Appalachian states meet in bid to combat heart disease

Tom Breen

CHARLESTON, W.Va. — Doctors, lawmakers and specialists convened last week in the hope of launching a public health network in 13 states to change one of the stark facts of Appalachian life: Residents are 20 percent more likely to die from heart disease than the rest of the country.

The task won’t be easy. States in Appalachia lead the country in heart disease risk factors such as smoking, obesity and lack of exercise, and those factors could partly come from long-held cultural practices and beliefs.

That’s why the conference, held last Thursday and Friday, included historians who can explain the unique characteristics of the region that stretches from Mississippi into upstate New York, including parts of Pennsylvania, Maryland, Ohio, Kentucky, Virginia, Tennessee, North Carolina, South Carolina, Georgia, Alabama and all of West Virginia.

Four of the five states with the highest rates of common heart conditions are in Appalachia, according to the federal Centers for Disease Control and Prevention (CDC). West Virginia is the highest in the country, with about 10.4 percent of adults reporting a common heart condition such as coronary heart disease, compared to a national average of about 6.5 percent.

Four Appalachian states also rank in the top five for the highest rate of cardiovascular disease-related deaths, according to the American Heart Association, which also sponsored the conference. While researchers have known that for years, they still don’t have a good explanation for it.

The CDC sees an Appalachian effort as a way to improve the overall cardiovascular disease rate in America.

The agency estimates heart disease will cost the United States roughly $248 billion this year, according to Dr. Darwin Labarthe, the head of the CDC’s Division for Heart Disease and Stroke Prevention.

“The drop in the bucket is what’s being invested now in prevention,” he said.

Dr. Tom Pearson, chairman of the Department of Community and Prevention Medicine at the University of Rochester in New York, says likely factors include the region’s lower economic status and a lack of access to health care.

But Pearson also said the traditional rural diet — high in fat and calories — has persisted, even as rural labor has become less strenuous because of mechanization.

It can be misleading to look for a single cause in the culture of such a large region, though, according to John Williams, a historian at Appalachian State University in North Carolina. Even though there are similarities in rural living, he said, the culture in New York state is much different than in Mississippi.

What’s more, some of the common risk factors in Appalachia may have less to do with traditional culture than with trends that can be seen nationwide, he said.

“Does the higher incidence of obesity come from the traditional Appalachian Sunday dinner, or is it from the spread of convenience stores and fast food in the last 25 years?” he asked.

(Associated Press)