Exploring Appalachia: A Region Rich in History - Research Paper

Introduction

The Appalachia region spreads over 13 states in the United States; it starts in New York and ends at Mississippi (Martis, 2018). It has 420 regions that cover three areas, which are Northern, Central, and the southern part (Martis, 2018). The Appalachia region is described with the fluctuating mountain ranges, hollows, and long waterways that spread through most sections. Since the recognition of the part as a distinctive area. Many myths and distorted information have been spread about the region. Most of the information spread has been about the region's inhabitants. They have been portrayed as uncivilized and likely to attack impulsively (Martis, 2018). With Appalachia being a distinctive region, the paper explores the health issues that are experienced in the area and compared to other parts of the state. By analyzing the regional disparities between the resident of the Appalachian society and the rest of the United States, the paper uncovers why incidences such as heart diseases, cancer, injury, stroke, and diabetes are significantly different as compared to other areas of the state.

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Health Comparison Between Appalachia and the Rest of the United States

Unlike other regions in the United States, getting quality health care in the area is a challenge to many. The population of the area is quite low, meaning that health personnel are not willing to set up their operations in the area (Woolley, Meacham, Balmert, Talbott, & Buchanich, 2015). Due to the low number of residents, it becomes even harder to get experts who can offer specialized care. The health disparities widened in the region compared to other areas of the United States (Woolley et al., 2015). The difference was driven by higher rates of child mortality, obesity, vehicle accidents, and drug overdose. Even with a higher life expectancy in the United States, the slower gain of death in the United States brought about a wider gap. An examination of the specific health disparities will cover child mortality, suicidal tendencies, heart diseases, cancer, injury, stroke, and diabetes, as well as chronic obstructive pulmonary disease.

Suicide and Suicidal Tendencies

According to the health report by Raleign, (2017), the rate of suicide in the Appalachian region is 14.5 per 100000 members of the population. The rate is 17% higher compared to the national rate that stands at 12.4 individuals per 100000 people (Raleign, 2017). All the five regions in the Appalachian area have a higher suicide rate compared to the national rate. The north-central and the south-central areas have the highest rates at 15.5 and 16.3 per 100000 people respectively (Raleign, 2017)

In rural areas, the rate of suicide is 15.9 per 100000 people, which are high by 21% compared to the urban areas (Raleign, 2017). The metro counties in the region reported a lower rate of 13.1 per 100000 members of the population (Raleign, 2017). Jake (2015) states that the economically distressed counties have a higher suicide rate of 16.4 per 100000 people as compared to non-distressed counties, which have a rate of 14.4 per 100000 people. The rate in the economically distressed areas is 14% higher (Jake, 2015). The entire Appalachian region suicide rate is higher by 32% as compared to the national average (Jake, 2015)

Comparing the states Appalachian and non-Appalachian portions, the Appalachian portions reported higher rates of suicide as compared to the non-Appalachian regions. The rates were 25% higher (Raleign, 2017). For instance, in the Appalachian new York, the suicide rates were 11.7 per 100000 comparing to the non-Appalachian region where it stood at 7.6 per 100000 individuals, the rate is 54% higher (Raleign, 2017). Apart from Kentucky, all the other states reported higher suicide rates in their Appalachian regions

Dragisic, Dickov, and Mijatovic, (2015) state that several factors contribute to the higher rates of suicide in the area. The main ones are a history of mental illness, depression, alcohol, and substance abuse and depression. Isolation and the lack of access to medical care are also portrayed as the leading causes of suicide. States in Appalachia tend to have robust rural populations (Dragisic et al., 2015). Out of the reported attempts of suicide, most of them are attributed to rural isolation and a high rate of gun ownership. A rugged sense of individualism has also been pointed out as a leading cause of suicide in the region. The tradition of self-reliance has been shown to increase suicidal tendencies.

Stine (2018) notes that military personnel in the region are less reluctant to vocalize their mental and health issues. They, therefore, tend to struggle with suicidal thoughts since the topic is still highly stigmatized in the Appalachia region. As per Stine (2018), the stigma surrounding talking of mental health issues is socialized into children from a young age. The higher the level of social stigma, the less the people are willing to seek services regarding mental behaviors and health. Stine (2018) notes that in instances where shame is not a factor, people suffering from mental health issues in the region can seek help from families and friends.

Heart Diseases

Mamudu (2018), points out that the distribution of heart disease in the region is unequal. The concentration of the disease is higher in eastern and western US counties. The Appalachian region records an unusually high death rate as compared to other areas of the United States. In the central Appalachian region, white males aged 35 to 64 are mostly affected by the issue. In a nutshell, the mortality rate in the area is 17% higher as compared to the national average (Lilly, Umer, Cottrell, Pyles & Neal, 2017). Central Appalachian region has the highest rate of incidences, with it reporting a figure high by 42% as compared to the national rate (Lilly et al., 2017). Out of the 82 regions in the county, 80 of them have a higher mortality rate as compared to the national average (Lilly et al., 2017). Incidences of heart disease in rural areas are likely to occur by 27% as compared the metro regions of the counties. The heart disease mortality rates in the distressed areas are higher by 29% as compared to the non-distressed regions (Lilly et al., 2017).

