All communities need to be engaged in their health and wellbeing, and all communities define health and wellbeing in different ways. In this post, we speak specifically to health engagement in Appalachian communities, though the lessons from this post are relevant to all.

Appalachian communities are incredibly diverse in terms of socio-economic status, educational attainment, race, language practices, and health status. And yet…

“Individuals living in rural areas have traditionally been underserved with regard to health care access. The reasons for this are multiple and varied, but mainly stem from the need to travel long distances to health care facilities, lack of health insurance, lack of specialized care and an inadequate number of health care providers working in rural areas.”
—VHA Office of Rural Health

Listen to the emphasis on distance in the above quote. Health in Appalachia, especially within its most rural areas, is greatly impacted by physical separation from resources. According to Appalachian health experts, the underlying cause of poor health outcomes in Appalachian is “the general absence of community-linked and community-responsive systems of health care across the region” (Ch. 4 of Appalachian Health and Wellbeing by Joel A. Halverson, Gilbert H. Friedell, Eleanor Sue Cantrell, and Bruce A. Behringer).

Beyond distance alone, the communication efforts between health professionals, health systems, patients and populations with low health literacy in Appalachia is inadequate. Educational and literacy differences create challenges, since many mountain communities are served by health professionals from outside the region, often international medical school graduates. The use of medical terminology for those with limited health literacy often affects communication, whether the providers are from Appalachia or from foreign countries. Providers’ understanding and acceptance of local behaviors and preferences also affect the delivery and acceptance of health care by Appalachian communities.

How to Improve Appalachia’s Health Disparities

The effective resolution of Appalachia’s health disparities should be based on four propositions (from Ch. 4 of Appalachian Health and Wellbeing):

1. Integration between local communities and health services and systems;
2. Collaboration between schools, businesses, civic organizations, religious communities, government entities, health professionals, and the media to view health as a shared responsibility;
3. Community Action, including efforts to communicate and connect people on issues of health; and
4. Attention to Local Conditions, including using local assets to link individuals, communities, and health services and systems to address local health disparities.

Overall, the experts agree that, “The recipe for success lies in community engagement in defining a ‘healthy community’ and determining the level of health care availability and quality.”

How to Engage Appalachian Communities in Health and Wellbeing

Engaging communities in health and wellbeing starts from the ground-up-listening to community voices and catalyzing community-based conversations around health is key to improving health literacy among communities and generating greater awareness of the community’s perspectives on health among providers.