Study of poor but healthy Appalachian counties aims to find community-based approaches to improving the region’s health

Though some people equate Appalachian areas with poverty, David Krol seeks to “shine a light” on a different picture—one that reflects “how health can flourish across Appalachia,” despite data that confirms economic hardship, Krol writes for the Robert Wood Johnson Foundation.

While Krol was reviewing the Appalachian Regional Commission‘s county-based economic data, which compares economic indicators like poverty and unemployment rates with national averages and then ranks each county, it occurred to him to overlay this county index with the annual County Health Rankings.

For the most part, Krol said he found what he expected, “that the most economically distressed counties in Appalachia would also be in the lowest quartiles of health outcomes and factors for their state.” But some counties that were economically distressed ranked in the top quarter of their state in health factors and outcomes.

“What was it about Wirt County, West Virginia; Pickett County, Tennessee; and Oktibbeha County, Mississippi, that helped them overcome significant economic challenges towards better health outcomes when similarly distressed counties in the same state did not?” he wrote.

The need to know why these “unexpected outliers” occurred has prompted Krol, with the help of the ARC and the Foundation for a Healthy Kentucky, to study how these counties have accomplished this and to look at whether this could be re-created in similar communities.

“This approach is rooted in the belief that communities have the best solutions to the problems they face—as opposed to solutions driven by outside experts,” he wrote.

It’s an opportunity to “go beyond the data.. to community conversations about what’s important,” Susan Zepeda, CEO of the foundation, told Krol.

Krol wrote, “Quantitative data can get only get us so far—it’s up to us to ask those critical questions of “Why? How? What can be done? It’s up to us to turn data into action.”

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