The Appalachian region of the United States sees hunger, poverty, disability, preventable illness and premature death in disproportionally high numbers. Yet, Appalachia also knows the quiet strength of people working together to lift one another up as a community. In this collection of essays, health professionals explore how clinics and communities address the barriers to healthcare that continue to plague this underserved region and discuss theoretical perspectives about Appalachian healthcare.Topics include regional dental care, cancer and diabetes treatment, the integration of primary care and behavioral health, telehealth, the importance of "patient responsibility," and the effects of faith, fatalism and family dynamics on the health of Appalachian youth. Avoiding simplification and stereotype while presenting data, analysis and anecdotes, this volume gives a detailed picture of Appalachia's complex and multi-faceted public health challenges.Instructors considering this book for use in a course may request an examination copy here.

Chaos. Frustration. Compassion. Desperation. Hope. These are the five words that author Wendy Welch says best summarize the state of foster care in the coalfields of Appalachia. Her assessment is based on interviews with more than sixty social workers, parents, and children who have gone through "the system." The riveting stories in Fall or Fly tell what foster care is like, from the inside out.In depictions of foster care and adoption, stories tend to cluster at the dark or light ends of the spectrum, rather than telling the day-to-day successes and failures of families working to create themselves. Who raises other people's children? Why? What's money got to do with it when the love on offer feels so real? And how does the particular setting of Appalachia—itself so frequently oversimplified or stereotyped—influence the way these questions play out?In Fall or Fly, Welch invites people bound by a code of silence to open up and to share their experiences. Less inspiration than a call to caring awareness, this pioneering work of storytelling journalism explores how love, compassion, money, and fear intermingle in what can only be described as a marketplace for our nation's greatest asset.

Chaos. Frustration. Compassion. Desperation. Hope. These are the five words that author Wendy Welch says best summarize the state of foster care in the coalfields of Appalachia. Her assessment is based on interviews with more than sixty social workers, parents, and children who have gone through "the system." The riveting stories in Fall or Fly tell what foster care is like, from the inside out.In depictions of foster care and adoption, stories tend to cluster at the dark or light ends of the spectrum, rather than telling the day-to-day successes and failures of families working to create themselves. Who raises other people's children? Why? What's money got to do with it when the love on offer feels so real? And how does the particular setting of Appalachia—itself so frequently oversimplified or stereotyped—influence the way these questions play out?In Fall or Fly, Welch invites people bound by a code of silence to open up and to share their experiences. Less inspiration than a call to caring awareness, this pioneering work of storytelling journalism explores how love, compassion, money, and fear intermingle in what can only be described as a marketplace for our nation's greatest asset.

The firsthand pandemic experiences of rural health-care providers—who were already burdened when COVID-19 hit—raise questions about the future of public health and health-care delivery.This volume comprises the COVID-19 pandemic experiences of Appalachian health-care workers, including frontline providers, administrators, and educators. The combined narrative reveals how governmental and corporate policies exacerbated the region's injustices, stymied response efforts, and increased the death toll.Beginning with an overview of the SARS-CoV-2 virus and its impact on the body, the essays in the book's first section provide background material and contextualize the subsequent explosion of telemedicine, the pandemic's impact on medical education, and its relationship to systemic racism and related disparities in mental health treatment.Next, first-person narratives from diverse perspectives recount the pandemic's layered stresses, including the scramble for ventilators, masks, and other personal protective equipmentthe neighbors, friends, and family members who flouted public-health mandates, convinced that COVID-19 was a hoaxthe added burden the virus leveled on patients whose health was already compromised by cancer, diabetes, or addictionthe acute ways the pandemic's arrival exacerbated interpersonal and systemic racism that Black and other health-care workers of color bear not only the battle against the virus but also the growing suspicion and even physical abuse from patients convinced that doctors and nurses were trying to kill them These visceral, personal experiences of how Appalachian health-care workers responded to the pandemic amid the nation's deeply polarized political discourse will shape the historical record of this "unprecedented time" and provide a glimpse into the future of rural medicine.Contributors: Lucas Aidukaitis, Clay Anderson, Tammy Bannister, Alli Delp, Lynn Elliott, Monika Holbein, Laura Hungerford, Nikki King, Brittany Landore, Jeffrey J. LeBoeuf, Sojourner Nightingale, Beth O'Connor, Rakesh Patel, Mildred E. Perreault, Melanie B. Richards, Tara Smith, Kathy Osborne Still, Darla Timbo, Kathy Hsu Wibberly

