Understanding the Impact of Wealth Inequality on Appalachian Health
Abstract
Wealth inequalities and socioeconomic status are well-known predictors of health outcomes in the United States. Although this relationship is known, the disparities between health and wealth have not been thoroughly researched in the Appalachian region. This study sought to better understand the impact of wealth inequality at the county level in Appalachia, with a focus on the wealthiest and poorest counties. Using 2025 Appalachian Regional Commission Economic Data and the County Health Rankings & Roadmaps 2025 National Dataset, the 423 counties of Appalachia were grouped into deciles based on three economic indicators: three-year average unemployment rate, per capita market income, and poverty rate. Health metrics were then compared between the Top and Bottom 10% of counties using t-tests. Across the 22 analyzed variables, there was a statistically significant difference between the richest and poorest counties for all variables (α=0.05). Most variables followed expected trends, with the bottom 10% of counties having worse health outcomes relative to the top 10%, except for three which exhibited inverse relationships. These were HIV prevalence, uninsured rates, and primary care physician ratios. These findings highlight the role of wealth, or lack thereof, in shaping health disparities in Appalachia. It is hoped that by implementing targeted economic and social policies, these disparities can be reduced across the region.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 4:30 PM
Room Number
Culp Ballroom 316
Poster Number
45
Presentation Type
Poster
Presentation Subtype
Posters - Competitive
Presentation Category
Health
Student Type
Graduate and Professional Degree Students, Residents, Fellows
Faculty Mentor
Randy Wykoff
Understanding the Impact of Wealth Inequality on Appalachian Health
Culp Ballroom 316
Wealth inequalities and socioeconomic status are well-known predictors of health outcomes in the United States. Although this relationship is known, the disparities between health and wealth have not been thoroughly researched in the Appalachian region. This study sought to better understand the impact of wealth inequality at the county level in Appalachia, with a focus on the wealthiest and poorest counties. Using 2025 Appalachian Regional Commission Economic Data and the County Health Rankings & Roadmaps 2025 National Dataset, the 423 counties of Appalachia were grouped into deciles based on three economic indicators: three-year average unemployment rate, per capita market income, and poverty rate. Health metrics were then compared between the Top and Bottom 10% of counties using t-tests. Across the 22 analyzed variables, there was a statistically significant difference between the richest and poorest counties for all variables (α=0.05). Most variables followed expected trends, with the bottom 10% of counties having worse health outcomes relative to the top 10%, except for three which exhibited inverse relationships. These were HIV prevalence, uninsured rates, and primary care physician ratios. These findings highlight the role of wealth, or lack thereof, in shaping health disparities in Appalachia. It is hoped that by implementing targeted economic and social policies, these disparities can be reduced across the region.
