Beating back the diseases of despair


By Scott Robertson

The Appalachia Regional Commission hosted a very important discussion in Johnson City yesterday afternoon. The roundtable, entitled “Health Disparities in Appalachia and Diseases of Despair” brought together health professionals, state and federal policy makers, economic development leaders, local elected officials, community service providers, and educators to examine the implications of health data for economic development in Appalachia.

We’ve all heard by now about the rising opioid abuse epidemic and the heavy toll other health problems, including those stemming from smoking, sedentary lifestyle and poor diet choices have exacted from the region. But putting that toll in economic terms brings to light the stark reality that we’re not just facing a problem today. We’re creating a handicap for the region for decades to come. And unless we take much stronger steps to address it today, we’re headed into a long self-destructive cycle.

The roundtable was prompted by publication of a new research report on Appalachian health entitled “Health Disparities in Appalachia.” It provides an updated county-level analysis and assessment of population health throughout the Appalachian region. Included is documentation of disparities between the region and the nation as a whole, as the title suggests. But also in the report are such items as geographic comparisons between rural and urban areas, interstate vs intrastate trends, and comparisons of distressed and non-distressed counties.

The report is a companion piece to “Appalachian Diseases of Despair” which focused on regional trends in drug overdose, suicide and liver diseases resulting from alcoholism. That report was published in 2015. It found that those factors are the primary drivers of rising morbidity and mortality among middle-aged white people in Appalachia.

Among the topics covered at the roundtable were questions like:

• How do we integrate economic and community development into a larger “culture of health” than can address the region’s health conditions?

• How can we take advantage of the region’s social infrastructure to address health challenges and build a stronger economy?

• What do the data suggest as the key challenges for having a competitive regional workforce and what successful strategies are being deployed around the region to address those challenges?

• What are the best strategies that can both improve Appalachia’s health conditions and, at the same time, strengthen the regional economy, such as increasing the number of specialists and mental health workers?

• How can healthcare providers work with businesses, local governments, and non-profit organizations to create a stronger regional economy? What are some best practices that are already occurring?

• How can we most effectively integrate the delivery of health care services into broader economic development plans?

There are bright spots, of course, and Northeast Tennessee’s strong healthcare economy, along with ETSU’s – and other higher education institutions’ – impact on that economy are among those. But perhaps the greatest bright spot is that the discussions are finally moving from simply stating the problem exists into asking what we can do, starting now, to save our health and our economy for the future.


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