The firsthand pandemic experiences of rural health-care providers—who were already burdened when COVID-19 hit—raise questions about the future of public health and health-care delivery.This volume comprises the COVID-19 pandemic experiences of Appalachian health-care workers, including frontline providers, administrators, and educators. The combined narrative reveals how governmental and corporate policies exacerbated the region's injustices, stymied response efforts, and increased the death toll.Beginning with an overview of the SARS-CoV-2 virus and its impact on the body, the essays in the book's first section provide background material and contextualize the subsequent explosion of telemedicine, the pandemic's impact on medical education, and its relationship to systemic racism and related disparities in mental health treatment.Next, first-person narratives from diverse perspectives recount the pandemic's layered stresses, including the scramble for ventilators, masks, and other personal protective equipmentthe neighbors, friends, and family members who flouted public-health mandates, convinced that COVID-19 was a hoaxthe added burden the virus leveled on patients whose health was already compromised by cancer, diabetes, or addictionthe acute ways the pandemic's arrival exacerbated interpersonal and systemic racism that Black and other health-care workers of color bear not only the battle against the virus but also the growing suspicion and even physical abuse from patients convinced that doctors and nurses were trying to kill them These visceral, personal experiences of how Appalachian health-care workers responded to the pandemic amid the nation's deeply polarized political discourse will shape the historical record of this "unprecedented time" and provide a glimpse into the future of rural medicine.Contributors: Lucas Aidukaitis, Clay Anderson, Tammy Bannister, Alli Delp, Lynn Elliott, Monika Holbein, Laura Hungerford, Nikki King, Brittany Landore, Jeffrey J. LeBoeuf, Sojourner Nightingale, Beth O'Connor, Rakesh Patel, Mildred E. Perreault, Melanie B. Richards, Tara Smith, Kathy Osborne Still, Darla Timbo, Kathy Hsu Wibberly

Chaos. Frustration. Compassion. Desperation. Hope. These are the five words that author Wendy Welch says best summarize the state of foster care in the coalfields of Appalachia. Her assessment is based on interviews with more than sixty social workers, parents, and children who have gone through "the system." The riveting stories in Fall or Fly tell what foster care is like, from the inside out.In depictions of foster care and adoption, stories tend to cluster at the dark or light ends of the spectrum, rather than telling the day-to-day successes and failures of families working to create themselves. Who raises other people's children? Why? What's money got to do with it when the love on offer feels so real? And how does the particular setting of Appalachia—itself so frequently oversimplified or stereotyped—influence the way these questions play out?In Fall or Fly, Welch invites people bound by a code of silence to open up and to share their experiences. Less inspiration than a call to caring awareness, this pioneering work of storytelling journalism explores how love, compassion, money, and fear intermingle in what can only be described as a marketplace for our nation's greatest asset.

Wendy Welch and her husband had always dreamed of owning a bookstore, so when they left high-octane jobs for a simpler life in an Appalachian coal town, they seized an unexpected opportunity to pursue their dream. The only problems? A declining U.S. economy, a small town with no industry, and the advent of the e-book. They also had no idea how to run a bookstore. Against all odds, but with optimism, the help of their Virginia mountain community, and an abiding love for books, they succeeded in establishing more than a thriving business - they built a community.

Stories from doctors, nurses, and therapists dealing on a daily basis with the opioid crisis in Appalachia should be heartbreaking. Yet those told here also inspire with practical advice on how to assist those in addiction, from a grass-roots to a policy level. Readers looking for ways to combat the crisis will find suggestions alongside laughter, tears, and sometimes rage. Each author brings the passion of their profession and the personal losses they have experienced from addiction, and posits solutions and harm reduction with positivity, grace, and even humor. Authors representing seven states from northern, Coalfields, and southern Appalachia relate personal encounters with patients or providers who changed them forever. This is a history document, showing how we got here; an evidenced indictment of current policies failing those who need them most; an affirmation that Appalachia solves its own problems; and a collection of suggestions for best practice moving forward.

