Rural Ohio Appalachian

Rural Ohio Appalachia and Type 2 Diabetes

Rural Ohio Appalachia has one of the highest rates of type 2 diabetes in the country. The main health discrepancy is that the illness primarily afflicted adults in the region as opposed to youngsters (WHO, 2017). Adults in Rural Ohio Appalachia have a higher prevalence of diabetes, higher rates of mortality, and a bad lifestyle when compared to persons in other parts of the country. As a result, the problem has a significant impact on the public health system due to the steady increase in the number of diabetes patients who require care, imposing significant economic expenditures (Myerson & Laiteerapong, 2016). In 2015, public health system experience 2.3 times medical expenditure due to the direct medical cost required in Rural Ohio Appalachian when compared to other regions in U.S (WHO, 2017).

Social Inequalities

Low level of income about the adult of living in Rural Ohio Appalachian is one of the primary social inequalities that have created the disparity (Hornbeck et al., 2016). Reports indicate the majority of the individuals with type 2 diabetes have low income within their families. The area is characterized by markedly unequal amount of money that each household has to spend determines several aspects of the family progress (Hornbeck et al., 2016).

Lack of education is another social inequality that led to the increase of diabetes type among adults in Rural Ohio Appalachian. In other words, people having insufficient knowledge on the importance of healthy lifestyle may serve as an opportunity for reducing the chances of this disease (Myerson & Laiteerapong, 2016). In particular, most individuals rural Ohio area did not go to college, and many dropped out of high school, therefore, having less information about health practices. Also, Rural Ohio Appalachian is characterized by poor access to healthcare services as there is a lack of hospital, clinics and transport system (Clark & Utz, 2014; Syed, Gerber & Sharp, 2013). Further, people are unable to receive proper medical care due to understanding in the existing health care facilities.

How the above social Inequalities perpetuate the Disparity

First, the lower income levels restrict the household on particular types of diets such as junky foods, excess carbohydrates as well as imbalanced diet within the household. It means that people in Appalachian have a higher chance of developing type-2 diabetes as compared to other communities in the U.S (CDC, 2014). Further, without education, individuals remain unaware of the importance of changing lifestyle and incorporating activities such as exercises in their lives (Arcury et al., 2006; RHI, 2017).

Analysis of the Inequalities

Social Force. The primary underlying cause of the health care disparity facing adult living in Appalachian is a lack of education. First, it is imperative to understand that people who are well educated tend to understand the context of the prevention and management of such diseases in any set of the environment (Arcury et al., 2006). Apart from being aware of the importance of observing healthy lifestyle, individuals with education tend to have jobs with good income. At the same time, education is fundamental to ensuring equitable and proper access to care due to the availability of professionals. However, lack of educated people in Appalachian has resulted in most families and adults being low-income earners. Also, Rural Ohio Appalachian Adults are more likely to experience a lack of physical exercise (Arcury et al., 2006).

Institutional Force. Therefore, the primary institutional force that significantly contributed to the social inequalities identified above is insufficient clinics and hospitals in the area. Further, Appalachian is characterized by understaffing in the already existing healthcare facilities (Clark & Utz, 2014). Additionally, Rural Ohio Appalachian Adults are less likely to experience availability to health insurance. Therefore, these individuals have diminished the chance of accessing to healthcare services.

Political Force. Distribution of medical policies is a major political force that affects the accessibility of healthcare in the United States in general. Government agencies and institutions play a critical role in the allocation of resources in most parts of the country (Clark & Utz, 2014). Similarly, United States politics impact delivery of equitable services to the population which has created healthcare burden among vulnerabilities communities such as people living in Appalachian rural areas.

Reasons U.S allow the Inequality to Exist. U.S allows the inequalities above to exist in the society because of discrepancies in its political and economic frameworks that determine the income that people or a family earns. In particular, the economic structure of the country has played a huge role. Apparently, it appears that wealthy continue to get rich while the economic condition of people in low class constantly deteriorates (Smith & Holloman, 2011).

Values that Shape American Societal Choices. The economic structure of United States helps individuals in higher economic class to make choices that benefit them and ensure their survival in the society without considering the poor. In other words, the social choices are based on perceived benefits of the decision made perpetuated by the economic status of people (Smith & Holloman, 2011).

Justification for a social justice perspective

A social justice perspective can an important remedy to the above health disparity because with equitable distribution of resource is extremely fundamental for people of Appalachian (Anderson et al., 2009). There should be an equal allocation of healthcare facilities and professional in the region to curb the problem. Similarly, social justice is crucial because it determines how decisions are made with regard to matters such as access to education and other health dimensions of life (Anderson et al., 2009).


The analysis has made it clear that Appalachian experience considerable health disparity and the most important strategy that need to be taken is the government to ensure local obligation to healthcare and harmonizing engagement. The state and the federal government should ensure availability of sufficient tools and resources for local agencies and institutions to fulfill their public responsibilities (Anderson et al., 2009). Also, there should be shared obligation among the three governments to develop health policies that are social justifiable.


Adults in Appalachian currently face health disparity majorly due to lack of education, low income, and poor access to healthcare services. These are primary determinants the major forces behind the variations and the disproportion of diabetic adults within this community. The issue is further exacerbated by institutional and political forces in the United States as a whole. Therefore, the most important solution to the problem is ensuring collaboration among state, local and federal government to ensure equitable distribution of tool and health resources.


Anderson, J. M., Rodney, P., Reimer-Kirkham, S., Browne, A. J., Khan, K. B., & Lynam, M. J. (2009). Inequities in health and healthcare viewed through the ethical lens of critical social justice: Contextual knowledge for the global priorities ahead. Advances in Nursing Science, 32(4), 282-294.

Arcury, T. A., & Quandt, S. A. (Eds.). (2006). Latino Farmworkers in the Eastern United States. Springer New York.

CDC. (2014). National Diabetes Statistics Report, 2014. Retrieved from

Clark, M. L., & Utz, S. W. (2014). Social determinants of type 2 diabetes and health in the United States. World journal of diabetes, 5(3), 296.

Hornbeck, C.A., Kollman, J., Payne, T.J., Sobotka, H.L. (2016). The Impact of Chronic Disease in Ohio: 2015. Chronic Disease Epidemiology and Evaluation Section, Bureau of Health Promotion, Ohio Department of Health, 2015. Retrieved 2nd August 2017, from CD%20Burden%20Final_Webv2.pdf

Myerson, R., & Laiteerapong, N. (2016). The Affordable Care Act and diabetes diagnosis and care: exploring the potential impacts. Current diabetes reports, 16(4), 27.

RHI. (2017). Rural Health Disparities. Retrieved from

Smith, L. H., & Holloman, C. H. (2011). Health status and access to health care services: a comparison between Ohio's rural non-Appalachian and Appalachian families. Family & community health, 34(2), 102-110.

Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013). Traveling towards disease: transportation barriers to health care access. Journal of community health, 38(5), 976-993.

WHO. (2017). About Diabetes. Retrieved from

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