Appalachian Health and Well-Being

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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.

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Editorial Reviews

From the Publisher

"-Carol S. Baugh, PhD is Coordinator, Appalachian Studies, Sinclair Community College, and Director, Fairborn Education Foundation and Alumni Association.-Bruce A. Behringer, MPH is Associate Vice President, Division of Health Science, East Tennessee State University.-Andrew C. Bernard, MD is Associate Professor of Surgery, Acute Care Surgery, Trauma and -Surgical Critical Care, College of Medicine, University of Kentucky.-Kristine Harper Bowers, BA is Research Assistant and Coordinator of Substance Abuse Projects, Office of Rural and Community Health and Community Partnerships, East Tennessee State University.-M. Kathryn Brown, PhD is an epidemiologist and a community health research consultant based in Cincinnati.-Eleanor Sue Cantrell, MD is Director, Lenowisco Health District, Virginia Department of Health.-Mark A. Carrozza, MA is Health Informatics Developer, The Health Foundation of Greater Cincinnati.-Jennifer Chubinski, MSPPM is Director, Community Research, The Health Foundation of Greater Cincinnati.-Julia F. Costich, MPA, JD, PhD is Associate Professor and Chair, Department of Health Services Management, College of Public Health, University of Kentucky.-Richard A. Couto is Distinguished Senior Scholar, Union Institute and University.-Richard J. Crout, DMD, PhD is Associate Dean for Research and Professor of Periodontics, School of Dentistry and Professor of Biochemistry, School of Medicine, West Virginia University.-Lisa Curtin, PhD is Associate Professor, Department of Psychology, Appalachian State University. -Sharon A. Denham, DSN, RN is Professor, School of Nursing, Ohio University.-Mark B. Dignan, PhD, MPH is Director, Prevention Research Center, University of Kentucky.-Michael S. Dunn, PhD is Associate Professor of Health Promotion, Coastal Carolina University.-E. Kelly Firesheets, PsyD is Director, Grantee Evaluation Services, The Health Foundation of Greater Cincinnati.-James L. Fisher, PhD is Research Scientist, Ohio Cancer Registry, The Ohio State University Medical Center and Adjunct Assistant Professor, College of Public Health, The Ohio State University. -Gilbert H. Friedell, MD is Director Emeritus, Office of Rural and Community Health and Community Partnerships, Division of Health Sciences, East Tennessee State University.-Joel A. Halverson, PhD is Research Assistant Professor, Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University.-Michael S. Hendryx, PhD is Director, West Virginia Rural Health Research Center and Associate Professor, Department of Community Medicine, West Virginia University.-Ronnie D. Horner, PhD is Professor and Chair, Department of Public Health Sciences, College of Medicine, University of Cincinnati.-Mira L. Katz, PhD is Associate Professor, Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University.Paul A. Kearney, MD is Professor of Surgery and Section Head, Acute Care Surgery, Trauma and Surgical Critical Care, College of Medicine, University of Kentucky.Susan E. Keefe, PhD is Professor, Department of Anthropology, Appalachian State University.Evelyn A. Knight, PhD is Associate Professor, Department of Health Behavior, College of Public Health, University of Kentucky. Robert L. Ludke, PhD is Professor, Department of Family and Community Medicine and Department of Public Health Sciences, College of Medicine, University of Cincinnati.Mary L. Marazita, PhD is Associate Dean of Research and Director, Center for Craniofacial and Dental Genetics, Professor and Vice Chair, Department of Oral Biology, School of Dental Medicine, Director, Professor, Human Genetics, Graduate School of Public Health, Professor, Clinical and Translational Science Institute, and Professor, Psychiatry, School of Medicine, University of Pittsburgh.Ann L. McCracken, PhD is the former Director of Evaluation, The Health Foundation of Greater CincinnatiJohn M. McLaughlin, PhD is Regional Medical Research Scientist and Director Outcomes Research, Specialty Medicines Development Group, Pfizer, Inc.Daniel W. McNeil, PhD is Professor, Clinical Psychology, Eberly Professor of Public Service, and Clinical Professor, Department of Dental Practice and Rural Health, West Virginia University.Melanie F. Myers, Ph.D, MS, CGC is Assistant Professor, Division of Human Genetics, Department of Pediatrics, and Director, Genetic Counseling Graduate Program, University of Cincinnati and Cincinnati Children's Hospital Medical Center.Phillip J. Obermiller, PhD is a Senior Visiting Scholar, School of Planning, University of Cincinnati and Fellow, Appalachian Center, University of Kentucky.Electra D. Paskett, PhD is Marion N. Rowley Professor of Cancer Research and Director, Division of Cancer Control and Prevention, Department of Internal Medicine, College of Medicine, Professor, Division of Epidemiology, College of Public Health, and Associate Director for Population Sciences, Comprehensive Cancer Center, The Ohio State University.Levi D. Procter, MD is with the Division of General Surgery, College of Medicine, University of Kentucky.Eric W. Rademacher, PhD is Co-Director, Institute for Policy Research, University of Cincinnati.Rebecca J. Schmidt, DO is Section Chief, Section on Nephrology, Department of Medicine, School of Medicine, West Virginia University.Shiloh K. Turner, MPA is Vice President for Community Investment, The Greater Cincinnati Foundation.Barbara B. Weaner, RN, MSN, RNC, FNP is a Nurse Practitioner, Section on Nephrology, Department of Medicine, School of Medicine, West Virginia University.Mary Ellen Wewers, PhD is Professor, Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University." --