As the novel coronavirus (Covid-19) spread around the world, so did theories, stories, and conspiracy beliefs about it. These theories infected communities from the halls of Congress to Facebook groups, spreading quickly in newspapers, on various social media and between friends. They spurred debate about the origins, treatment options and responses to the virus, creating distrust towards public health workers and suspicion of vaccines.This book examines the most popular Covid-19 theories, connecting current conspiracy beliefs to long-standing fears and urban legends. By examining the vehicles and mechanisms of Covid-19 conspiracy, readers can better understand how theories spread and how to respond to misinformation.

Clinicians and academics on improving medical communications in Appalachia.According to the National Institutes of Health, about 25 percent of the American population does not trust doctors and medical professionals. Focusing on rural Appalachia specifically, Wendy Welch, PhD, MPH, and Beth O'Connor, Med, discuss the region's complex relationships with modern medicine and its institutions in this important collection. Offering multiple academic and clinical perspectives in thirteen unique essays, Medical Mistrust in Appalachia explores the history of this skepticism toward healthcare, analyzing the region's relationship to medical infrastructure and the relationship between medicine and marginalized communities.This volume fills a gap in scholarship by elevating the voices of practitioners and wrestling with the realities of medical mistrust as a cultural phenomenon—one born from a system that has historically struggled to center the safety and health of Appalachian communities. Presenting medical mistrust as a justifiable reaction in the interest of self-preservation, Welch and O'Connor address Appalachian stereotypes while confronting the ways medical institutions have fostered environments of mistrust and inequality. Importantly, Welch and O'Connor conclude with a discussion of how medical infrastructure and Appalachia can move forward together. Medical Mistrust in Appalachia is a must-read for rural healthcare professionals, medical students, and readers interested in Appalachian culture.

The Appalachian region of the United States sees hunger, poverty, disability, preventable illness and premature death in disproportionally high numbers. Yet, Appalachia also knows the quiet strength of people working together to lift one another up as a community. In this collection of essays, health professionals explore how clinics and communities address the barriers to healthcare that continue to plague this underserved region and discuss theoretical perspectives about Appalachian healthcare.Topics include regional dental care, cancer and diabetes treatment, the integration of primary care and behavioral health, telehealth, the importance of "patient responsibility," and the effects of faith, fatalism and family dynamics on the health of Appalachian youth. Avoiding simplification and stereotype while presenting data, analysis and anecdotes, this volume gives a detailed picture of Appalachia's complex and multi-faceted public health challenges.Instructors considering this book for use in a course may request an examination copy here.

Chaos. Frustration. Compassion. Desperation. Hope. These are the five words that author Wendy Welch says best summarize the state of foster care in the coalfields of Appalachia. Her assessment is based on interviews with more than sixty social workers, parents, and children who have gone through "the system." The riveting stories in Fall or Fly tell what foster care is like, from the inside out.In depictions of foster care and adoption, stories tend to cluster at the dark or light ends of the spectrum, rather than telling the day-to-day successes and failures of families working to create themselves. Who raises other people's children? Why? What's money got to do with it when the love on offer feels so real? And how does the particular setting of Appalachia—itself so frequently oversimplified or stereotyped—influence the way these questions play out?In Fall or Fly, Welch invites people bound by a code of silence to open up and to share their experiences. Less inspiration than a call to caring awareness, this pioneering work of storytelling journalism explores how love, compassion, money, and fear intermingle in what can only be described as a marketplace for our nation's greatest asset.

