J. Brady Scott

I recently returned home to Kentucky to visit my family and heard a sobering comment. A local funeral director, in casual conversation, stated that for the first time it seemed that young people in rural Kentucky are being buried more often than the elderly. 

As stories like this and others were told, heads around me nodded in some sort of resigned agreement, but no one ever appeared shocked. It seems the incredibly poor health of some Kentuckians has become an accepted way of life, at least by some.  

Even if few are shocked these days, there are health disparities across Kentucky that still are alarming. Life expectancy in some rural Kentucky counties, like Floyd County where I grew up, is up to nine years less than some other Kentucky counties. Disturbingly, parts of rural Appalachia Kentucky actually experienced a decline in life expectancy from 1980 to 2014 while at the same time life expectancy increased for most of the rest of the country. Drug and alcohol abuse, poverty, smoking, obesity and lack of leisure-time physical activity are each to blame.

Obesity presents a particular problem for Kentuckians. A report of CDC data from 2017 shows Kentucky ranks eighth in the country for obesity. That same report ranks Kentucky first in the country for percentage of adults who admit to engaging in zero physical leisure activity. A 2019 study published by the Southern Medical Journal reported more troubling findings, noting that less than one in ten rural Appalachians engage in recommended levels of physical activity.

To be sure, there are many efforts being made to address some of the issues that lead to poor health outcomes in rural Appalachia Kentucky. The Mountain Air Project, a five-year study by the University of Kentucky examining risk-factors associated with asthma and COPD in southeast Kentucky, is well underway. Federal grant money has been provided to help Kentucky reduce opioid deaths. Access to primary care, women’s, and pediatric services are expanding across the region. Food programs are bringing fresh fruits and vegetables to the schools in rural Appalachia Kentucky. Progress is being made in many other areas, but will it be enough? 

For Kentuckians, increasing their physical activity may be the easiest and one of the most productive ways to improve one’s health and reverse these trends. According to the Mayo Clinic, exercise helps control weight and combat certain diseases, like stroke, Type 2 diabetes, and depression. The American Heart Association also notes that physical activity can help lower blood pressure, boost levels of good cholesterol, improve circulation, and even help prevent bone loss that may lead to osteoporosis.

Given the many positive benefits of exercise, it’s worth thinking about why so many Kentuckians, especially those in rural Appalachia, don’t do it. The SMJ study notes very real barriers to exercise in rural Kentucky, including long travel time to exercise facilities and little access to parks or other community resources. Costs associated with gym membership and travel may also prohibit some from utilizing facilities that are indeed available.

While there are very real barriers to exercise and physical activity, many physical activities can be done for free without belonging to a gym, including walking, biking, cleaning the house and even doing workouts at home. Little things at work can help increase your activity level, like replacing your coffee break with a brisk 10-minute walk. As the SMJ study suggests, community members such as teachers, coaches and faith leaders may be effective advocates for better health through increasing physical activity. The Partnership for a Fit Kentucky has many resources available for Kentuckians ready to embrace a healthier lifestyle. Regardless, something needs to change and quickly. The hope for a bright, thriving future in rural Appalachia Kentucky depends on a pivot towards better health.

J. Brady Scott is a respiratory therapist and associate professor in the Department of Cardiopulmonary Sciences, Division of Respiratory Care, College of Health Sciences at Rush University (Chicago, IL) and a Public Voices Fellow with The OpEd Project. He is a native of Floyd County.

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