LOUISVILLE, Ky (Sept. 12, 2017) Kentucky residents living in the Appalachian region of the Commonwealth have more mental health care providers available to them than those living in the rest of the state, according to a recent health disparities report. But there are proportionally fewer dentists, primary care and specialty physicians in those Eastern Kentucky counties. And the number of mental health professionals still may not be enough, given that far more adults in the Appalachian region of the state report feeling mentally unhealthy.
The report, Health Disparities in Appalachia, issued by the Foundation for a Healthy Kentucky, the Appalachian Regional Commission (ARC), and the Robert Wood Johnson Foundation (RWJF), 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.
According to the report, the number of mental health care providers in proportion to the population is 6 percent higher in Appalachian Kentucky than in non-Appalachian Kentucky. Appalachian Kentucky's supply of mental health providers is still about 7 percent below the national average of 201 providers for every 100,000 residents, however. Meanwhile, Appalachian Kentucky adults report feeling mentally unhealthy about 25 percent more often than average Americans, and about 15 percent more often than adults elsewhere in Kentucky, the report found.
Moreover, in every other category of health providers measured, the 54 counties that make up Appalachian Kentucky fall far behind the national average and the remainder of the state.
"Tracking the availability of health care providers is important for policy makers and provider organizations to understand where there may be a need for incentives to increase numbers," said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky. "This report shows some clear gaps that need to be filled in the Eastern portion of the Commonwealth."
Generally, Appalachian Kentucky falls behind both the nation and the rest of Appalachia in terms of the number of health care providers available to treat the area's population. For example, the number of primary care physicians who work with the eastern portion of the state's population is 26 percent lower than the national average, and 21 percent lower than the rest of the Common-wealth. The dearth of specialty physicians is even greater: proportionally, there are 59 percent fewer specialty doctors in Appalachian Kentucky than in the nation as a whole, and 60 percent fewer than in non-Appalachian Kentucky. For dentists, there are 42 percent fewer in Kentucky's Appalachian region than its non-Appalachian areas, and 37 percent fewer than in the nation as a whole.
"There remain long waiting lists for mental health professionals in Appalachian Kentucky and, while Appalachian women have some of the highest rates of depression, they are among the least likely to access mental health care," said Fran Feltner, director of the Center for Excellence in Rural Health and a member of the Foundation's Community Advisory Committee. One resource Feltner mentioned is community health workers. "Community health workers are trained in mental health first aid to recognize symptoms of depression and to help guide patients into treatment." A list of community health workers is available on the Center's website here.
Kentucky Primary Care Association clinics in Appalachia are driving change in the delivery of health care services at the community level to address many of these disparities, according to the Association's CEO Joe Smith. "They are integrating critical services essential to improving health. They are reaching out to schools and communities with oral health, primary care, behavioral health and vision care to create a coordinated system of essential services targeted at improving health. They are extending hours for the convenience of the community and partnering with other organizations and each other to address gaps in specific health care needs of the communities and patients they serve. Bottom line: They are engaging patients and communities in their own health to address some of the most critical health care problems in Appalachia.
"Changing these statistics will take time, commitment and resources, along with significant changes in policy at the federal and state levels," Smith concluded.
Health Disparities in Appalachia, as well as key findings for Kentucky from the report, are available on the Appalachian Regional Commission website here.
About the Foundation for a Healthy Kentucky
Since the Foundation opened its doors in 2001, it has invested more than $27 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 www.healthy-ky.org.
Bonnie J. Hackbarth