Epidemiology In Appalachia Flashcards
1
Q
Geography of Appalachia
A
EKY is central Appalachia
NY-PA-WV-EKY-Tennessee-NC-SC-GA-MI
2
Q
Health disparities in Appalachia
A
- heart disease
- cancer deaths
- COPD
- injury deaths
- stroke deaths
- diabetes
- mental health
- obesity
- depression
- suicide
- opioid abuse
3
Q
Heart disease in Appalachia
A
- heart disease mortality rate: 17% higher than national rate
- central Appalachia: 42% higher mortality rate than national
- rural counties: 27% higher than the rate for large metro counties within the region
Socioeconomic, higher risk factors (HTN, HLD, DM), sedentary lifestyle, economic impacts, higher rate of obesity
4
Q
Cancer deaths and Appalachia
A
- cancer mortality: 10% higher than national rates
- 85% of Appalachian counties: cancer mortality higher than national average
- 81 out of 82 counties within central Appalachia has higher cancer mortality rates than national rates
- rural counties: 15% higher than metro areas in region
- economically distressed counties: 20% higher than other areas of Appalachia
5
Q
COPD and Appalachia
A
- COPD mortality 27% higher than national rate
- all subregions have higher mortality rates than national rate
- rural counties: 55% higher than large metro counties
- economically distressed counties: 43% higher than other areas in Appalachian region
Coal exposure contributes
6
Q
Diabetes and Appalachia
A
- 11.9% prevalence vs 9.8% nationally
- all subregions of Appalachia have a higher prevalence than national average
- central Appalachia has highest prevalence at 13.5%
- rural areas: 13% vs 10.5% in regions metro areas. Mortality 36% higher
- economically distressed counties: 13.7% vs 11.7% in non distressed
- mortality rate 11% higher than national average. Mortality 33% higher
Economically distress dont have access to healthy things, unhealthy things are cheaper,
7
Q
HIV and Appalachia
A
- 57% lower in Appalachia region vs national rate
- southern Appalachia has the highest, but still 41% lower than national
- large metro areas more than twice as likely to have HIV than rural regions
- non-distressed counties have 57% higher rate than distressed counties
8
Q
Depression and Appalachia
A
- feeling of mentally unhealthy: 14% more often than average
- nott central and central apppalachia: 25% more often than ever age
- rural counties: 10% more likely than large metro areas
- economically distressed counties: 10% more likely than large metro areas
- prevalence from Medicare billing: 16.7% depression vs 15.4% nationally
- north central and central regions: 19%
- rural and economically distressed counties highest
9
Q
Obesity and Appalachia
A
- 31% adulthood obesity in Appalachia vs 27.4% nationally
- all five subregions have higher prevalence, but highest in central and north central regions
- rural counties have higher adult obesity prevalence (33.1 vs 29.5%)
- economically distressed counties have higher prevalence (34.7 vs 30.7%)
10
Q
Hospitalizations and Appalachia
A
Heart disease: 17% higher than national average
- 47% higher in central Appalachia than national
- 13% higher in rural counties
- 20% higher in economical distressed counties
COPD: 23% higher than national average
- 75% higher in central Appalachia than national
- 39% higherin rural counties
- 42% higher in distressed counties
11
Q
Opioid drug abuse in Appalachia
A
- historically, central Appalachia had large number of physical laborers, thus more prone to workplace injury and chronic pain
- combination of the need for pain relieve coupled with pharmaceutical companies being able to heavily market their medications (with very little oversight of federal control)=perfect recipe for disaster
- very little understanding of true dependence of pain killers and very little education to the public or health professionals
1984: Vicodin
1995: OxyContin (went from $48mil in sales in 1996 to $1.1 bill in 2000
1999: Percocet
12
Q
Opioid abuse
A
- in 2014, seven Appalachia counties accounted for more than a fifth of nationwide opioid related deaths
- in 2015, KY providers wrote 97 opioid RXes per 100 persons
13
Q
Opioids in overdoes deaths
A
- from 2011 to 2016, opioid Rx rates in the US dropped by an average of 17.8%, settling at 67 Rx per 100 people. In WV, rates fell 31.2 percent over that same period, with 29 percent, 25.7 percent and 14.8 percent drops in KY, OH, and PA
- from 1999 to 2016 overdose deaths in PA jumped 736 percent. In KY, OH, and WV, deaths were up more than 1000%. Nationally, overdose deaths were up 528%
14
Q
Hep C and Appalachia
A
- 2006-2012: rates of hep C infection sky rocketed in central Appalachia
- rates of Hep C infection in people under 30 increases 364%
- coincidence with a 21.1% increase in treatment admissions for opioid dependence and 12.6% increase in patients reporting injection as primary route of drug administration
- thus, concern for HIV increase in the future as well
15
Q
Pike county stats
A
- premature death: 12,161 vs 8,716 state
- total mortality: 1,113 vs 912
- physically unhealthy dats per month: 8 vs 5
- mentally unhealthy days per month: 6 vs 4
- diabetes: 17% vs 13% in state
- HTN: 45% vs 39% state
- cancer deaths (age adjusted rate per 100,000 population) : 223 vs 198 state. Line/bronchus»colorectal>breast>prostate
30. 8% regular smokers - 37% obese
- 39.2% without physical activity
- 22% of adults and 6.5% of kids without health care
- in 2012, employment share of healthcare industry was 17.1%, 4053 employees. Also brought in 11.0% of the county’s gross product
