Healthcare Disparities in Rural Appalachia

 

    Throughout my summer breaks from both high school and a couple during undergrad, I took part in medical service trips to parts of rural Appalachia, more specifically parts of eastern Kentucky, eastern Tennessee, and southwestern West Virginia. While I was there, I assisted doctors, physicians associates, nurses, the list goes on in providing medical care to hundreds of disadvantaged Americans, as many, if not all of them fell well below the poverty line. It was truly heart wrenching to see how these people had to live given their circumstances and the medical conditions from which they suffered. There was an utter lack of healthcare available to them in these towns that were once booming epicenters of coal production, as the nearest medical clinic was often times over an hour away. While there is an entirely larger conversation to have about the plethora of socioeconomic, educational, and infrastructural disparities that occur in these regions of the U.S., the medical inequities and the poor access to healthcare seem to be at the top of this list.

            Appalachia has higher mortality rates in seven of the leading causes of death in the United States including, heart disease, cancer, COPD, injury, stroke, diabetes, and suicide (Smith, 2021). While working in the clinics, there also was not a day that went by, where we did not see a coal miner come in from a 12+ hour shift covered from head to toe in soot from one of the few mines still open, complaining of respiratory problems (mainly asthma). Upon treatment of these young men, chest x-rays and cardiorespiratory testing were performed, among other things, and the results would shock anybody as entire portions of their lungs were filled with ash and dust. Many of them men admitted that they had not seen a doctor in years, as missing a day of work to go to a medical clinic meant no pay that day, which they often times could not come to sacrifice. Besides those working in the coal mines, many individuals we treated were pre-diabetic or already diabetic, obese, suffering from atherosclerosis, or CVD. In conversations I had had with these patients, many of them said it was cheaper to buy soda than it was to buy milk and getting fresh fruits and vegetables was like stumbling upon a gold mine. As a result, processed foods and beverages loaded with additives, sugar, and other harmful ingredients seemed to be the basis of peoples diets, as I had one mom tell me, “I’m afraid to give my son (who was 2-years old) water, as I do not know if it will be safe for him to drink, so I give him soda and juice instead.”

            All of this presents an extreme ethical dilemma to those of us living in the United States, as many often think, “people don’t live like that in the U.S.” but in all honesty, I have seen worse poverty within the borders of our country than I have seen in parts of Africa and South & Central America. The average life-span in Eastern Kentucky is on average 8-9 years less than the national average of 79 years of age, due to severe lack of proper healthcare, dramatic food deserts, poor working conditions, and widespread lack of working opportunities (Jackson et al., 2017). This thus raises the question of “what can I do and how can I help” these individuals who quite literally have nothing while many of us, myself included are very fortunate to live the lives we do. I believe that as a future healthcare professional, we all ought to campaign and advocate for equitable access to healthcare in areas where people need it the most and make it our mission to not only serve our own communities but those within our country who have faced medical disparities. Serving communities in parts of the country like those mentioned, I believe will help one become a better physician in learning about the plights these people face, while concurrently learning more about diseases and illnesses that disproportionately affect certain regions of our country.

References

Jackson, B. E., Oates, G. R., Singh, K. P., Shikany, J. M., Fouad, M. N., Partridge, E. E., & Bae, S. (2017). Disparities in chronic medical conditions in the Mid-South. Ethnicity & health, 22(2), 196–208. https://doi.org/10.1080/13557858.2016.1232805

Smith, E. (2021, January 6). Human Rights in Appalachia: Socioeconomic and health disparities in Appalachia. Retrieved November 23, 2021, from https://sites.uab.edu/humanrights/2021/01/06/human-rights-in-appalachia-socioeconomic-and-health-disparities-in-appalachia/.