The Challenge in Rural Appalachia

 Authors: Richard Crespo,  Matthew Christiansen,  Kim Tieman,and  Richard Wittberg 

Citation: Crespo, R., Christiansen, M., Tieman, K., & Wittberg, R. (2020). An Emerging Model for Community Health Worker–Based Chronic Care Management for Patients With High Health (opens in a new window)

Care Costs in Rural Appalachia. National Library of Medicine.

• The challenge in rural Appalachia, however, is no sustainable funding mechanisms exist that support Community Health Workers.
• People in Appalachia have lower access to health care and have higher rates of chronic diseases including heart disease, stroke and diabetes.
• We found that the residents in counties classified as distressed by the Appalachian Regional Commission were 1.4 times more likely to report diabetes than residents of non-distressed counties, regardless of race.
• A recent study found that residents of distressed and at-risk counties have a 40% to 50% lower odds of having annual foot and eye examinations and 30% lower odds of receiving diabetes education (21), which further highlights the importance of addressing barriers to health screening and preventive care.
• The CHW becomes the eyes and ears of the Chronic Care Management team, bringing issues they see in the home back to the team, strategizing with the team to overcome barriers to compliance, and implementing those strategies with the patient.
• CHWs become highly knowledgeable in disease management through the practical experience of seeing what it takes for people to get their condition under control.