PIKEVILLE, Ky. - A new report says women ages 35 to 44 in Appalachia are dying of drug overdose, suicide and alcoholic liver disease at rates 69% higher than women in the rest of the nation.

For those ages 25 to 34, the rate is almost that high.

The Appalachian Regional Commission report on so-called "diseases of despair" is based on Centers for Disease Control and Prevention data from 2018, but researchers say financial, child care, and mental-health struggles due to the pandemic will likely worsen the situation.

Wendy Wasserman, director of communications for the Commission, said this public-health crisis is closely tied to economic development.

"One of the reasons that we've been looking at this is because overdose, suicide, and liver disease are taking a disproportionate impact on prime working age," said Wasserman. "That, by definition, impacts economic potential."

Among men ages 35 to 44, the report says the 'diseases of despair' mortality rate is 50% higher in Appalachia than the rest of the U.S.

Wasserman said boosting mental-health and substance-abuse resources, and transportation for working-age people in the region, is even more critical as the pandemic stretches into next year.

In Kentucky, these mortality rates were 21% higher overall than in non-Appalachian states. Since 2017 in general, rates of overdose, suicide and liver disease have trended downward in the 13 states that make up the Appalachian region.

But Wasserman said there's no guarantee that will continue.

"What we did see is that that disparity was narrowing," said Wasserman. "But again, the pandemic has been such a huge disrupter in everything, that we don't know until we look at the data in another year or two."

Wasserman said she believes the COVID-19 crisis could spur innovative efforts to combat decades of economic stagnation and job loss.

"I am hoping that one of the unintended consequences of the pandemic is creative interventions," said Wasserman. "We've all have to be more creative again - in our personal lives, in our professional lives. The economy needs to be more creative. People need to rise to the occasion to be able to survive."

The report also says compared to the rest of the nation, Appalachian residents continue to face stark disparities in educational attainment, employment and income.


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The Centers for Disease Control and Prevention report the life-shortening blood disease sickle cell anemia affects about 100,000 Americans, mostly people of color.

And many individuals with the illness do not get the important screenings and treatments.

Sickle cell disease causes normally healthy, round, and flexible blood cells to become 'C' or sickle-shaped and stick to small blood-vessel walls.

This blockage prevents blood and oxygen flow to the arms, legs, and internal organs. Around 1,700 Hoosiers, mostly women of color, are impacted by the disorder.

Lisa Hoffman, grants and team manager with Innovative Hematology, said she would like to see better public awareness about the inherited disease.

"I would like to think it's not an issue about race, but 87% of the people in Indiana that have sickle cell are Black or African American," said Hoffman. "There are other diseases that affect predominantly white folks, and those diseases seem to get a bit more attention."

Patient education is essential for addressing sickle cell anemia complications. The blockages cause repeated episodes of severe pain, organ damage, infections, or sometimes a stroke.

Innovative Hematology indicates that 52% of sickle cell anemia patients in Indiana are female, and 48% are male.

One barrier to care is insufficient or no insurance coverage, which affects disease management. Another is a lack of medical providers with knowledge of detecting the illness. This can lead to a misdiagnosis or prescribing an ineffective treatment plan.

Hoffman said family members in dual roles as caregivers often do not get needed support. And other factors can present additional burdens for a patient.

"If you're a single mom and you have sickle cell disease and you are having a pain crisis and really should go to the hospital," said Hoffman, "you face a lot of barriers - such as, who's going to watch my child? How am I going to get there?"

The Indiana Statehouse hosted 174 attendees for Sickle Cell Advocacy Day last week, to raise the voices of those in the community who are affected by the painful disorder.

Hoffman said she wants legislators to extend health care services beyond age 21 for individuals with this specific condition.


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Alabama has one of the highest maternal mortality rates in the country and access to care remains a serious issue, especially in rural areas.

Now, one group is working to change that. Alabama Arise has released a Maternal Health Toolkit designed to connect women, families and advocates with critical resources.

Jennifer Harris, senior health policy advocate for the nonprofit, said the goal is to give women the information they need to navigate the health care system.

"We have high maternal and infant mortality death rates," Harris reported. "We also have a number of growing maternal health deserts where women lack access of care. So the toolkit was created in mind to let women know about resources."

Alabama Arise is advocating to improve maternal health care access. The group is backing House Bill 89, a bipartisan bill sponsored by Rep. Marilyn Lands, D-Huntsville, which would provide up to 60 days of prenatal care while a pregnant woman's Medicaid application is processed, ensuring faster access to critical services.

Harris pointed out the toolkit not only breaks down the maternal health landscape but also provides guidance on essential health care services, including Medicaid coverage. With more than half of Alabama's births covered by Medicaid, ensuring women understand their options is a key part of improving outcomes. The toolkit further connects women to local programs and support networks, which Harris added are essential in easing the stress of navigating maternity care.

"When you have a pregnancy during that time, it can be a lot. It can be overwhelming. It's a lot of things that are happening in a very short amount of time," Harris acknowledged. "We know a big support in that is building community for parents and family. So the resource page has a list of different programs, different agencies."

She added the Alabama Maternal Health Toolkit is more than just a guide, it is a resource designed to close gaps in care and connect women with vital services, from Medicaid enrollment to postpartum support.

February is American Heart Month, and an Arizona heart attack survivor wants more folks to learn CPR - which he said saved his life.

Bob Spicer called himself the luckiest man alive after having a widowmaker heart attack. It occurs when the largest of the three arteries that provide blood to the heart is 80% to 100% blocked.

He said if it weren't for his wife - who is a nurse, performing CPR on him - he wouldn't be here.

"She actually did CPR on me for about 10 to 15 minutes before they were able to find the automated external defibrillator to actually shock my heart back," said Spicer. "You know even one person in your family, or two people in your family have those types of skills, there is going to be a lot more people walking around."

About 90% of folks who suffer an out-of-hospital cardiac arrest die, according to the American Heart Association.

But the association says if someone performs CPR immediately, it can double or triple a cardiac arrest victim's chance of survival.

To find CPR training near you, visit CPR.heart.org.

Brian Kellar is the CEO of Banner Heart Hospital and Baywood, Goldfield and Ironwood Medical Centers and this year's Phoenix Heart Walk Chair. Kellar said heart health can impact anyone and at any age.

He recalled that two years ago, professional football player Damar Hamlin collapsed on the field after he went into cardiac arrest.

"Damar Hamlin's heart had stopped," said Kellar. "And without that kind of intervention, without somebody there - Damar Hamlin doesn't make it."

Kellar said while genetics can play a role in overall heart health, fluke situations can also cause cardiac arrest.

He encouraged everyone to get a heart check-up for peace of mind or to understand what treatment options are best for them.

He said next month's Phoenix Heart Walk will bring together thousands of people to raise awareness and celebrate survivors.

"This can affect people of all races, creeds, colors, ages - doesn't matter," said Kellar. "We see success stories and better education and awareness on how to intervene and how we can help healthier communities continue to arise."

The Phoenix Heart Walk is Saturday March 29 at the Wesley Bolin Memorial Plaza.