Chaos. Frustration. Compassion. Desperation. Hope. These are the five words that author Wendy Welch says best summarize the state of foster care in the coalfields of Appalachia. Her assessment is based on interviews with more than sixty social workers, parents, and children who have gone through "the system." The riveting stories in Fall or Fly tell what foster care is like, from the inside out.In depictions of foster care and adoption, stories tend to cluster at the dark or light ends of the spectrum, rather than telling the day-to-day successes and failures of families working to create themselves. Who raises other people's children? Why? What's money got to do with it when the love on offer feels so real? And how does the particular setting of Appalachia—itself so frequently oversimplified or stereotyped—influence the way these questions play out?In Fall or Fly, Welch invites people bound by a code of silence to open up and to share their experiences. Less inspiration than a call to caring awareness, this pioneering work of storytelling journalism explores how love, compassion, money, and fear intermingle in what can only be described as a marketplace for our nation's greatest asset.

The firsthand pandemic experiences of rural health-care providers—who were already burdened when COVID-19 hit—raise questions about the future of public health and health-care delivery.This volume comprises the COVID-19 pandemic experiences of Appalachian health-care workers, including frontline providers, administrators, and educators. The combined narrative reveals how governmental and corporate policies exacerbated the region's injustices, stymied response efforts, and increased the death toll.Beginning with an overview of the SARS-CoV-2 virus and its impact on the body, the essays in the book's first section provide background material and contextualize the subsequent explosion of telemedicine, the pandemic's impact on medical education, and its relationship to systemic racism and related disparities in mental health treatment.Next, first-person narratives from diverse perspectives recount the pandemic's layered stresses, including the scramble for ventilators, masks, and other personal protective equipmentthe neighbors, friends, and family members who flouted public-health mandates, convinced that COVID-19 was a hoaxthe added burden the virus leveled on patients whose health was already compromised by cancer, diabetes, or addictionthe acute ways the pandemic's arrival exacerbated interpersonal and systemic racism that Black and other health-care workers of color bear not only the battle against the virus but also the growing suspicion and even physical abuse from patients convinced that doctors and nurses were trying to kill them These visceral, personal experiences of how Appalachian health-care workers responded to the pandemic amid the nation's deeply polarized political discourse will shape the historical record of this "unprecedented time" and provide a glimpse into the future of rural medicine.Contributors: Lucas Aidukaitis, Clay Anderson, Tammy Bannister, Alli Delp, Lynn Elliott, Monika Holbein, Laura Hungerford, Nikki King, Brittany Landore, Jeffrey J. LeBoeuf, Sojourner Nightingale, Beth O'Connor, Rakesh Patel, Mildred E. Perreault, Melanie B. Richards, Tara Smith, Kathy Osborne Still, Darla Timbo, Kathy Hsu Wibberly

The firsthand pandemic experiences of rural health-care providers—who were already burdened when COVID-19 hit—raise questions about the future of public health and health-care delivery.This volume comprises the COVID-19 pandemic experiences of Appalachian health-care workers, including frontline providers, administrators, and educators. The combined narrative reveals how governmental and corporate policies exacerbated the region's injustices, stymied response efforts, and increased the death toll.Beginning with an overview of the SARS-CoV-2 virus and its impact on the body, the essays in the book's first section provide background material and contextualize the subsequent explosion of telemedicine, the pandemic's impact on medical education, and its relationship to systemic racism and related disparities in mental health treatment.Next, first-person narratives from diverse perspectives recount the pandemic's layered stresses, including the scramble for ventilators, masks, and other personal protective equipmentthe neighbors, friends, and family members who flouted public-health mandates, convinced that COVID-19 was a hoaxthe added burden the virus leveled on patients whose health was already compromised by cancer, diabetes, or addictionthe acute ways the pandemic's arrival exacerbated interpersonal and systemic racism that Black and other health-care workers of color bear not only the battle against the virus but also the growing suspicion and even physical abuse from patients convinced that doctors and nurses were trying to kill them These visceral, personal experiences of how Appalachian health-care workers responded to the pandemic amid the nation's deeply polarized political discourse will shape the historical record of this "unprecedented time" and provide a glimpse into the future of rural medicine.Contributors: Lucas Aidukaitis, Clay Anderson, Tammy Bannister, Alli Delp, Lynn Elliott, Monika Holbein, Laura Hungerford, Nikki King, Brittany Landore, Jeffrey J. LeBoeuf, Sojourner Nightingale, Beth O'Connor, Rakesh Patel, Mildred E. Perreault, Melanie B. Richards, Tara Smith, Kathy Osborne Still, Darla Timbo, Kathy Hsu Wibberly

