By Bob Weaver

Health care in the Appalachian mountains will be scrutinized for the first time in many years, creating a data-base in the 13-state, 199,000 square mile area that stretches from New York to Mississippi. The $150,000 project is being funded by the Appalachian Regional Commission.

Cancer, heart disease and infant mortality rates have been infamously high.

The data-base is described as a top-to-bottom review of health problems, including accessibility problems often experienced in the rural areas of central and southern West Virginia.

The Aging Well project which has focused on Calhoun County, including their international conference which came to rural areas of West Virginia, has highlighted problems with access. Fear has been expressed in Washington that the tax cut would scale back rural health services, requiring older and economically deprived residents to face access barriers.

Broad-based health care organizations like Minnie Hamilton Health Care provide a large menu of services to rural areas, and the study could impact on the future of the institution.

Currently, most rural residents are unable to afford the annual premiums for private insurance which cost between $4000-$6500 and significant scale backs in Medicaid coverage means more people are "unqualified."

The Southwest Virginia Graduate Medical Education Consortium has found that residents in the far western section of Virginia in the mountains, die 30% faster that the rest of the state.

The UVA study said that mountain people are more than 50% likely to die of chronic obstructive pulmonary disease, 26% more likely to die of heart disease and more than 53% more likely to die of pneumonia or flu. They are also 60% more likely to die of suicide.

The ARC project will also target the financial conditions of the 13-state region, attempting to determine where need may be greatest. or where financial cutbacks in Washington would be most dramatically felt. The Appalachian region was also found to have 30% fewer physicians.

Rural health problems are compounded with a national health system which continues with over 50 million people unable to afford insurance and millions more with HMO's that throw-up barriers or limit access to care.

Insurance premiums continue to rise between 12-17% each year, causing businesses to cancel insurance coverage or opt to have employees pick up more of the tab. America spends about 15% of its gross national product, the most of any country, on care that often does not reach its citizens.

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