Mamudu (2018) points out that the disparity in the mortality incidences is highest in black men, followed by white men. Black women take the third position while white women come forth. Mamudu (2018), notes that there is a fair distribution of heart disease and the death rates among the geographic subgroups. An essential takeaway is that death rates from heart disease are dominant in the central and southern areas of the Appalachian region affecting all the subgroups. Among the white men, the highest rates of heart disease appear in eastern Kentucky, and southern Ohio. High rates are also seen in the south part of the region including Alabama-Georgia border (Raleign, 2017)

Cancer

In a report prepared by Raleign, (2017), the cancer mortality rate in the Appalachian region fell by 14 between 2008 and 2014. The improvement was low as compared to that of the United States, which was 21% (Raleign, 2017). Even though the regions perfomance improved. The gap between the Appalachian region and the United States as a whole increased between the periods. Between the years 1989-1995, the mortality rate from cancer in the area was only 1% higher as compared to the national average (Raleign, 2017). In the year 2008-2014, the rate in the region was 10% high as compared to the national average (Raleign, 2017).

Yao, Alcala, Anderson, Balkrishnan (2016) note that cancer mortality rates declined in all regions. However, disparities remained in that the rural areas of Appalachia, while the urban areas out of Appalachia had the lowest rates. Residents in rural Appalachia had low diagnosis rates of breast cancer as compared to their urban counterparts. The rates of survival were also lower for those in rural areas, which was mostly 3-5 years (Yao et al., 2016). From the available data, Appalachia carries a higher burden compared to the non-Appalachia areas. More specifically, for tobacco-related cancers. For all the tumors, the region has the highest rates regardless of sex, religion, or age. Over the years, the incidences of cancer in Appalachia and non-Appalachia areas have decreased (Wilson, Ryerson, Singh, & King, 2016). However, the gap of oral, lung and thyroid cancers is still the same (Wilson et al., 2016)

Diabetes

Ann (2017) states that people in distressed counties are diagnosed with diabetes 2.8 years earlier as compared to those living in non-distressed Appalachia areas. Those in distressed counties are 1.3 times more likely to have diabetes as compared to those in non-distressed Appalachian counties (Ann, 2017). In the 78 counties classified as distressed, people aged 45-64 years had higher chances of getting diabetes as compared to their counterparts. 1in 5 resident were at risk compared to the 1 in 8 residents of non-Appalachian regions (Ann, 2017).

According to the center for disease control (2017), the 644 county areas were labeled as the diabetes belt. In 2011, approximately 11.7 % of the population was diagnosed with the condition (CDC, 2011). The rate was lower in other areas where only 8.55 of the community were diagnosed with the condition. Over 33% of the counties in the diabetes belt lie in the Appalachia region (CDC, 2017). The center for disease control states that multispectral engagement is essential to control and prevent the burden of diabetes in the region.

Stroke

In the years 1989-1995 and 2008-2014, Raleign (2017) notes that the incidences of stroke in the region fell by 35%. The decline is an improvement as compared to the 40% experienced by the entire United States (Raleign, 2017). Even though there was some improvement, the relative gap between the Appalachia region and the US rose slightly over the two periods. In the period 1989-1995, the mortality rate from stroke was only 4% high compared to the United States. From 2008 through 2014, the rate in the area rose to 14% higher as compared to the national rate, thus a display of increasing disparity (Raleign, 2017).

Sergeev (2013) notes that the mortality rate in Appalachia for stroke was 20.5% high compared to the regions outside Appalachia. The rates were 96.67, and 80.25 per 100000 persons for stroke mortality, respectively (Sergeev, 2013) the rate of strokes was higher in African Americans compared to other racial categories. Caucasians, Asians, and Native American Indians followed suit, respectively. The rates of rural-urban stroke mortality rates were significant outside Appalachia but insignificant within the region. The racial disparities for stroke in the area warrant further investigation for the possible health cause and possible solutions and interventions (Sergeev, 2013)

Injury

The primary purpose of injury in the region are accidents, motor vehicle-related injuries and injuries by an intimate partner. Motor vehicle-related injuries is the leading cause of death in the area. Even though all the sub-regions in the Appalachian have mortality rates from injury being higher as compared to the national average. The figure in central Appalachia is much higher, more than double the national rate. In central Appalachia, 84 out of 85 sub-regions report mortality rates that are higher as compared to the entire nation (Raleign, 2017). The rate of injuries in the rural counties of the Appalachian regions is 47% higher as compared to that of large metro counties (Raleign, 2017). In distressed counties, the rate is 55% higher as compared to that of the non-distressed areas of the Appalachian...