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College of Public Health

Dr. Wykoff and Olivia Egen Publish Article on the Future of Appalachian Health

Randy Wykoff and Olivia Egen

Dr. Randy Wykoff, dean of the College of Public Health and doctoral student Olivia Egen, have published an article in Now & Then: The Appalachian Magazine. The special theme of this edition of the magazine is “the Future of Appalachia.”  The authors used this as an opportunity to write an opinion piece about the future of health in Appalachia. 

“We welcome this opportunity to share our thoughts and ideas about improving health in Appalachia” said Dr. Wykoff “ Now & Then is a wonderful vehicle because it allows us to speak to a broad audience, including many folks who care deeply about Appalachia, but who may not be sure about how to improve the health of the region.”

The authors identified four general areas where the region should focus:  Changing Health-Related Behaviors; Impacting the Social Conditions that are Associated with Poor Health; Assuring Access to Affordable Healthcare; and Disrupting the Intergenerational Cycles of Poor Health.

According to the Appalachian Regional Commission, in 2010, the number of deaths per 100,000 residents in Appalachia was over 1,000 while nationally, approximately 25% higher than the rest of the nation.  The authors recommend four specific, interrelated steps to fundamentally change the health status of the region.  

An article in the New England Journal of Medicine disclosed that 40% of early deaths in America are related to behaviors and/or lifestyles.  Therefore, changing health-related behaviors as a first step is critical to improving health in Appalachia.  Pre-natal programs, school-age programs, and programs that identify adults who are already engaged in health-threatening behaviors target three critical points of intervention.  Impacting social conditions, including those associated with income and education, are a second step in the process, especially critical at the school-age level.

The authors emphasized the importance of access to affordable health care and pointed out that often it is issues such as transportation, mobility, culture, and inadequate financial resources that impede individuals from seeking medical attention. 

The final step to brightening the future of health in Appalachia interweaves the first three steps into a culminating mandate to disrupt the intergenerational cycles of poor health in Appalachia.  “Time and again, we see the impact of inter-generational cycles of poor health.  It is growing abundantly clear that if we want to improve the health of people living in Appalachia, we must attack this problem directly, concludes the article.  “We must all work together the systematically provide children with the best possible start to their lives.”

Founded in 1984, Now & Then: The Appalachian Magazine published twice annually in June and December, presents a fresh, revealing picture of life in Appalachia, past and present, with engaging articles, personal essays, fiction, poetry, reviews, and photography.

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