By Kelly Lenox, National Institute of Environmental Health Sciences
For the latest in her series of community forums, Linda Birnbaum, Ph.D., director of NIEHS and the National Toxicology Program, visited southeastern Kentucky for the Appalachian Health and Well-Being Forum. Before the July 25 event at the Letcher County Cooperative Extension Office in Whitesburg, Birnbaum visited community groups, health organizations, and a clinic in the region.
The University of Kentucky (UK) served as host. They and other organizers targeted the Appalachian region’s long-standing disparities in health and well-being, by focusing the event on innovative programs, stories of success and lessons learned, and potential resources.
“The visit painted a hopeful picture of the strength of the mountain communities and the dedicated health professionals who are not only delivering top notch care, but also listening to the needs of the people,” said Heather Henry, Ph.D., from the NIEHS Hazardous Substances Research Branch, which oversees Superfund Research Program (SRP) grants.
Organizers emphasized the importance of community and sense of place in Appalachia. “Health is not [simply] the absence of disease,” Birnbaum said at the forum. “We need to be looking at the health of the whole community.” She spoke as part of a panel that included four others.
- Moderator Ernie Scott, director of the Kentucky Office of Rural Health.
- L. M. (Mike) Caudill, CEO of the nonprofit Mountain Comprehensive Health Corporation in Whitesburg,
one of the largest rural health centers in Kentucky.
- Dawn Brewer, Ph.D., assistant professor in the UK Department of Dietetics and Human Nutrition.
- Frances Feltner, D.N.P., head of the UK Center of Excellence in Rural Health in Hazard.
Birnbaum pointed out that NIEHS research on how the environment impacts health provides information to both decision-makers and individuals. “Knowledge is power,” she said. “If you know something is wrong, you can work to fix it.”
After the meeting, Brewer reflected on the panel’s interaction with the groups and perspectives represented in the audience. “The forum gave attendees the opportunity to share information about their programs with one another, which resulted in collaborations forming between various organizations,” she said, noting that connections she made there are already helping to open doors for collaboration and further work in the region.
From University to Appalachia
A day earlier, in Lexington, Birnbaum and staff met with university officials and with researchers and trainees in the UK Superfund Research Center (SRC). Several of the SRC scientists joined the visits to the southeastern part of the state and assisted at the forum.
In Hazard, Feltner led Birnbaum and the group on a tour of the Center of Excellence in Rural Health (CERH), which addresses health disparities by educating health professionals, offering health care, and engaging the community. Feltner emphasized that many factors play a role in health and well-being. “Poverty has a lot to do with access and health,” she said, citing the case of a cancer patient who had to take a bus to get treatment and then return alone, suffering from nausea.
After the tour, the area’s natural resources and economic resources took center stage, during a working lunch with representatives of local groups.
Research Enhances Local Efforts
In Whitesburg later, the group met with NIEHS grantees conducting community-based participatory research, and visited local organizations and the Mountain Comprehensive Health Corporation (MCHC) clinic.
MCHC doctors participate in the FARMACY program, which supports healthy eating for individuals experiencing conditions such as obesity, cardiovascular disease, and pregnancy. The physicians write prescriptions for fresh produce, redeemable at the local farmer’s market.
How nutrition may lessen the effects of environmental exposures is one topic studied by scientists at the SRC. “This trip puts meaning behind our research,” said Bernhard Hennig, Ph.D., SRC director. Henry agreed. “The UK SRC program and local efforts to improve health in the Appalachian region really enhance one another,” she said.
The FARMACY program also helps create demand for farming jobs, providing more options in an area where coal jobs are quickly disappearing.
Community, Commitment, and Collaboration
John Schelp, NIEHS special assistant for community engagement and outreach , observed further connections between research and practice. “At the [MCHC] health clinic, while visiting wards from maternity and child health to diabetes and the largest black lung clinic in the country, I was struck by how NIEHS research touches on every one of those areas,” he said.
“There’s an infectious sense of community, commitment, and collaboration among the people of eastern Kentucky,” noted NIEHS legislative liaison Jed Bullock. “Their efforts speak volumes about the value of the SRP and NIEHS research, because they are the direct beneficiaries, putting this research into action to create healthier lives.”