Of the 41 health indicators examined through this initiative, the Appalachian Region performed better than the nation overall on 8: HIV prevalence, travel time to work, excessive drinking, student-teacher ratio, chlamydia prevalence, percentage of the population under age 65 that is uninsured, diabetes monitoring among Medicare patients, and the social association rate.

For the remaining 33 indicators, the performance in the Appalachian Region was worse than the performance in the United States as a whole. The analysis included 7 of the 10 leading causes of death in the United States: heart disease, cancer, chronic obstructive pulmonary disease (COPD), injury, stroke, diabetes, and suicide—and the Appalachian Region had higher mortality rates than the nation for each.

The disparities data analysis found that

  • Mortality due to poisoning—which includes drug overdoses—is markedly higher in the Region than in the nation as a whole.
  • The Appalachian Region’s number of physically unhealthy days, mentally unhealthy days, and prevalence of depression are all higher than the national averages for these measures.
  • Obesity, smoking, and physical inactivity—risk factors for a number of health outcomes—are all higher in Appalachia than in the nation overall.
  • The Region also has lower supplies of healthcare professionals when compared with the United States as a whole, including primary care physicians, mental health providers, specialty physicians, and dentists.
  • Lower household incomes and higher poverty rates—both social determinants of health—reflect worse living conditions in the Region than in the nation as a whole.

The analysis also examined the changes over the last 20 years in eight measures: heart disease mortality, cancer mortality, stroke mortality, infant mortality, the supply of primary care physicians, poverty rates, education levels, and years of potential life lost.

Over the past two decades, the Appalachian Region has experienced improvements in seven of the eight measures—all except the poverty rate. However, the progress made by the Region often comes up short when compared with the progress made by the United States overall, and indicates a widening gap in overall health between Appalachia and the nation as a whole. To see a detailed discussion of change in these eight measures, see the report Health Disparities in Appalachia.