Appalachia includes a broad swath of territory extending from southern New York, Pennsylvania and Ohio southward to involve all of West Virginia, parts of Virginia, Maryland, North and South Carolina, Eastern Kentucky and Tennessee and northern portions of Georgia, Alabama and Mississippi (see map at Appalachian Regional Commission, www.arc.gov/appalachian_region/MapofAppalachia.asp). The name comes from the Appalachian Mountains, which form a geological backbone for the region.
Appalachia encompasses 420 counties with more than 25 million residents. Ninety-three counties are currently considered economically distressed. Many of the depressed counties are in Eastern Kentucky. Nine are in Tennessee.
Health within Appalachia, particularly its midsection, is slipping compared to the rest of the U.S. A review in the August issue of Health Affairs analyzes this discrepancy in terms of infant mortality and life expectancy from 1990 to 2013. The gaps in these measures increased during this interval.
From 1992 to 1994, infant mortality in Appalachia, 9.2 per 1,000 live births, was close to the rest of the country, 9.3 per 1,000 live births. From 2009 to 2013, infant mortality showed a 16 percent increase relative to the areas outside Appalachia. Income is a determining factor in infant mortality. Appalachian infant mortality is 39 percent higher than low-poverty regions of the country.
Appalachia encompasses 420 counties in 13 states: New York, Pennsylvania, Ohio, West Virginia, Virginia, Maryland, North Carolina, South Carolina, Kentucky, Tennessee, Georgia, Alabama and Mississippi.
Clif Cleaveland, M.D.Life expectancy shows striking disparities. Appalachian residents died 0.6 years earlier than people outside the region in the interval 1990-1992. By 2009-2013, the gap had increased to 2.6 years. The starkest gap in life expectancy – 13 years – was seen between African-American males in high-poverty areas of Appalachia compared with white females in low-poverty regions in the rest of the nation.