Creating a Culture of Health in Appalachia:
Disparities and Bright Spots

An initiative to identify and explore Appalachian communities with better-than-expected health outcomes.

Across Appalachia, many communities face significant health challenges and are working to find ways to build stronger population health with limited resources.

Data show that the challenges are clear: The Creating a Culture of Health in Appalachia research initiative documents worse-than-average health outcomes for many Appalachian counties on a range of measures, including cancer, heart disease, and diabetes mortality rates. The disparities in outcomes between Appalachia and the U.S. are often stark.

See the health disparities data

But this initiative also finds something else in Appalachia’s health landscape: “Bright Spot” communities, which have outcomes that, while still deeply challenging, are better than expected given local socioeconomic and health factors and resource limitations.

What is making a difference in the health of these Bright Spot communities? This initiative explores the local approaches and assets that may be helping them—and could help other communities—achieve better health outcomes.

Learn more about the initiative

The Creating a Culture of Health in Appalachia initiative compiled data on 41 health indicators to establish a comprehensive and comparative overview of population health in Appalachian counties and in the nation. The indicators include both health outcomes (such as disease mortality) and factors that influence health outcomes (such as smoking and access to health care providers).

Bright Spot communities are the 42 Appalachian counties identified through the initiative’s data analysis as having better-than-expected health outcomes given their characteristics and resource levels. Through selective case studies, the initiative explored Bright Spot communities’ unique culture of health and the local approaches that may support better health outcomes.

Drawing on the initiative’s findings, three issue briefs were developed to inform community efforts related to the widespread Appalachian health issues of obesity, opioid misuse, and smoking. The briefs offer practical strategies and recommendations to community leaders, funders, and policymakers.