Oliver’s Twist

Health inequities abound in this country. I’ve used this site to speak out against the health inequities inflicted upon African Americans, Latinos, and other people of color; however, I’ve tried to make it clear here (and in other writing) that it’s not only victims of racial discrimination who suffer from health disparities but working people in general who bear an unequal burden of sickness and death.

Nowhere is this fact more clear than among workers and working farmers in rural America. Take the coalfields of far southwestern Virginia, for example. Whereas the death rate in the state is 780/100,000, the rate in southwestern Virginia is more than 1,200/100,000. About 203/100,000 Virginians die of heart disease each year compared with about 340/100,000 in the Virginia coalfields. It’s the same with cancer deaths: statewide, 185/100,000 people die from solid tumor cancers; whereas in the state’s southwestern coalfields, some 260/100,000 die from those cancers.

The psychological distress and dis-ease of this population is also high. Virginia’s overall suicide rate is 11/100,000, whereas in the coalfields it’s double at 22/100,000. Substance abuse, particularly prescription drug addiction, is rampant in southwestern Virginia, which takes its toll in human suffering and death. Fatal drug overdoses in the state occur at a rate of 8/100,000; however, in far southwestern Virginia, the rate is 40/100,000.

As noted in earlier posts, social inequities underlie these health inequities. Nearly 10% of Virginians live below the federal poverty line; 20% of people in Virginia’s coalfields live below this poverty line. The per capita income of people in far southwestern Virginia is about 58% of the per capita income of the state’s population.

Working people in the coalfields of Virginia lack access to health care — both because of a scarcity of available physicians and health care facilities and owing to the high number of people lacking health insurance. Some 20% of people in southwestern Virginia are uninsured compared with about 13% statewide.

Until these social inequities are resolved, health inequities will continue to plague the coalfields of southwestern Virginia and the rest of rural America. A national, single-payer health plan would go a long way toward decreasing the disparities.

(Statistics on southwestern Virginia obtained from the Healthy Appalachia Institute. www.healthyappalachia.org)