The Appalachian Regional Commission

The Appalachian Regional Commission (ARC) is a federal-state partnership created in 1965.

ARC’s mission is to be an advocate for and partner with the people of Appalachia to create opportunities for self-sustaining economic development and improved quality of life.

Funds a wide range of programs:

A 3,000 mile-plus Appalachian Development High System;

Physical infrastructure projects;

Education and human resource development;

Health demonstration projects and initiatives.

Appalachia’s Progress & Challenges

The number of economically distressed counties has fallen from 219 in 1960 to 121 in 2003;

But was as low as 80 distressed counties in 1980.

Appalachian employment grew by 19.3% between 1991 and 2001, compared to 23 % for U.S.

The regional poverty rate has been cut in half, but is still higher than the U.S. (13.6% vs. 12.4%).

Economic Status of Counties

121 Distressed counties that have per capita incomes two-thirds or less national rate, and poverty and unemployment rates 150% or more than national rate.

259 Transitional counties that are between distressed and competitive status.

21 Competitive counties near national averages.

9 Attainment counties at or above national averages.

Economic Challenges & Opportunities

Appalachia’s Economic Challenges:

Job gap in creation of high-wage jobs;

Intensified global competition for older industries;

Shrinkage of “prime-age” workforce.

Appalachia’s Opportunities;

Entrepreneurial focus on high-growth sectors;

Productivity improvements to retain manufacturing base;

Investment in high-skill education & training.

History of ARC Health Program

In 1965 the Appalachian Regional Development Act Section 202 set up the Demonstration Health Program.

Established the Health Advisory Committee (25 members):

Conduct a comprehensive evaluation of the Region’s health needs;

Establish guidelines and criteria for funding projects.

Appalachian Health Policy Advisory Council

15 member group chaired by ARC Federal Co-Chairman.

Tasked to increase understanding of health and health care problems unique to region.

Not project specific.

Forum for exchanging ideas and information.

Develop and promote solutions to regional health care problems

Advisory Committee Research and Analysis Efforts

Established health data committee to analyze morbidity and mortality rates.

Recommended ARC-funded studies of:

An analysis of the financial viability of health care institutions in the region (draft completed);

The economic development role of health care services in the region (draft completed);

A bio-statistical analysis of excess morbidity and mortality rates for Appalachian counties (study nearing drafting stage).

Collaboration

ARC/CDC Division of Diabetes Translation - $450,000 to mobilize communities to develop local strategies that best address quality of life for people with diabetes.

ARC/CDC Division of Cancer Prevention and Control - $400,000 effort to reduce cervical cancer in Central Appalachia

ARC/NHSC/SAMHSA – Mental Health and Substance Abuse in Appalachia - Conference

J-1 VISA PROGRAM

Must be sponsored by a state within the Region with recommendation of the governor

Primary care (family practice, pediatrics, obstetrics, internal medicine or psychiatry) 40 hours per week in HPSA for a minimum of 3 years

Sponsor must demonstrate good faith effort to recruit a U.S. doctor during the six months preceding waiver request.

Physician, prior to employment, must be licensed by the state where he or she will practice.

HEALTH CHALLENGES FOR APPALACHIA

Few dentists per capita, particularly in our distressed counties.

ARC’s distressed counties: 20/100,000

National average: 28/100,000;

Access to obstetric care is declining in rural areas.

Only 35 % of our distressed counties have a hospital that offers obstetric services.

Nationally, 61% offer such services.

Limited availability of mental health and substance abuse treatment services

Only 8% of distressed counties had hospital-affiliated substance abuse outpatient services;

Only 20% had mental health services.

Nationally 25% had substance abuse treatment in 2000, down from 29% in 1994.