Dr. Tania Basta's presentation centered around the misconceptions with HIV/AIDS in Appalachia.

ATHENS, Ohio (March 28, 2010) – For the second Soup & Substance of the year, Dr. Bruce Martin, Assistant Professor in the Department of Recreation and Sport Pedagogy, partnered with the Live Healthy Appalachia initiative to organize a collection of speakers on poverty and health in Appalachia.

Dr. Frank Schwartz, Professor of Endocrinology in the College of Osteopathic Medicine, Dr. Tania Basta, Assistant Director of the Appalachian Rural Health Institute and Assistant Professor in the College of Health Science and Professions, and Dr. Michele Morrone, Director of the Environmental Studies Program and Associate Professor in the College of Health Science and Professions, spoke about their experiences and research pertaining to Appalachia.

Stretching from the southern part of New York to the northeast part of Mississippi, Appalachia runs through the eastern coast of Ohio. Since Athens County, is located within Appalachia, poverty and health issues concerning socioeconomic factors are popular research topics in the region.

Diabetes in Appalachia

Dr. Schwartz began the event with an in-depth discussion on the barriers for diabetes prevention and care in the Appalachian region.

Diabetes, a disorder of both carbohydrate and fat metabolism, ranks number one in the United States’ direct health care costs and is very common throughout the East Coast, and specifically in Appalachia. According to Dr. Schwartz, the Appalachian population is commonly mischaracterized as “at-risk” for many chronic diseases including diabetes. Although diabetes may be common in the region, it is due to access and finances, rather than ethnicity.  “This is not an ethnic problem,” said Dr. Schwartz. “This is a socioeconomic problem.”

Dr. Schwartz explained that the more economic inequality (disparity) and insecurity a community has, the more they are “at-risk” for chronic diseases.

“If you take Appalachian Rural Commission (ARC) individual county poverty rates and you overlap them with prevalence rates of diabetes in this region: the greater the poverty, lower the income, and lower the education levels, [then] the higher the prevalence of obesity and diabetes,” Dr. Schwartz said. “This is a direct reflection of socioeconomic status.”

Dr. Schwartz stressed that a range of factors contribute to the risk for developing diabetes including stress, inactivity, and even food being at the center of a region’s social activities. A lack of adequate amounts of food, which can foster “food insecurity,” is also known as a contributing factor in the risk of diabetes.

In an effort to educate the public about diabetes in the Appalachian region and help decrease the epidemic, Dr. Schwartz has begun setting up programs and organizing grant funds to find more aggressive and unique ways to reach out to high-risk diabetic communities.

HIV Knowledge in Appalachia

Dr. Basta’s presentation focused on the lack of HIV-related knowledge among individuals living in rural Appalachia.

According to Dr. Basta, HIV is a commonly misunderstood disease in the region, and as the rate of infection continues to rise, so do the misconceptions. But why are there so many misconceptions in this region in particular? Dr. Basta pointed to socioeconomic factors that influence access to prevention, education, and resources. Out of one million HIV cases in the U.S., 90,000 are living in non-metropolitan areas like Appalachia, characterized by low resources and struggling economies.

“The majority of research has been focused on people who are actually living with HIV/AIDS; very little has focused on prevention, especially in rural areas,” said Dr. Basta. “[Therefore], there are lack of programs in rural areas, a lack of coordinated services and a lack of funding for HIV.”

Dr. Michele Morrone discussed the environmental and socioeconomic issues concerning Appalachia.

In order to target and research the fallacies of HIV/AIDS in Appalachia and design educational tools for people to learn more about disease, Dr. Basta conducted a survey in Vinton County, Ohio, which is about an hour southwest of Athens and well below the U.S. economic status average. From her research, she concluded that men have less knowledge of HIV testing than women, and that there is a need to inform providers about how to properly educate patients. Dr. Basta plans to implement educational HIV/AIDS programs in Appalachia that will help combat the misconceptions.

Environmental health and social justice issues in Appalachia

Dr. Morrone concluded the event by discussing a unique socioeconomic issue concerning the poverty and health in Appalachia. She found that the indicators of socioeconomic status are mostly discovered through education and unemployment rates, but environmental justice issues such as waste disposal, coal mining and toxic release is another key component.

“Socioeconomic conditions lead to differential exposures. These exposures occur in our environment through crowding and pollution,” said Dr. Morrone. “Then, we also have differential vulnerability, which is your lifestyle and medical care that makes you more vulnerable to illness and disease.”

As result of this differential exposure and vulnerability, there is a health outcome, which could be different for people in areas that do not have the same exposures or vulnerabilities. According to Dr. Morrone, the most commonly accepted definition of environmental justice is when one segment of the population has a disproportionate burden due to environmental conditions. Environmental justice has since evolved into a popular social movement after the 1980s and is mostly concentrated around urban communities and racial problems.

Dr. Morrone and her research partners wanted to know about the rural populations affected by environmental social justice to understand how it affects Appalachia, so they examined specific case studies such as a power plant and water system in Ohio, that are directly related to the environmental health and social justice issues in Appalachia. Through their research, they concluded that the largest vulnerability issue in environmental problems is related to the access to health care in Appalachia.

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Soup & Substance is a quarterly dialogue series that explores the many dimensions of diversity, empowers thought-provoking discussion, works to build and increase awareness about multi-perspectives, and is committed to effectively and inclusively addressing diversity related issues.

For more information, visit http://www.cehs.ohio.edu/news-events/events.htm.

Story and photos by Nicole Bersani