The purpose of this memo is to assess a health inequity that exists in West Virginia and document it with the available data. Specifically, the paper will describe preventable deaths and difficulty accessing healthcare as the health inequities in West Virginia and some of the critical determinants of these disparities. One of the recommendations for reducing the healthcare disparity is expanding insurance among uninsured minority communities. The other solutions recommended in the paper are expanding health promotion programs and establishing community and individual-level interventions to encourage healthy behaviors in the state.
Background
A study by Johnson et al. (2021) states that West Virginia’s uneven socio-economic and geographic barriers have resulted in the current healthcare disparities witnessed in the state. The state’s rural nature has made it challenging to maintain medical facilities accessible to most of the residents.
Moreover, the mountainous terrain has been considered a significant barrier to healthcare access as it slows down travel on winding roads. Similarly, studies reveal that people experience lengthy travel times to the closest healthcare facilities. With an increase in the aging population, the abovementioned factors have made it difficult for the elderly to access medication or prevent preventable deaths.
As revealed by Johnson et al., 50.9% of West Virginia’s population resides in rural areas, and the Appalachian rurality of the state has contributed to the high cases of obesity, cardiovascular disease, diabetes, smoking, and obstructive pulmonary disease (COPD). A third of the state’s population also lives with multiple chronic conditions affecting older adults. During the COVID-19 pandemic, West Virginia recorded one of the highest numbers of deaths due to the virus (Wes et al., 2021). This was an indication that the health disparities in the state make its residents vulnerable to health disasters in the future.
Analysis
Although West Virginia experiences health inequities, the state’s policymakers are faced with limitations on the tools they can use to identify and assess healthcare deserts since WV presents unique challenges (Hong et al., 2023). As such, existing strategies for identifying healthcare-deprived regions like Health Professional Shortage Areas (HPSA) have been considered unsuitable for directing WV policies since each of the 55 counties has different HPSAs, making prioritizing resources challenging.
Furthermore, the need for up-to-date healthcare facilities and physician databases has also made it challenging to come up with solutions to WV’s problems. For example, the available physician license datasets have been found to include misleading, inconsistent, and out-of-date data. Also, since HPSA relies on zip code data, this approach has been unsuitable in WV, given that zip codes need spatial context and covariate information. Similarly, rural census tracts need to be bigger to record the spatial variation of access to healthcare services.
Nonetheless, as Hong et al. state, WV established the HealthLink project as an alternative way of solving healthcare disparities in the region. The state’s rural nature, however, means that more efforts geared towards addressing the two health inequities in the region are needed (Hendricks et al., 2021). This will help reduce risk factors in the state and promote health information and healthy living among the residents.
Recommendation(s)
Expanding healthcare insurance for the uninsured WV residents, especially the underserved, will go a long way in ensuring the population can have more access to healthcare services. Even though the minority population is smaller in WV compared to other US states, it is 50% more likely to experience a lack of insurance than its white counterparts. As such, policymakers must champion affordable healthcare insurance among low-income earners.
Health promotion programs geared towards helping patients have also been identified as strategies to reduce healthcare disparities among rural regions like WV since geographical isolation means that services must be established in each community. These programs are considered more sustainable since they are less costly and can be established in different locations in the state, despite the size of the population. Community leaders and local legislators should spearhead these programs.
Similarly, developing individual or community-level interventions to encourage people to adopt healthy behaviors will help reduce the prevalence of diabetes, obesity, and other lifestyle-related diseases (Richman et al., 2019). This will reduce the need for healthcare services, leading to lower
Conclusion
Healthcare inequities in West Virginia require better interventions and programs. Although the HealthLink initiative has helped increase healthcare information, more actions like interventions encouraging healthy behaviors will reduce the prevalence of diabetes and other lifestyle-related conditions. Besides, increasing insurance among the uninsured minority population will increase access and establishing community-based programs will solve issues related to terrain and travel distances when seeking healthcare services.
References
Hendricks, B., Paul, R., Smith, C., Wen, S., Kimble, W., Amjad, A., … & Hodder, S. (2021). Coronavirus testing disparities associated with community-level deprivation, racial inequalities, and food insecurity in West Virginia. Annals of Epidemiology, 59, 44–49.
Hong, I., Wilson, B., Gross, T., Conley, J., & Powers, T. (2023). Challenging terrains: socio-spatial analysis of Primary Health Care Access Disparities in West Virginia. Applied Spatial Analysis and Policy, 16(1), 141–161.
Johnson, J. E., Bhandari, R., Lastinger, A., & Reece, R. (2021). The Compounding Effect of Rurality on Health Disparities Among Black Patients with COVID-19. Journal of Appalachian Health, 3(4), 11.
Richman, L., Pearson, J., Beasley, C., & Stanifer, J. (2019). Addressing health inequalities in diverse, rural communities: an unmet need. SSM-population Health, p. 7, 100398.
Wen, S., Prasad, A., Freeland, K., Podury, S., Patel, J., Subedi, R., & Sriwastava, S. (2021). Clinical characteristics and outcomes of COVID-19 in West Virginia. Viruses, 13(5), 835.
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