Appalachian Region Endures Dramatic Health Challenges Compared with Nation, New Research Shows

August 2017

Health Disparities Are Most Severe in Region’s Rural and Economically Distressed Areas

Contacts: Wendy Wasserman, Appalachian Regional Commission, 202.884.7771,
Bonnie J. Hackbarth, Foundation for a Healthy Kentucky, 502.326.2583,
WASHINGTON, D.C., August 24, 2017—Health Disparities in Appalachia, a new report issued today by the Appalachian Regional Commission (ARC), the Robert Wood Johnson Foundation (RWJF), and the Foundation for a Healthy Kentucky, documents dramatic disparities in health outcomes and other health-related factors in the Appalachian Region when compared with the nation as a whole, as well as substantial variations in health throughout the Region’s 420-county footprint.

The study reviews 41 population and public health indicators to provide a comprehensive overview of the health of the 25 million people living in the Appalachian Region, which spans 13 states from northern Mississippi to New York’s Southern Tier.

Key findings include: “This report begins to identify key health challenges confronting Appalachia,” said ARC Federal Co-Chair Earl F. Gohl. “Now we need to understand the implications these findings have for Appalachia’s economy so we can continue working towards a brighter future for the Region.”

The report also examines 20-year trends for selected indicators. While the Region and the country have made improvements on many health measures, the improvements made by the nation overall frequently outpace those made by the Region, resulting in widening disparities. For instance: “These data bring attention to the growing health gap between Appalachia and the rest of the country,” said Hilary Heishman, senior program officer, Robert Wood Johnson Foundation. “The U.S. can’t be healthy as a whole if we are leaving whole regions behind. Both taking on the challenges and building on the assets that counties in Appalachia have will be essential to building a Culture of Health.”

Health Disparities in Appalachia is part of "Creating a Culture of Health in Appalachia: Disparities and Bright Spots," a multi-part health research project conducted by ARC in partnership with the Foundation for a Healthy Kentucky with funding from the Robert Wood Johnson Foundation. The research team was led by PDA, Inc., of Raleigh, North Carolina, in collaboration with the University of North Carolina’s Cecil G. Sheps Center for Health Services Research and Wake Forest School of Medicine.

Data sets used in this report included county-level data compiled from numerous sources, such as: County Health Rankings and Roadmaps; Centers for Disease Control and Prevention; Centers for Medicare & Medicaid Services; Area Health Resource Files; and the American Community Survey. These data sets are available at

“In measure after measure, the Central Appalachian region—including Eastern Kentucky—faces greater health challenges, and gaps are widening at a faster rate, than in the rest of Appalachia and the nation,” said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky. “Appalachia’s economic livelihood is absolutely dependent on improving these health measures. The Foundation believes that the single most effective step we can take toward that end is to reduce our high smoking rates.”

About the Appalachian Regional Commission
The Appalachian Regional Commission ( is an economic development agency of the federal government and 13 state governments focusing on 420 counties across the Appalachian Region. ARC's mission is to innovate, partner, and invest to build community capacity and strengthen economic growth in Appalachia to help the Region achieve socioeconomic parity with the nation.

About the Robert Wood Johnson Foundation
For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working with others to build a national Culture of Health enabling everyone in America to live longer, healthier lives. For more information, visit Follow the Foundation on Twitter at or on Facebook at

About the Foundation for a Healthy Kentucky
Since the Foundation opened its doors in 2001, it has invested nearly $26.7 million in health policy research and advocacy, as well as demonstration project grants across the Commonwealth. Funded by an endowment, the mission of the nonpartisan Foundation is to address the unmet health needs of Kentuckians by developing and influencing policy, improving access to care, reducing health risks and disparities, and promoting health equity. Follow the Foundation on Twitter, Facebook, and YouTube, and visit our website at