virginia? Using census data and personal interviews, …

Untangling Neoliberalism’S Gordian Knot: Cancer Prevention And Control Services For Rural Appalachian Populations, George F. Bills

Theses and Dissertations--Sociology

In eastern Kentucky, as in much of central Appalachia, current local storylines narrate the frictions and contradictions involved in the structural transition from a post-WWII Fordist industrial economy and a Keynesian welfare state to a Post-Fordist service economy and Neoliberal hollow state, starving for energy to sustain consumer indulgence (Jessop, 1993; Harvey, 2003; 2005). Neoliberalism is the ideological force redefining the “societal infrastructure of language” that legitimates this transition, in part by redefining the key terms of democracy and citizenship, as well as valorizing the market, the individual, and technocratic innovation (Chouliaraki & Fairclough, 1999; Harvey, 2005). This project develops …

Climate Influence On The Health Of An Appalachian City, Ryan Wade Becka

Theses, Dissertations and Capstones

In 2008 the Center for Disease Control (CDC) found Huntington, West Virginia, to be the unhealthiest city in America. A Gallup Poll conducted in 2010 found the Huntington-Ashland metropolitan area number one of 188 metro areas where depression diagnoses are most common. Manifestations of poor health in Huntington may be related to Seasonal Affective Disorder (SAD), a type of depression that occurs mainly in winter months. Symptoms of SAD are reported as a lack of energy, sleeping more, and consuming high amounts of carbohydrates and starchy foods. I theorize that these maladaptive behaviors may be a reaction to climate conditions …

Free Clinics And The Uninsured: The Need For Remote Area Medical In Central Appalachia After Health Reform., James W. Watson

Electronic Theses and Dissertations

In 2008, the election of President Barack Obama brought health care to the forefront of national discussions and led to the passage of the Patient Protection and Affordable Care Act (ACA). The legislation changed the rules of health care delivery in the United States, but the ACA did not do one fundamental thing: It did not end the need for many of the nation's most needy patients to seek free medical care from groups such as Remote Area Medical (RAM).

A mobile clinic, RAM brings together volunteer dentists, physicians, nurses, and other professionals as well as support staff for multi-day …

Breast Cancer Trends Among Kentucky Women, 2004-2007, Kara Ann Hagan

Theses and Dissertations--Nutrition and Food Systems

The purpose of this study is to investigate the discrepancies of female breast cancer mortality between the Appalachian and Non-Appalachian regions of Kentucky using data from the Kentucky Cancer Registry. This study identified subtype, reproductive, and regional differences in women with breast cancer in Kentucky. Among women with breast cancer living in Kentucky from 2004 to 2007, one and three live births significantly increased a woman’s risk of breast cancer mortality by 91% and 58% respectively, compared to a woman with zero live births. Progesterone receptornegative tumor status significantly increased a woman’s risk of breast cancer mortality by 64% compared …

On The Outside Looking In: A Qualitative Study Of Southern Appalachian First-Generation Students' Perceptions Of Higher Education., Michael Steven Briggs

Electronic Theses and Dissertations

This study was designed to investigate Southern Appalachian, first-generation students' expectations of higher education. Research indicates that many first-generation students drop out of college after only 1 semester; however, little research exists concerning the expectations and experiences of first-generation college students from Southern Appalachia.

The study employs a qualitative methodology based in the tradition of grounded theory to highlight students' experiences while encouraging the emergence of data-driven theory based on what the researcher heard. Thus, the entire study is couched in the interpretivist philosophy of research.

Eleven full-time university students were interviewed for the study. They were asked to identify …

A Sociological Study Of Atheism And Naturalism As Minority Identities In Appalachia., Kelly E. Church-Hearl

Electronic Theses and Dissertations

This qualitative study aims to provide a sociological understanding of people who hold minority beliefs about spirituality and religion and to improve our sociological and social-psychological understanding of a-religious and alternatively religious people. Data were collected through indepth interviews with 10 atheist and 11 naturalist respondents. The study examines the religious histories of the respondents, how they left mainstream religion, how they adopted a minority identity with regard to religion/spirituality, and their personal experiences living in a predominately Christian area. I hypothesized that atheists and naturalists would hold minority identities and feel subordinated or oppressed by the dominant group: Christians. …