Throwaway
Lives
We
know that public health in Appalachia is a
national disgrace. We don't need more studies. We
need to teach young people to take control of
their own health.
Several
national publications, including Time Magazine,
The Washington Post and the New York
Times Magazine, have highlighted the abysmal
health of the people of Central Appalachia, and of
the Virginia coalfields in particular. Federal and
state authorities have spent significant funds
verifying the same statistics over and over but
little has been accomplished to ameliorate the
problems so thoroughly documented.
Some
small portion of the heart and respiratory
problems ravaging the mountain population might be
due to congenital factors or, in specific
locations, to air and water quality. But the
overwhelming majority of the chronic health
problems are self-inflicted, the consequence of
tobacco, drug abuse, fatty and sugar-laden foods,
lack of exercise and a fatalistic outlook on life
that relieves individuals of responsibility for
their own health.
While
historical abuses of the environment and workforce
may have shaped a culture of low self esteem and
malaise about the future, there is no excuse for
allowing such self-defeating attitudes to go
unchallenged. Coalfield communities must instill
healthier lifestyles through intense health
education beginning in early childhood and
continuing through high school. As President Bush
famously said: “Childrens do learn.”
Children
respond to community and adult encouragement,
expectations and rewards. Just as coalfield kids
prove they are capable of stellar achievements in
sports, like high school football, they could
improve their longer-term health and fitness if
their communities made it a priority.
Students
and health care professionals in preventive health
care public health, exercise, nutrition and
naturopathic medicine (as taught in science-based
accredited schools, not the self-taught quacks)
are the key to turning around the health of
thousands in the coalfields. But they must do more
than talk the talk. Children respond to role
models, not preaching or threats.
One
thing is for certain, the existing hodgepodge of
programs is not working well. Given limited
resources, we may need to perform a coldly
calculated triage: If a high percentage of the
region’s adult population is set on an
irreversible course of lifestyle-driven premature
disease and death, perhaps we should focus our
limited resources on the young. If we concentrate
our programs on mobilizing dedicated educators and
focusing programs where they do the most good,
perhaps we can move the statistics in the right
direction within a generation.
How
else, but through early intervention, can we alter
the fact that Appalachian adult males use tobacco
at a rate three times the national average?
Nicotine is a known threshold drug to other health
wrecking substances, particularly cocaine, meth
and prescription drugs. How else can we persuade
kids, otherwise destined to early mortality due to
obesity and diabetes, to adopt alternate
lifestyles unless we marshal our forces to teach
them better today?
Sociologists
often blame the government and coal industry for
the current lack of health care and sustainable
jobs in the coalfields. Certainly an argument can
be made that a culture of throwaway lives emanated
from decades of coal miners being expendable. In
the early and mid part of last century thousands
of miners were killed and maimed each year. For
every three soldiers killed in combat during WWI,
one miner died back home getting out the coal for
the industrial war effort.
The
deep-seated cultural preference for living for
today, based on the conviction that God has a
certain date planned for a person to die, persists
to a troubling degree in our mountain society.
Whatever historical justification there may have
been for such hopelessness, however, today is
today. Future generations must embrace
self-discipline and control what they put into
their bodies.
Indian
reservations, inner cities and coalfield
communities share the same issues of poverty,
despair and self-inflicted wounds. We accomplish
nothing by affirming well known facts over and
over. Let's get busy addressing the problems with
prevention and education. We can no longer
tolerate the idea that Appalachia is a place of
throwaway lives.
--
May 5, 2008
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