Appalachian Health and Well-Being

Appalachian Health and Well-Being

Appalachian Health and Well-Being

Appalachian Health and Well-Being


Appalachians have been characterized as a population with numerous disparities in health and limited access to medical services and infrastructures, leading to inaccurate generalizations that inhibit their healthcare progress. Appalachians face significant challenges in obtaining effective care, and the public lacks information about both their healthcare needs and about the resources communities have developed to meet those needs.

In Appalachian Health and Well-Being, editors Robert L. Ludke and Phillip J. Obermiller bring together leading researchers and practitioners to provide a much-needed compilation of data- and research-driven perspectives, broadening our understanding of strategies to decrease the health inequalities affecting both rural and urban Appalachians. The contributors propose specific recommendations for necessary research, suggest practical solutions for health policy, and present best practices models for effective health intervention. This in-depth analysis offers new insights for students, health practitioners, and policy makers, promoting a greater understanding of the factors affecting Appalachian health and effective responses to those needs.


As director of the Center for Health Services at Vanderbilt University from 1975 to 1988, I had the professionally and personally enriching experience of working with community leaders in rural, low-income communities in and around Tennessee. Our work, like the chapters of this book, addressed all the factors that promote health and well-being, including economic, political, psychological, environmental, and social ones. From these community leaders I learned to put health and health care in a socioeconomic and political context. I recall in particular Square Mormon, an African American farmer in predominantly black Fayette County in West Tennessee. He and his county were pioneers in the voter registration efforts of African Americans in the South. He understood his later work on health care, in his hometown of Rossville, as a seamless continuation of the “movement.” “The people in Fayette County, when their eyes came open, they had really got sick for justice” (p. 72).

Diagonally across the state, some 400 to 500 miles to the northeast in the Appalachian coalfields of Tennessee, eastern Kentucky, southern West Virginia, and southwestern Virginia, I was privileged to be part of other community leaders’ efforts to develop health care services. They too were sick for justice—they wanted health care, jobs, and environmental quality, and they fought against ruinous extractive economies, scandalously inadequate tax systems, and the disparity between high levels of basic human needs and insufficient services.

More than thirty years mark the distance between that work and this book. Much has changed for the better. The chapters in this collection document measures of improved health status and ongoing innovations in the provision and coordination of services. There are also several constants from then to now, as this book shows. For instance, we still need to understand that health encompasses more than medical care and illness, and we still need to place these aspects in a broader context of their potential underlying determinants, which is the framework this volume uses. There is also a continuing connection between health and justice, or . . .

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