It’s a sad truth that Appalachia lags behind the rest of the country — dramatically in some measures — when it comes to health, but a new report shows the gap between Appalachia and the rest of the United States is expanding.
And the worst health disparities tend to be centered in Eastern Kentucky. Not coincidentally, the nation’s highest smoking rates are found in Kentucky, where 9,000 people a year die of smoking-related illnesses.
The report, “Health Disparities in Appalachia,” shows that Appalachian Kentucky’s health is falling further behind not only the rest of the nation, but the rest of Appalachia. It portends an ominous future for more than a million of our neighbors, family members and friends. A future that policymakers and well-meaning citizens simply cannot ignore.
Kentucky is now the cancer-mortality capital of the nation. While residents of Appalachia succumb to cancer at a 10 percent higher rate than the national average, the rate is 35 percent above that average in Eastern Kentucky. The rate of heart disease mortality in Appalachia is 17 percent higher than the national average; it’s 45 percent higher in Appalachian Kentucky.
Similarly, the mortality rate for diabetes is much higher in Eastern Kentucky. For lethal poisoning — including drug overdoses — the rate for Appalachian Kentucky is 141 percent higher than the nation. Certainly, overdoses are a contributing factor to the overall rate of early death, which is 63 percent higher in the eastern region of the commonwealth than the U.S. average.
The single most effective policy changes Kentucky can make to improve residents’ health are changes that reduce our smoking rates and exposure to secondhand smoke. We have known for decades that cigarette smoke is deadly. Yet the smoking rate for adults living in Appalachian Kentucky is nearly 60 percent higher than the national average.
Two policy changes are proven to reduce these rates:
▪ Smoke-free laws that keep all indoor workplaces free from secondhand smoke.
▪ Significant increases in tobacco taxes.
While nearly two-thirds of those living in rural Kentucky favor smoke-free laws, they’re less likely to be covered by them than their urban counterparts. And only about a third of Kentucky residents are protected by comprehensive smoke-free laws.
We encourage every locality in the commonwealth without such a law to look at the health benefits. Smoke-free laws, the only way to eliminate exposure to secondhand smoke, reduce breathing issues such as asthma, as well as heart attacks and cancer deaths. And they reduce smoking rates.
Increasing Kentucky’s tax on cigarettes by an additional $1 per pack will reduce youth smoking by an estimated 11.2 percent. That’s 23,200 fewer kids who will become adult smokers. Another 29,400 adults will quit. The long-term health-care cost savings are estimated at $1.07 billion. The tax increase must be at least $1/pack; otherwise tobacco companies will undermine the health benefits with point-of-sale promotions.
We know these policies work. Instead of costing an arm and a leg, they save health care dollars and, more significantly, they save lives. And our polling shows that a majority of Kentuckians support them.
We must rewrite the storyline in this latest, appalling narrative for a quarter of our population. We can, and we must join together in a unified campaign to enact the policies that will reduce smoking, improve health, and transform the future of Appalachia.
Ben Chandler is president and CEO of the Foundation for a Healthy Kentucky. The foundation, along with the Robert Wood Johnson Foundation and the Appalachian Regional Commission, produced the “Health Disparities in Appalachia” report.