Social Association Rate

The social association rate measures the number of social organizations per 10,000 population. The data come from County Health Rankings and are based on 2013 data from the Census Bureau’s County Business Patterns. Greater levels of social relationships and interaction positively affect a number of outcomes, including those associated with both mental and physical health.

For this measure, social organizations include membership organizations such as bowling centers, fitness centers, golf clubs, and any type of business, civic, labor, political, professional, religious, or sports organizations.

  • The social association rate in Appalachia is 33 percent higher than the rate found in the nation as a whole.
  • Social association rates are highest in Northern Appalachia (14.2 associations per 10,000population) and South Central Appalachia (13.3 per 10,000). Only Central Appalachia (8.8 per 10,000) has a rate lower than the national figure.
  • There is no clear urban-rural pattern in social association rates throughout Appalachia. The Appalachian Region’s large metro counties (10.9 associations per 10,000 population) and its rural counties (11.8 per 10,000) both report rates lower than the Regional average, yet higher than the national average.
  • The social association rate in the Appalachian Region’s non-distressed counties is 28 percent higher than the rate found in the Region’s distressed counties.


Smoking

Adult smoking prevalence measures the percentage of adults age 18 and over that report that they currently smoke cigarettes. The figures for this measure come from County Health Rankings and are based on 2014 data from CDC’s Behavioral Risk Factor Surveillance System survey.

With 19.8 percent of adult residents in the Appalachian Region self-identifying as smokers, smoking is more prevalent throughout the Region than the nation as a whole, where this number is 16.3 percent.

  • Smoking is an especially pronounced problem in Central Appalachia, where 25.2 percent of adults report being smokers.
  • There is an urban-rural divide in smoking prevalence throughout the Appalachian Region. In the Region’s rural counties, 22.5 percent of adults report being cigarette smokers, compared to just 17.3 percent of those living in large metro areas.
  • In the Appalachian Region’s distressed counties, 24.7 percent of adults are cigarette smokers, compared to 19.4 percent of residents in the Region’s non-distressed counties.


Physically Unhealthy Days

Physically unhealthy days are the number of days per month the average adult age 18 years and older reports feeling physically unhealthy or of poor physical health. The data for this measure come from County Health Rankings and are based on CDC’s Behavioral Risk Factor Surveillance System (BRFSS) survey data collected in 2014. The data for this measure have been age-adjusted.

This measure is intended, in part, to examine overall quality of life; that is, how do people feel on a typical day? It is also intended to capture the aspects of poor health that may not be picked up by other morbidity measures focusing on specific diseases and illnesses.

  • The average adult in the Appalachian Region reports feeling physically unhealthy 14 percent more often than the average American.
  • With 5.1 physically unhealthy days per person per month, residents in Central Appalachia report feeling physically unhealthy 42 percent more often than the average American. This figure is the highest among the five Appalachian subregions.
  • Residents living in the Appalachian Region’s rural counties are 24 percent more likely to report feeling physically unhealthy than those living in the Region’s large metro areas.
  • Residents living in the Appalachian Region’s distressed counties are 25 percent more likely to report feeling physically unhealthy than those living in the Region’s nondistressed counties.


Mentally Unhealthy Days

Mentally unhealthy days are the number of days per month the average adult age 18 and older reports feeling mentally unhealthy or of poor mental health. The data for this measure come from County Health Rankings and are based on CDC’s Behavioral Risk Factor Surveillance System (BRFSS) survey data collected in 2014. The data for this measure have been age-adjusted.

  • The average resident in Appalachia reports feeling mentally unhealthy 14 percent more often than the average American.
  • With 4.5 mentally unhealthy days per person per month, residents in both North Central and Central Appalachia report feeling mentally unhealthy 25 percent more often than the average American.
  • Residents living in the Appalachian Region’s rural counties are 10 percent more likely to report feeling mentally unhealthy than those living in the Region’s large metro areas.
  • Residents living in the Appalachian Region’s distressed counties are 10 percent more likely to report feeling mentally unhealthy than those living in the Region’s non-distressed counties.


Poisoning Mortality

Poisoning mortality is the number of deaths with poisoning as the primary cause per 100,000 population, per year. The data for this measure come from the Compressed Mortality File provided by the National Center for Health Statistics. The data have been age-adjusted and cover the 2008–2014 period. Death from poisoning includes deaths associated with medication abuse, both pharmaceutical and illicit. Although it is natural to think of a child ingesting a household cleaner as poisoning, these incidents are rare relative to unintentional deaths due to overdose of medications or other drugs.

  • The poisoning mortality rate in the Appalachian Region is 37 percent higher than the national rate.
  • All five Appalachian subregions have higher poisoning mortality rates than the national rate. The poisoning mortality rate in Central Appalachia is 146 percent higher than the nation as a whole.
  • The poisoning mortality rate for the Appalachian Region’s rural counties is 40 percent higher than the rate for the Region’s large metro counties—and 76 percent higher than the national rate.
  • The poisoning mortality rate for the Region’s distressed counties is 63 percent higher than the rate for the Region’s non-distressed counties—and more than double the national rate.