""This volume pulls together an enormous amount of information that has been scattered in obscure publications in diverse fields. It synthesizes that information, puts it in context, and makes it available to the anyone interested in general health issues. It should be in the library of every postsecondary education institution with an Appalachian constituency."--Wayne Meyers, M.D." --

""A well-written, insightful work that encompasses the breadth of this important topic."--Baretta R. Casey, M.D., M.P.H." --

""Ludke and Obermiller's work goes far beyond the borders of Appalachia to document the relationship between health and economic status. It particularly emphasizes the long-term effects of poverty on health. Its usefulness is not limited to Appalachia but to all those who believe that the opportunity for good health should not be defined by income and wealth."--William W. Philliber, author of Appalachian Migrants in Urban America" --

""An important and much-needed book. Mountaineers, both those inside the region as well as those beyond it, will receive better care from health-care providers and more humane treatment by policy makers if both read carefully the multidisciplinary perspectives contained in this timely volume."--Chad Berry, author of Southern Migrants, Northern Exiles" --

""An excellent introduction to the persisting health challenges of Appalachia, where health disparities are one of the continuing markers of inequality. In this volume some of the region's leading health researchers examine the economic, environmental, behavioral and systemic causes of those disparities."--Ronald D Eller, Distinguished Professor of History, author of Uneven Ground: Appalachia since 1945" --

""Brings together researchers who present data addressing health disparities affecting urban and rural Appalachians and offers possible solutions."--Kentucky Enquirer" --

""Ludke and Obermiller summarize the state of Appalachian health.... An important addition to the body of work documenting the state of Appalachia."--Kentucky Libraries" --

""A truly exemplary book.... Surveys nine areas of health in the region and concludes with policy recommendations."--Apalachian Heritage" --

""An important addition to the body of work documenting the state of Appalachia." --Kentucky Libraries" --

""This medical text, the first of its kind, focuses on health of the region's inhabitants as well as those who have moved away." --Library Journal" --

""While the idea of geographically-based health disparities is still evolving, this engaging resource has greatly expanded the concept in what is a remarkable volume of well-organized, well-written, evidence-based studies on health in Appalachia presented from a host of critical perspectives. This book should become required reading for policy makers, health care providers, community activists, and students everywhere. -- Elke Jones Zschaebitz, David C. Gordon, Family and Community Health" --

"Appalachian Health and Well-being develops an enriched analytical framework for health care and creates a new, comprehensive source of knowledge that will benefit multidirectional efforts to improve Appalachian health. Authors offer informed recommendations for assessing and preventing disease and promoting health. This compliation is a pioneering work that will inform and guide readers and serve as a model for future Appalachian health research." -- Journal of Appalachian Studies

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Product Details

  • ISBN-13: 9780813135861
  • Publisher: University Press of Kentucky
  • Publication date: 3/7/2012
  • Pages: 400
  • Product dimensions: 5.80 (w) x 9.00 (h) x 1.50 (d)

Meet the Author

Robert L. Ludke is a professor of family and community medicine at the University of Cincinnati. He is also a member of the Board of the Urban Appalachian Council.

Phillip J. Obermiller is a Senior Visiting Scholar in the School of Planning at the University of Cincinnati and a past president of the Appalachian Studies Association.

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Table of Contents

List of Illustrations ix

Foreword xi

Introduction 1

Part I Appalachian Health Determinants

1 Genetic Contributions to Health Melanie F. Myers Carol S. Baugh 27

2 Health and the Physical Environment Michael S. Hendryx 47

3 The Quest for an Appalachian Health Lifestyle Evelyn A. Knight 67

4 Health Care Systems Joel A. Halverson Gilbert H. Friedell Eleanor Sue Cantrell Bruce A. Behringer 89

Part II Appalachian Health Status

5 The Heart of Appalachia Ann L. McCracken E. Kelly Firesheets 111

6 Diabetes and Its Management Sharon A. Denham 131

7 Obesity and Food Insecurity Jennifer Chubinski Mark A. Carrozza 149

8 Cancer-Related Disparities James L. Fisher John M. McLaughlin Mira L. Katz Mary Ellen Wewers Mark B. Dignan Electra D. Paskett 167

9 Chronic Kidney Disease-A Hidden Illness Barbara B. Weaner Rebecca J. Schmidt 187

10 Trauma Levi D. Procter Andrew C. Bernard Paul A. Kearney Julia F. Costich 209

11 Mental Health Susan E. Keefe Lisa Curtin 223

12 Substance Abuse Michael S. Dunn Bruce A. Behringer Kristine Harper Bowers 251

13 Oral Health Daniel W. McNeil Richard J. Crout Mary L. Marazita 275

Part III Urban Appalachian Health

14 Identifying Appalachians Outside the Region Robert L. Ludke Phillip J. Obermiller Eric W. Rademacher Shiloh K. Turner 297

15 The Health Status and Health Determinants of Urban Appalachian Adults and Children Robert L. Ludke Phillip J. Obermiller Ronnie D. Horner 315

16 Community-Based Participatory Health Research in an Urban Appalachian Neighborhood M. Kathryn Brown 339

Acknowledgments 361

Selected Bibliography 363

List of Contributors 367

Index 371

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