Appalachian

Transcultural Project
By: Katie, Natalie, Reagan, Shelby, Bianca,
Maci
  –The Appalachian region is a 205,000-square mile region that
follows the spine of the Appalachian Mountains. (Southern New
York to Northern Mississippi).
 –This region includes 420 counties across 13 states, including
Overview Alabama, Georgia, Kentucky, Maryland, Mississippi, New York,
North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee,
Virginia, and West Virginia.
 –Though many individuals would define Appalachia as a place, the
culture of the Appalachian people is important to understand and
is often overlooked because of some of its unique characteristics.
Overview
  –Appalachian people are considered a
different culture and consist of people from many unique
backgrounds, including Native Americans, Irish, English and
Scotch, and descendants of German and Polish immigrants.
Overview  –The Appalachian Mountains isolated individuals who lived in the
area from the influences around them and thus created a new
culture.
  –People of the Appalachian culture are known for being very
independent. They use a lot of their own resources and are known
for hunting and growing their own crop. The Appalachian area is
extremely rich in natural resources. Appalachian people are very in
touch with nature.
 –In the past, the Appalachian region was deemed democratic but
in recent years it has shifted to be more Republican. Economic
changes have made Republican views more appealing to many
Overview Appalachian people.
 –The Appalachian region is also known for having a high rate of
illiteracy. Many individuals are uneducated. However, over the
years, there has been improvement in the education in
Appalachia. In 2019, the number of Appalachian adults over the
age of 25 with at least a high school diploma has risen to 87%.
 –Appalachian people typically tend to be landowners, politicians
or businesspeople if they are wealthier, or coal-miners, loggers or
factory workers for those Appalachian people who are poorer.
  –Overall, the Appalachian area is known for being very poor due
to it be isolated from urban growth centers but the area has
improved over the years and is not as poor of an area as it what is
the past.
 –An Appalachian Regional Committee (ARC) was created in
Overview attempt to lower the poverty rate and increase the education in
this area. The goal was to overall improve the economy, which it
did. However, this region is still considered poor and uneducated
in comparison to other areas.
  Overall healthcare beliefs

 Appalachian people are extremely family oriented, which means that they seek medical
care from their family members before they go to see a doctor or nurse practitioner

 Family involvement must be incorporated into the plan of care for the patient and hospital

Health Care policies

Practices  When they need to be seen by a doctor or health care professional it is normal for most
members of the family to come observe the consultation and treatment

 People living in Appalachia are more likely to have health care insurance compared to
other Americans
 Resistant and hesitant to receive vaccines and immunizations
 Do not often participate in preventative health screenings

 Traditional practices
 Appalachian traditional health care systems include herbal remedies, folk beliefs, and lay
practitioners
  Magicoreligious Beliefs

 Use combinations of religious texts, traditional herbal medicine, and

down-home remedies to treat those in their communities
Health Care
Practices  Folk magic, faith healing, superstitions, and granny magic are all
religious beliefs that relate to their system of health care

 "Granny Magic" is making a resurgence in popularity as the

Appalachian people are reembracing their heritage
  Rehabilitation

 There are rehabilitation services available to Appalachian

Health Care people, but because of transportation barriers and lack of providers
these services can be hard for them to use.
Practices
 Transplantation

 Hesitant but not opposed to receiving transplants

  Self-medication
 White pine, black pine, ginseng, windroot, apple root, elderberry,
boneset, phytolacceaceae (pokeweed), and lycoperdaceae (puffball)
 Pain/sick role
 Often appear stoic
 Rely on health care professionals to see their nonverbal cues
Health Care  Have difficulty describing pain

