Appalachians are in poor health relative to other Americans. For example, the ageadjusted all cause mortality rate for Appalachian in 2006 was over 900 per 100,000 compared to a rate of 760 per 100,000 for those outside of Appalachia. This essay shows that health disparities start before birth—the incidence of low birth weight is 90 1,000 in rural Appalachia compared to 83 per 1,000 outside the U.S. These disparities continue through childhood and into adulthood. Moreover, although African Americans are generally in poorer health relative to white Americans, disparities between Appalachia and the rest of the U.S. are much greater for whites. These disparities are not surprising given the continued poverty of Appalachia. This paper draws on the literature to discuss the likely consequences of these disparities for the future health and well being of Appalachia’s children.

Document Type

Research Paper

Publication Date


Discussion Paper Number

DP 2009-10