The Availability of Health Care in Appalachia

The lack of access to healthcare services exacerbates disparities in Appalachia. Although historic and large-scale reforms to the Appalachian health system have been enacted over the years, inadequate access to health services remains a pressing concern for state policy-makers and their rural constituents. This chapter explores present variation in healthcare access among Appalachia’s residents. Using a county-level comparative approach, the study presented in this chapter reveals gaps in Medicaid coverage, provider availability, scope of practice constraints, and number of hospitals between Appalachian counties and peer counties in the rest of the United States. It also details the development of regionwide initiatives to improve access to care, such as the Frontier Nursing Service, Appalachian Regional Healthcare and the National Health Service Corps. However, as the authors note, Appalachia’s lack of health infrastructure requires continued attention and investment if its residents are to maintain good health.