Southwest Virgina's Mortality Mystery

I noticed a story earlier in the week that looked at the declining life expectacy in various parts of the USA, including Southwest Virginia, but I did not find time to do a post on it. Now, today, the Washington Post has a story that focuses on Southwest Virginia's declining life expectancies, particularly for women. The article looks at a number of factors, but never adequately focuses on what I suspect is a major factor: lack of health insurance coverage that allows preventative treatment and diognostic tests. It is mentioned briefly, but fails to point out that emergency room care in non-profit hospitals does NOT include such medical treatment. Therefore, I believe much of the population lacks decent medical insurance coverage and as a result lacks minimal quality care. In fact, years ago my sister who is a nurse practioner worked in a clinic in that area of the state under a UVA grant and was horrified at the conditions and lack of medical care.

*

As backward as the greater Norfolk area seems at times, it is down right cosmopolitan and progressive compared to the southwest part of the Virginia which is the poorest area in the state and also the most backward in terms of social views and education. Other than coal mine operations, there are not many large employers in that area of the state - not anymore that is. Furniture manufacturers, textile mills and other former large manufacturing and industrial employers that once paid a living wage and provided health insurance coverage have largely closed down as jobs have been exported overseas. As the article notes, even Wal-Mart closed a store in that region. The state is making efforts to induce new employers to relocate to that part of the state, but few progressive firms would want to be based in that area. While the area is physically beautiful and has gorgeous mountains (the Appalachian Trail runs throught the area), socially it is like a 1950's time warp in the worse sense and no liberal or gay in their right mind would move there if they had a choice in the matter. In fact, those with brains and ambition leave the area for more progressive parts of the state or country. Thus, the area is in a downward spiral - the more backward and reactionary it becomes, the fewer would be employers want to relocate there. Bigotry, reactionary politics (Southwest Virginia is the GOP's most secure bastion in Virginia) and fundamentalist Christianity which predominate the area have a very high price in terms of driving development and progress away. Here are some story highlights:

*

In this corner of southwest Virginia, cow-speckled fields and empty downtown streets tell of a slower, calmer life. It's a place where older men can be found around a table every morning drinking 25-cent coffee with the nearest Starbucks miles away. Residents will tell you little distinguishes the city of Radford and neighboring Pulaski County from elsewhere in rural America. That is what troubles health-care workers here most about a new study that found a sharp drop in life expectancy for women in the two communities.

*
According to the study, life expectancy for women dropped in nearly 1,000 counties but fell most in Radford and Pulaski. In 1983, life expectancy for women in the two jurisdictions was about 84 years. By 1999, it had dropped 5.8 years, to 78. No other jurisdiction in the nation had a decrease of more than 3.3 years.

*

But in an area struggling economically, where the day's gas prices might determine whether it's worth a drive to the doctor's office, it's not always easy to push preventive measures, he said. "If you are struggling to put food on the table, you don't have time to think about prevention," Hershey said, adding that lack of health insurance is a significant problem in southwest Virginia.

*

On Main Street in the town of Pulaski, economic distress is clear. "For Sale" signs hang on several storefronts, and even at lunchtime, few people stroll the streets. It wasn't always like this, business owner David Allen said. That was before popular stores left and major manufacturers, such as Pulaski Furniture, where many residents worked, closed. Now everyone talks about expected layoffs at Volvo, a major employer. "It's going downhill," John Stevens said. "We even lost a Wal-Mart here. Who loses a Wal-Mart?"