Rural Sociology Commons^™

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. …

Correlates Between Childhood Trauma And Reproductive Health Behaviors Among Women In Appalachia, Haley Metcalf

Electronic Theses and Dissertations

The lasting effects of childhood trauma into adulthood have been well corroborated by research from a variety of sources. Previous research has found a vast number of psychological, behavioral, and health related outcomes that are negatively affected by victimization in childhood. This piece strives to assess the correlates between childhood trauma and adult reproductive behavior and well-being for women living in Appalachia. The NCIPC has found that residents of Appalachia are at higher risks for both experiencing childhood traumas and poor health outcomes (2017). To create long-term positive reproductive health behaviors among Appalachian women, it is essential to examine how …

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.

Clinician Identified Barriers To Treatment For Individuals In Appalachia With Opioid Use Disorder Following Release From Prison: A Social Ecological Approach, Amanda M. Bunting, Carrie B. Oser, Michele Staton, Katherine S. Eddens, Hannah K. Knudsen

Sociology Faculty Publications

Background: The non-medical use of opioids has reached epidemic levels nationwide, and rural areas have been particularly affected by increasing rates of overdose mortality as well as increases in the prison population. Individuals with opioid use disorder (OUD) are at increased risk for relapse and overdose upon reentry to the community due to decreased tolerance during incarceration. It is crucial to identify barriers to substance use disorder treatment post-release from prison because treatment can be particularly difficult to access in resource-limited rural Appalachia.

Methods: A social ecological framework was utilized to examine barriers to community-based substance use treatment among individuals …

Growing Economic Possibility In Appalachia: Stories Of Relocalization And Representation On Stinking Creek, Kathryn Engle

Theses and Dissertations--Sociology

This project explores the agricultural heritage and current social landscape of the Stinking Creek community of Knox County, Kentucky, and the legacy of the local nonprofit organization the Lend-A-Hand Center. Through participatory research, this project presents a reflexive account of the Lend-A-Hand Center Grow Appalachia Gardening Program examining the diverse economy of the Stinking Creek watershed and possibilities for new economic imaginings and post-coal futures for central Appalachia. This dissertation includes an oral history project, a theoretical examination, and an ethnographic reflection, bridging several literatures in the fields of agricultural history, Appalachian Studies, Participatory Action Research, research within the diverse …

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 …

“I Wonder What You Think Of Me”: A Qualitative Approach To Examining Stereotype Awareness In Appalachian Students, Chelsea G. Adams

Theses and Dissertations--Educational, School, and Counseling Psychology

Historically, Appalachia has been stereotyped as being a culture bred in poverty and ignorance. Much research has shown that stereotyping reveals a pattern of behavioral change and an impact on psychological well-being for the stereotyped (e.g., Pinel, 1999; Woodcock, Jernandez, Estrada, & Schultz, 2012), and has largely been centered on race and gender (e.g., Byrnes, 2008; Tuckman & Monetti, 2011). Less is known about the development of culture-specific stereotypes such as those related to Appalachians – a highly stigmatized group (Daniels, 2014; Otto, 2002). The purpose of this study was to gain an understanding of how adolescents in rural Appalachia …

Mental Health Treatment Seeking Patterns And Preferences Of Appalachian Women With Depression, Claire Snell-Rood, Emily Hauenstein, Carl G. Leukefeld, Frances Feltner, Amber Marcum, Nancy E. Schoenberg

Behavioral Science Faculty Publications

This qualitative study explored social-cultural factors that shape treatment seeking behaviors among depressed rural, low-income women in Appalachia—a region with high rates of depression and a shortage of mental health services. Recent research shows that increasingly rural women are receiving some form of treatment and identifying their symptoms as depression. Using purposive sampling, investigators recruited 28 depressed low-income women living in Appalachian Kentucky and conducted semistructured interviews on participants’ perceptions of depression and treatment seeking. Even in this sample of women with diverse treatment behaviors (half reported current treatment), participants expressed ambivalence about treatment and its potential to promote recovery. …

Women And Healthcare In Appalachia: Impeding Circumstance And The Role Of Technology, Ashley Cano

Electronic Theses and Dissertations

For decades, healthcare access and quality in central and southern Appalachia have trailed the rest of the country. Entrenched poverty and low educational attainment compound healthcare problems. This study examines the healthcare obstacles women encounter in southern and central Appalachia and analyzes how technology use, such as Internet searching and social media affect women’s healthcare decisions. Data were analyzed from four focus groups conducted with women from the region. Results indicate that seeing a physician or not did not influence women’s propensity to search the Internet for health-related information or to seek support through social media sites. Additionally, women reported …

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.

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 …

Job Skills, Tolerance, And Positive Interactions: The Gendered Experiences Of Appalachian Migrants, Kelli Brooke Alford

Masters Theses & Specialist Projects

The following study examines gendered learning experiences of a population of Appalachian migrants surveyed from the late 1970s to the early 1990s. The respondents who participated in the survey used for this study began their lives in Appalachia. These respondents then left Appalachia for various other areas in the country and even around the world only to ultimately return to the mountainous region later in their lives. To begin, theory will be introduced concerning the stratification of gender in the Appalachian economic landscape, as well as a theoretical framework placing Appalachian women in an interlocking web of oppression with other …

Factors That Contribute To Student Graduation And Dropout Rates: An In-Depth Study Of A Rural Appalachian School District, Ann Lyttle-Burns

Online Theses and Dissertations

There has been a wealth of research conducted on the national epidemic of high school dropouts spanning several decades. It is estimated that the class of 2009 cost the nation $335 billion in lost wages, taxes and productivity over their lifetimes (Alliance for Excellent Education, 2009). The citizenry of the country suffers not only because of the loss in revenue but also as a result of the education level of the population. Individuals who choose to drop out of high school are not prepared for the most basic minimum wage jobs available, much less well paying jobs that sustain livelihoods. …

“You’Re Surviving But I Don’T See How You’Re Living” Appalachian Women Talk About Tanf And Employment In Their Communities, Pon-Chu Tsou

University of Kentucky Master's Theses

This thesis studies qualitative data to examine the lived experiences of Kentucky Transitional Assistance Program (K-TAP) recipients in Appalachian Kentucky. This research suggests that PRWORA legislation utilize the importance of place-based analyses to implement and evaluate poverty policy. For women who are attempting to meet PRWORA’s goals, the local services available to the women and the barriers they face to employment highlight the role place has in this national policy discussion. Of the women interviewed, recipients who resided in economically distressed areas had fewer opportunities to participate in employment activities than women in at-risk or transitional areas. While many strived …

Opportunity, Community, And Teen Pregnancy In An Appalachian State, Robert Bickel, Susan Weaver, Tony Williams, Linda Lange

SHU Faculty Publications

Teen pregnancy has become an issue that educators and public policy makers are obliged to treat as a serious problem. Too often, explanations of teen pregnancy have included uncritical use of the notion of adolescents at risk. Recently, however, attention has been given to structurally-determined contextual factors in explaining teen pregnancy. Such contextual factors include economic and educational opportunities and costs, as well as chances for valued participation in socially and culturally stable communities. This interest in contextual factors parallels a development in the literature on high school dropouts. A data set previously employed to study variability in drop-out rates …