The Register-Herald, Beckley, West Virginia

Today's Front Page

March 17, 2010

Data indicate McDowell is unhealthiest county in W.Va.

By Tom Breen Associated Press

CHARLESTON — The health divide in West Virginia isn’t just a matter of the insured and the uninsured or the wealthy and the poor. It’s also a question of north and south.

Counties in southern West Virginia, led by McDowell County, suffer from poorer health and shorter life expectancy than their northern counterparts, according to data from the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

The two organizations recently posted a ranking of West Virginia’s 55 counties by health outcomes such as life expectancy and health factors, like obesity and access to doctors. In both categories, McDowell ranks 55 of 55, followed by Mingo County, which ranks 54th in both.

Joining them toward the bottom of both lists are other southern counties like Logan, Wyoming, Boone, Lincoln, Mason and Wayne.

These counties have higher-than-average rates of smoking and obesity and see more premature deaths than the rest of the state. McDowell County, for example, has a rate of premature death nearly twice the state average, with almost 40 percent of residents describing their health as “fair or poor,” compared to 22 percent statewide.

By contrast, the healthiest counties tend to be in the northern part of the state. Monongalia County, on the Pennsylvania border, ranks first in health behaviors, with Pendleton County getting the laurels for health outcomes. Joining them are northern counties like Jefferson, Grant and Ohio.

“West Virginia definitely has a health disparity,” said Sen. Roman Prezioso, D-Marion, chairman of the Senate Health and Human Resources Committee, who is currently working with his House of Delegates counterpart on the state’s health budget at the Capitol.

The numbers back up Prezioso, but explanations for that divide vary from social and economic factors to the difficulty rural residents have in getting to their doctors.

“You can’t pinpoint it to one factor,” said Jennifer Plymale, director of the Robert C. Byrd Center for Rural Health at Marshall University.

It’s also not as simple as saying people in rural areas lack access to health care, she said. A study the center did on Lincoln County found that people generally are able to get to doctors — but the journey and the cost make it harder and less frequent.

“It’s not a journey over Interstate 64, it’s over hill and dale,” she said. “And people without reliable transportation have found ways to make those trips, but it costs them money they need for other things in their lives.”

Economic and educational factors cited in the report may also play a role. Nearly half McDowell County’s children live in poverty, and 5 percent of its residents have college degrees, compared to 14 percent and 34 percent respectively in Monongalia County.

“It’s partly a result of the chronic socio-economic disadvantages that are present in those counties,” said Michael Hendryx, a professor in the Department of Community Medicine at West Virginia University.

Hendryx argues there is another factor in the disparity: coal.

In a 2008 article in the American Journal of Public Health he authored with Washington State University Professor Melissa Ahern, Hendryx found people who live in West Virginia mining communities are at greater risk for kidney disease, lung disease and high blood pressure than people living in communities that don’t produce coal.

The mining industry has questioned Hendryx’s findings, but he says the proof is in data like that collected by the Robert Wood Johnson Foundation.

“Those disparities will not even out. There is absolutely no way, in my view,” he said.

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