Chaos. Frustration. Compassion. Desperation. Hope. These are the five words that author Wendy Welch says best summarize the state of foster care in the coalfields of Appalachia. Her assessment is based on interviews with more than sixty social workers, parents, and children who have gone through "the system." The riveting stories in Fall or Fly tell what foster care is like, from the inside out.In depictions of foster care and adoption, stories tend to cluster at the dark or light ends of the spectrum, rather than telling the day-to-day successes and failures of families working to create themselves. Who raises other people's children? Why? What's money got to do with it when the love on offer feels so real? And how does the particular setting of Appalachia—itself so frequently oversimplified or stereotyped—influence the way these questions play out?In Fall or Fly, Welch invites people bound by a code of silence to open up and to share their experiences. Less inspiration than a call to caring awareness, this pioneering work of storytelling journalism explores how love, compassion, money, and fear intermingle in what can only be described as a marketplace for our nation's greatest asset.

Wendy Welch and her husband had always dreamed of owning a bookstore, so when they left high-octane jobs for a simpler life in an Appalachian coal town, they seized an unexpected opportunity to pursue their dream. The only problems? A declining U.S. economy, a small town with no industry, and the advent of the e-book. They also had no idea how to run a bookstore. Against all odds, but with optimism, the help of their Virginia mountain community, and an abiding love for books, they succeeded in establishing more than a thriving business - they built a community.

Stories from doctors, nurses, and therapists dealing on a daily basis with the opioid crisis in Appalachia should be heartbreaking. Yet those told here also inspire with practical advice on how to assist those in addiction, from a grass-roots to a policy level. Readers looking for ways to combat the crisis will find suggestions alongside laughter, tears, and sometimes rage. Each author brings the passion of their profession and the personal losses they have experienced from addiction, and posits solutions and harm reduction with positivity, grace, and even humor. Authors representing seven states from northern, Coalfields, and southern Appalachia relate personal encounters with patients or providers who changed them forever. This is a history document, showing how we got here; an evidenced indictment of current policies failing those who need them most; an affirmation that Appalachia solves its own problems; and a collection of suggestions for best practice moving forward.

As the novel coronavirus (Covid-19) spread around the world, so did theories, stories, and conspiracy beliefs about it. These theories infected communities from the halls of Congress to Facebook groups, spreading quickly in newspapers, on various social media and between friends. They spurred debate about the origins, treatment options and responses to the virus, creating distrust towards public health workers and suspicion of vaccines.This book examines the most popular Covid-19 theories, connecting current conspiracy beliefs to long-standing fears and urban legends. By examining the vehicles and mechanisms of Covid-19 conspiracy, readers can better understand how theories spread and how to respond to misinformation.

Clinicians and academics on improving medical communications in Appalachia.According to the National Institutes of Health, about 25 percent of the American population does not trust doctors and medical professionals. Focusing on rural Appalachia specifically, Wendy Welch, PhD, MPH, and Beth O'Connor, Med, discuss the region's complex relationships with modern medicine and its institutions in this important collection. Offering multiple academic and clinical perspectives in thirteen unique essays, Medical Mistrust in Appalachia explores the history of this skepticism toward healthcare, analyzing the region's relationship to medical infrastructure and the relationship between medicine and marginalized communities.This volume fills a gap in scholarship by elevating the voices of practitioners and wrestling with the realities of medical mistrust as a cultural phenomenon—one born from a system that has historically struggled to center the safety and health of Appalachian communities. Presenting medical mistrust as a justifiable reaction in the interest of self-preservation, Welch and O'Connor address Appalachian stereotypes while confronting the ways medical institutions have fostered environments of mistrust and inequality. Importantly, Welch and O'Connor conclude with a discussion of how medical infrastructure and Appalachia can move forward together. Medical Mistrust in Appalachia is a must-read for rural healthcare professionals, medical students, and readers interested in Appalachian culture.