Eastern Kentucky health stats are gloomy. Why are these ‘bright spots’ doing better?

Kaye Morrow is director of the McCreary County Public Library.  The library has worked to help improve the health of county residents, providing health information, hosting exercise programs and working with other community agencies.
Kaye Morrow is director of the McCreary County Public Library. The library has worked to help improve the health of county residents, providing health information, hosting exercise programs and working with other community agencies.

The public library in McCreary County has books, of course, and reading programs for young people and computers for people to access the internet.

But it also provides information on substance abuse, hosts healthy-cooking classes and diabetes workshops, puts on book walks that combine reading and exercise for kids and helps patrons research health issues.

Director Kay Morrow, a social worker by training, said it’s important for the library to be a community resource that’s more than a collection of books.

“The health of the community is important,” Morrow said. “We just try a little bit of everything.”

That work is one reason McCreary County is recognized as a “bright spot” in a study released Tuesday on health in Appalachia.

The study highlights counties in Appalachia with health outcomes that are better than expected when taking into account a wide variety of factors that influence health, such as the poverty rate, access to places to exercise,adequate transportation and the number of doctors.

In McCreary County, for instance, the death rate from strokes was 37 percent better than expected and the rate of deaths from injuries was 40 percent better.

In neighboring Wayne County, also profiled in the study, the death rate from strokes was 34 percent better than expected and the death rate from poisoning — meaning drug overdoses, primarily — was 36 percent better than expected, according to the analysis.

The two counties were the only ones from Kentucky profiled in the report, which was a partnership of the Appalachian Regional Commission (ARC), the Robert Wood Johnson Foundation and the Foundation for a Healthy Kentucky.

Appalachia includes 420 counties spread across 13 states,including more than 50 in Eastern and Southern Kentucky.

Poor health outcomes in Appalachia have been well-documented.

A study released last year, for instance, found the years of life that people in the Appalachian region of Kentucky lose to health problems such as heart disease and cancer is 63 percent higher than the national average.

The study released Tuesday was a follow-up to that study, but with a different goal: to highlight Appalachian counties doing better than expected on health outcomes and list potential reasons why, as examples to other counties.

“While Appalachia lags behind the rest of the nation on many key measures of health,this research offers concrete examples of what communities are doing about it,” said Tim Thomas, the ARC federal co-chair.

The findings don’t mean the counties in the report are doing great on health.

For instance, the heart-disease death rate in McCreary County from 2008 through 2014 — the years analyzed in the study — was 259 per 100,000 people, far above the national rate of 175.

McCreary County’s population is only about 17,500; researchers project a rate per 100,000 people from a smaller population in order to come up with a standard measure.

The heart-disease death rate in Wayne County in the same period was 229 per 100,000, also well above the national figure.

The poisoning death rate also was relatively high in both counties — 30.8 per 100,000 in McCreary County and 20.7 in Wayne, compared to 14.9 nationally.

But counties cited in the report — which includes an interactive site with information on Appalachian counties — performed better on many health measures than researchers would have predicted, based on a statistical model that considered barriers to good health results.

For example, the expected heart-disease death rate in McCreary County would have been 278 deaths per 100,000 population, but was only259.9, the report said.

And in Wayne County, the expected death rate from poisoning would have been 32.3 per 100,000, but was only 20.7 between 2008 and 2014.

The report identified 42 counties doing better than expected on health measures. The other Kentucky counties were Pulaski, Russell, Lincoln,Green, Adair, Lewis and Morgan.

The report found some common threads in Appalachian counties beating the odds on expected health results.

One was that they have community leaders engaged in health initiatives.

The report said those leaders in Wayne County include Morrow; Sue Singleton, who runs the McCreary County Christian Care Center’s food pantry but also provides medicine to people; and Pastor Braxton King, who directs Lord’s Gym, which provides a place to exercise but also works to combat substance abuse.

Another common thread was collaboration among different sectors such as health providers, including county and regional health departments; public officials and agencies, including libraries and schools; churches; food pantries; and volunteers.

One example the report cited was the University of Kentucky Cooperative Extension office in Wayne County and its connection to non-profit groups.

The office promotes healthy eating with the Hope Center, which is operated by the Wayne County Association of Ministers and serves homeless people, the elderly,single mothers and domestic-violence victims and others in need.

The center requires people seeking help to complete six classes before they can get access to its food pantry, the report said.

The extension office works with the Wayne County Health Department — also cited as a community health leader — on diabetes education, the report said.

The study said that in McCreary County, strong volunteer organizations, the emergency medical service and the library work to help residents get access to health and social services.

Other themes the report noted were different providers sharing resources to provide transportation, food and shelter to people in need; a commitment to public health by local health providers; programs to combat substance abuse; an active faith community; and a committed network of volunteers.

Ben Chandler, president of the Foundation for a Healthy Kentucky, said that while money is important in efforts to improve health, the findings show that collaboration among a variety of groups and service providers also is critical.

There’s always something that can be done, he said.

“Sometimes it can be as simple as giving your neighbor a ride to the clinic or passing out a breast cancer awareness pamphlet at church,” Chandler said. “No question, health care resources and investment are important and continue to be critical needs for the region. But just as valuable is the willingness to come together to meet needs beyond health care.”