Space-Time Patterns of Mortality and Related Factors, Central Appalachia 1969 to 2001
Striking inequalities in wealth, education, and health divide Appalachia’s population. A spatiotemporal information system was used to explore transformations in the spatial patterns of central Appalachia’s county-level mortality rates between 1969 and 2001 in relation to several socioeconomic variables. High rates of poverty in Appalachia have deep roots, but the implementation of development policies since the 1960s suggests that differences between Appalachian and non-Appalachian areas should have decreased. The results reveal that the complex interaction between mortality rates and associated socioeconomic factors remains relatively constant through time, and improvements in mortality, as well as health, education, and economic development, are occurring. Nonetheless, inequality persists in central Appalachia with the increasing clustering of relatively high mortality rates in Appalachian Kentucky and West Virginia. These clusters are not associated with the borders of Appalachia but with state borders, suggesting that state-level processes are strongly influencing health outcomes.
Urban and Regional Information Systems Association Journal, Vol. 20, No. 2, 21-31.