Southwest Virginians continue to have some of the state’s poorest health outcomes and face some of its most challenging health factors, according to a new report.
Nine cities and counties in the far southwest corner of the state rank near the bottom of all localities statewide according to the 2022 County Health Rankings report compiled by the University of Wisconsin Population Health Institute. The annual report ranks each locality in every state based on a series of health outcomes and the underlying factors that influence health, such as access to clinical care, food insecurity, alcohol and drug use.
The cities of Bristol and Norton, along with Buchanan, Dickenson, Lee, Russell, Smyth, Tazewell and Wise counties all rank among the bottom 25% of Virginia’s 133 localities, according to the report.
Northeast Tennessee fared somewhat better with Sullivan and Washington counties ranking in the top third of that state’s 95 counties, while Carter, Hawkins and Johnson ranked near the middle, the report shows.
People are also reading…
The rankings in health outcomes are based on how long people live and how they feel while alive. Health factors are what influences health, including health behaviors, access to clinical care, social, economic and physical environment factors.
The new rankings closely mirror prior reports for a region beset by high rates of diabetes, cancer, obesity, alcohol and drug abuse and premature death. All conditions that the Health Wagon sees and treats on a daily basis, said President and CEO Dr. Teresa Tyson.
“It just shows how the need for health care still exists. We’re so grateful they expanded Medicaid but it’s a fallacy that everybody has some type of insurance. They simply do not,” she said. “They make a little too much for Medicaid and we have patients with Medicare who can’t afford co-pays and deductibles. We’re all about removing those barriers to health care access.”
In 2021, Health Wagon providers treated more than 10,000 patients and had more than 35,000 patient encounters. Many of those occurred in mobile units where health care was delivered in parking lots in towns across the region.
The study, for example, examined length of life by reviewing the total number of deaths that occurred in a year among people below the age of 75. Each locality in Southwest Virginia scored well below the state average with Tazewell and Smyth counties ranked at the bottom.
The study also documents health factors, including adult smoking, adult obesity, food environment, physical inactivity, access to exercise opportunities, excessive drinking, alcohol-impaired driving deaths, sexually transmitted infections and teen births.
This region’s health issues were made worse by COVID-19, she said.
“People are not getting their cancer screenings. We’ve got events geared toward getting back to regular pap smears, mammograms, colorectal cancer screenings, because all that was on the backburner,” Tyson said.
The study also looked at how many people have no health care insurance, the ratio of primary care physicians, dentists and mental health providers to the number of residents. Other factors measured include educational attainment, unemployment, children living in poverty, crime rates and physical issues including the quality of housing people reside in.
“We know that we have one of the most vulnerable populations in the nation. We strive every day to turn back these numbers and the health care disparities,” Tyson said, adding. “Virginia has more [economic] disparity than any other state in the nation.”
A part of this region’s health crisis is connected to its economic struggles.
Some sections of Virginia are among the most affluent in the nation. Three Virginia counties — all just outside Washington, D.C. — rank among the 10 wealthiest in America, with Loudoun County ranked number one in the nation, according to Forbes.
It is no coincidence those three — Loudoun, Fairfax and Arlington counties — rank third, fourth and second, respectively, atop the state’s health rankings.
At the opposite end of the spectrum is Dickenson County which the U.S. Census ranked as the poorest county in Virginia based on per capita income, median household and family income.
Correspondingly, Dickenson County had this region’s lowest health ranking and among the 10 lowest in Virginia. Its ratio of residents to primary care providers is three times the state average – meaning it’s three times more difficult to get access to basic health care than the average Virginia community.
Its jobless rate is nearly 2% higher than the state average, it has twice the number of children living in poverty compared to the Virginia average and the ratio of patients to dentists is 10 times the state average.
Oral and dental health was long the region’s overwhelming need during the Remote Area Medical Clinics held over the past two decades in Wise County, Tyson said. After helping bring those events and seeing the overwhelming need, Tyson and her team will break ground next week on a new state-of-the-art dental clinic in Wise.
“It was always our dream to have our own dental facility,” she said. “[At RAM] we had people come a week ahead, stand in the hot sun, sleep in their cars. We wanted to offer a more permanent solution for the oral health needs of Southwest Virginia and beyond. So many people came here year after year to help and give us hope we could have a project of this magnitude.”
Dr. Olivia Stallard will oversee the dental clinic, working with volunteer providers and dental students from Lincoln Memorial University’s new College of Dental Medicine, Tyson said. It is expected to open this fall.