How Our Location Ranks for Health & Wealth

The southern West Virginia and Southwest Virginia coalfields developed into significant industries in the 1880s with the opening of railroads into the mountains. After peaking at 140,000 direct coal jobs in the 1940s, in WV, coal now supports 11,600 employees, or 2% of that state's workforce.
Declines in population and production have been followed by consistently high unemployment, poor health, poverty, and high rates of prescription drug addiction.

Still a major coal producing county, McDowell County, WV was recently ranked as the worst place to live in the United States (Rudd, 2016), with more than a third of its residents living in poverty and unemployment approaching 10% (Stebbins, 2017). 
This is also the center of the opioid crisis, with McDowell County possessing the highest overdose rate in the country (Raby, 2016)  at 52.8 deaths/100,000 and 6.9 deaths/100,000 from other overdoses.

McDowell county, WV is classified as a low-income, low access census tract using vehicle access per the USDA Economic Research Service. .
Not only has McDowell County been an environmentally extractive community for the length of this coal intervention, coal owners are not co-located in the area and profit does not return.

The last twenty-five years has seen the development of an ATV trail system, which offers some development for hospitality business owners, but the accompanying jobs for hire fall far below that of a coal wage, and are mostly low or minimum wage. 

The ATV systems largely rely upon coal companies for trail access, and, can also be argued to be environmentally degrading (Cochran, ).

There is no Plan B for significant economic development through government and little political will. (Huey Perry; Shannon Bell).


INCOME AND HEALTH

• Poverty rate 33.2% per DataUSA. (All data below is from the same place)
• Median household income is $27,682 compared to WV at $36,711 and US $62,843.
• Incidentally, the average male salary in WV is $59K whereas the average for females is $42K.
• Patient to primary care physician ratio is 3,645 to 1.  (Mercer County is 1,598 to 1) 

Behavioral health – percentage of population affected with

• Major depressive episode – 8.26% - highest in US
• Adults with serious mental illness – 5.18% - one of highest 11 states in US
• Opioid overdose death rate – 43.4 deaths per 100,000 people (age-adjusted) – highest in US
• Drug overdose death rate – 52 deaths per 100,000 people (age-adjusted) – highest in US

Health risks

• Adult obesity – 44.9% prevalence – highest in WV
• Diabetes – 17% prevalence
• Adult smoking – 31.4% - highest in WV