Giving coal country a healthy makeover

One of the least healthy places in the United States is taking an unexpected shift toward better health. In West Virginia's coal country, a growing health gap is fueled in part by shrinking industry and prosperity. Hari Sreenivasan reports on how health workers and community leaders in Williamson are trying to turn that around with greater medical access, healthier food and a stronger economy.

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    West Virginia is a state that sees more than its share of economic hardship and tough times. When Gallup compiled a list of the most miserable states in the U.S. earlier this year, West Virginia came in number one.

    Less than half of residents there describe themselves as thriving, and they also report low levels of life expectancy and household income. But in the southwest corner of the state, a movement is under way to change that by changing its approach to health and its place in the community.

    Once again to Hari Sreenivasan.


    Williamson, West Virginia, has been known for a few things over the years: as a coal town, a mountain town, a feuding town made famous by the Hatfields and McCoys. But Williamson, West Virginia, has never been a running town.

    In fact, it's one of the least healthy places in the United States. So the fact that hundreds of locals are now showing up for monthly 5K races is a sign of something deeper here, an unexpected shift toward better health in coal country.

    Dr. Dino Beckett is among those responsible for the new energy. When he moved back home after medical residency, Beckett's main goal was expanding basic health care in this part of the state.

    DR. DINO BECKETT, Williamson Health and Wellness Center: Everyone was like, 'Why would you go back to southern West Virginia to practice medicine?' And I really couldn't think of a better place to be, because it was such a joy to grow up here and have these people look out for you and help you with whatever was going on in your life.


    More so, Beckett thought he could do something about the challenges they faced, including some of the highest rates of diabetes, hypertension and obesity in both the state and the nation.

    Nearly a quarter of the city's 3,000 residents live below the federal poverty line. And to make matters worse, the coal industry has been shedding jobs by the thousands in recent years, wiping out much of the area's private health insurance base.


    Mr. Charles, how are you doing?


    Before he found Dr. Beckett, Herb Charles was among the unemployed coal miners who had simply stopped going to the doctor. His family qualified for Medicaid like many in this area, but for the longest time, he couldn't find a primary care physician who would accept it.


    I'm going to take a listen.


    Beckett's first idea to fill the growing health gap was to open a free clinic.


    We had it once a month, and we became inundated with patients that didn't have insurance, so we decided to start having it more frequently.


    But that wasn't nearly enough either. Eventually, he met up with Monica Niess and Selim Sandoval, who work with a consulting company called The Write Choice Network.

  • SELIM SANDOVAL, Write Choice Network:

    That goes in the sink, honey.


    The couple travel the country in an R.V. with their two little girls, helping communities like Williamson apply for government dollars to establish what is known as federally qualified health centers, or, more simply, clinics that treat people regardless of their insurance status, usually in low-income communities.

    These centers receive a big financial boost under the Affordable Care Act. And after Niess and Sandoval's successful application, one came to Williamson. It changed the game.

  • MONICA NIESS, Write Choice Network:

    Instead of having programs that are coming and going and depending on grant funding, by rolling them under the health umbrella of the health center, and being able to use our federal funding, as well as our revenue generation to support these programs, it sustains all of these programs and all the efforts into the future.


    The Williamson Health and Wellness Center opened earlier this year with 13 staff members able to see anyone who comes through the door, from the elderly to newborns.

    But the center's most aggressive fight is taking place outside these walls. Vicki Hatfield is a nurse practitioner with the Diabetes Coalition, the outreach wing of the operation.

  • VICKI HATFIELD, Mingo County Diabetes Coalition:

    I always say, if you can't treat diabetes as a practitioner in southern West Virginia, you better move. Because you're going to see a lot of it.


    She says nearly 14 percent of the local population is diabetic.


    You look so pretty.


    Hatfield and her colleagues visit the most worrisome of these patients, like Jeanette Hunter, directly in their homes.


    Can you tell me where I'm touching?


    They check vital signs, monitor insulin intake and, perhaps most important, offer practical advice on day-to-day habits.


    I always say, it has to be more than medicine.


    It's meant that, in recent months, Hunter's blood sugar level have stabilized, from consistently high to nearly perfect.


    Keep up the good work.


    OK. Thank you.


    Leaders here say the next step to getting the whole town healthy is to boost the economy and increase access to healthier food. But that part of the plan is still under construction, literally.

    Remember Herb Charles, the unemployed coal miner? Just the other day, he was hired full-time by a construction company that is currently restoring an old building downtown. When the dust clears, the so-called Health Innovation Hub, another offshoot of the Health Center, will serve as a space for budding entrepreneurs to find the support they need to open more businesses, like Debbie Young's new restaurant, 34-8, which opened its doors just a few weeks ago after similar support from the Health and Wellness team.

    Young plans to serve healthy food, some of it from the health coalition' new community garden, and perhaps someday from the farm being developed on a reclaimed strip mine several miles away.

    ERIC MATHIS, Williamson Health and Wellness Center: Right here is what you all are going to help us design for growing specific foods for farmers market.


    Eric Mathis, the Health and Wellness Center's outreach coordinator for these projects, says it all shows that a new economy is emerging in the region.


    We're looking forward to a day that is coming, coming soon, to where Central Appalachia can look out to the rest of the United States and say, 'Catch up with us. We're the innovators.'


    But that's a tough sell for many locals. Fred and Donna Baldwin have lived in this area their entire lives. They watched as the local economy collapsed, Fred lost his job in the mines, and their children moved away. They're skeptical that sustainable Williamson can repair what has been lost.


    I'm afraid that it won't be enough, because the way the economy is going, I'm afraid that it's going to become a ghost town. And I would hate to see that happen, because we will lose a lot.


    It's not hard to find others who agree, but there seems to be just as many Williamson residents getting caught up in the optimism. On this Saturday, there's a new farmers market overflowing with locally grown produce. Lively music. Even a belly dancing troupe.

    Almost everyone agrees the new energy is a welcome sight. The trick, they say, will be to keep it moving.

    Sustainable Williamson received one of six Robert Wood Johnson Culture of Health awards, chosen from 250 entrants. The Robert Wood Johnson Foundation has been an underwriter of PBS NewsHour.

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