Self-Rated Health in Rural Appalachia

Health perceptions are incongruent with health status and health behaviors. Appalachia is characterized by poor health behaviors, poor health status, and health disparities. Recent programs have not shown much success in improving health status or reducing health disparities in the Appalachian region.

Since a person's perception of personal health precedes his or her health behaviors, the purpose of this project was to evaluate the self-rated health of Appalachian adults in relation to their objective health status and their current health behaviors. Appalachian adults (1,576) were surveyed regarding health behaviors – soda consumer (drink 12 ounces or less, or 1 can or less a day), or non-consumer (drink more than 12 ounces or more than one can a day), fast food consumer (eating fast food 3 or more times a week) or healthy food consumer (eating fast food less than 3 times a week), smoking (smoker or non-smoker), exercise (exercise more than 30 minutes a week) and inactive (exercise less than 30 minutes a week), blood pressure medication (yes, no), and self-rated health.

Blood pressure and cholesterol were measured.

Weight status was based on body mass index (BMI): normal weight (18.5 to 25.0), overweight (25.1 to 30.0), and obese (greater than 30.0). Participants reported being healthy, while being inactive (65%), having high blood pressure (76%), being overweight (73%), or having high cholesterol (79%). Between 57% and 66% of the people who considered themselves healthy had at least two disease conditions or poor health behaviors.

The association between self-rated health and poor health indicators in Appalachian adults is distorted. The public health challenge is to formulate messages and programs about health and health needs which take into account the current distortion about health in Appalachia and the cultural context in which this distortion was shaped.

This study was published in the journal BioMed Central Public Health.


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