Practices  Mental health barriers

 Appalachian people report higher rates of mental health problems
compared to the United States population
 Limited access to transportation
 Distance to treatment facilities
 Shortage of treatment providers
 Values of individualism and self-reliance
  Perception Of Providers
Health perception was significantly worse in residents within
Health Care communities in Appalachian counties compared to non-
Practitioners Appalachian community residents.
Black residents report significantly better health perceptions than
do white residents.
  Folk Practitioners/ Practices
People in Southern Appalachia gradually accepted professionals as
Health Care experts in the early 20th century, but the practice or use of folk
Practitioners medicine has declined.
Appalachian folk healers and folk medicine do not give credit to
those practitioners who have earned their title.
  Gender and Health Care
More women work park-time.
Health Care Women’s and men’s practice patterns and characteristics are similar
except that women are more likely to provide prenatal and do
Practitioners vaginal deliveries.
Physician's practicing are largely graduates of medical schools in or
near the region.
 Tobacco use in the Appalachian Culture
Deaths from heart disease, cancer, and chronic lower respiratory
disease occur more frequently in Appalachia than in the rest of the
country.
High-Risk On average, Appalachians die from COPD at a rate that is 31%
Behaviors higher than the rate for residents in the rest of the country.
Smokeless tobacco use is higher in Central Appalachia due to
coalworkers not being able to light up a cigarette or other form of
tobacco inside the mine.
 Alcohol use in Appalachian Culture
Studies have shown that fewer Appalachian adults drink alcohol
compared to adults in the rest of the country.
High-risk Adolescents in the Appalachia culture have higher rates of heavy
Behaviors alcohol use than older people.
 Substance Abuse
Over the past 2 decades substance abuse rates have been rising in
Appalachian culture.
Prescription medications, specifically opioids, are abused at rates
exceeding national averages in rural Appalachia, resulting in a
negative impact on the health of the overall population.
High-risk Central Appalachia has a higher rate of non-medical drug use. This is
Behaviors because Central Appalachia has a large number of physical laborers
such as, coal miners and loggers, making the population prone to
workplace injury and chronic pain.
Central Appalachia has a high rate of Hepatitis C and HIV due to
injection of substances which has increased the regions social and
economic burdens.
 Physical Activity & Diet
Appalachian people are at greater risk for obesity and obesity-related
chronic illnesses than non-Appalachian counties.
Studies have found that people in Appalachia are less likely to be
physically active.
Contributing factors to the lack of physical activity are the rural areas
not having: sidewalks, easily accessible parks, commercial and public
High-risk recreational facilities, and various organized recreational leisure
opportunities that are commonly found in urban areas.
behaviors Appalachian diets today are high in meat and saturated fat as compared
to fruits and vegetables being more common back in the day. Their diets
consist of junk foods rather than fresh, organic, healthier choices due to
economic reasons. 18% percent of Appalachian people are living below
the poverty line, so the price difference between fresh ingredients and
fast food is significant for many families.
Examples of some traditional Appalachian foods include soda, sweet
tea, and fried cornbread.
 Safety
The Appalachian Region has
higher traffic fatality rates than the rest of the United States.
Appalachian youth and young adults 15–24 years of age have the
highest traffic fatality rates at 18.8 fatalities per 100,000 people.
Traffic fatality rates among Appalachian pedestrians and cyclists
are lower than non-Appalachian. This is likely due to a lower
High-risk prevalence of walking and biking in the region, rather than traffic
safety.
Behaviors In Appalachia, rural fatality rates
are 64% higher than urban fatality rates.
Nearly one-fifth of all Appalachian drivers involved in fatal traffic
crashes are alcohol-impaired. While driver alcohol impairment is
slightly lower in Appalachia than non-Appalachia, it is still very
high, especially among men aged 20 to 34 and drivers involved
in crashes during the late night and early morning hours.
 The Bell
 The local church bell would chime to alert others a death has occurred.
 Family and friends stop what they were doing and gather to comfort
the loved ones of the deceased.
 Immediate family would make funeral preparations for burial, women
Death Rituals would bring food, men would leave fields to dig a hole for the
grave, and the local carpenter would build a coffin.
 After the bell chimes, every mirror in the house would be covered with
dark cloth and curtains would be closed.
 Swinging hands on clocks were also stopped to record the time of
death and allowed time to stand still for the deceased.
 Preparing the Body
 The deceased would be "laid out" by being placed on a cooling
board and two chairs so that their body could be stretched out
straight.
 The body would then be covered with a sheet and tied with a rope.

Death Rituals  Saining, a blessing, was then performed to protect the body.
 Additional measures were taken to prevent skin
discoloration, eyes opening, or the corpse from rising.
 Once the corpse in place, it would be washed with soap and water
then dressed in their best attire.
 The body was never left alone until it was time for burial.
 Sitting Up with the Dead
 Houses were made with two front doors.
 The custom of "sitting up with the dead," also known as a "wake," is
when the body would be placed in the coffin for viewing.
 Handmade quilts, flowers, and herbs would be placed over the body
Death Rituals in the coffin
 Items were placed in the coffin such as jewelry, tobacco, pipes, toys,
a bible, and every once in a while, an alcoholic beverage
 Grave decorations included personal effects, toys, shells, rocks,
pottery sherds, wildflowers and weeds, plant or vegetable
wreaths, crepe paper flowers
 After the day of the wake, the body would be loaded in a wagon and
taken to the church for the funeral service as family and friends
walked behind it dressed in all black.
 Today's Rituals and Bereavement
 The modern funeral industry has altered these customs.
 The social dimension has changed now that caskets are
commercially produced, graves are seldom and dug by hand, and
Death Rituals modern funeral homes made burial more convenient.
 The downside of modern ritual is less personal involvement.
 The Appalachian culture is now known for open-casket funerals,
burial rather than cremation, and burying the dead in areas not
designated as cemeteries, such as the hillside.
 Religious Practices
 Christianity has been the longest standing religion
in the Appalachian culture. Religion for the
Appalachian people is based off independence and religious
hierarchies. Both stem from the evangelical tendencies
of the pioneers. Protestantism is the most used
denomination in Appalachian culture.
Spirituality  Many of the 18th/19th century traditions are still seen today in the
Appalachian culture. Some of these traditions include
chanted preaching, congregational shouting, snake handling, and
foot washing. A popular one is called "water baptism". On any
Sunday, a request for water baptism can be made. This
symbols their faith in Jesus Christ. The water does not wash away
the sins but means the person has become a new creature in
Christ.
Spirituality
 Use Of Prayer
 Praying is an everyday part of the lives of the Appalachian
culture. They pray at the beginning of each day in their chapel,
Spirituality pray before each meal, and at the beginning and end of each
workday with those they serve. They believe that praying helps
strengthen their spiritual bond. They believe that praying helps
strengthen their ability to love , the kind of love that heals
wounds, stops oppression, and builds new life.
 Meaning Of Life
 The Appalachian people believe that spirituality and religion is
what makes up their humility, family structure, self-efficiency, and
Spirituality hospitality.
 In Appalachian culture, they believe in evil and good constantly
working in the world.
 Their meaning of life is their faith and doing good by God.
 Individual Strength
• Since spirituality/religion plays such a huge role in the Appalachian
people, all of their individual strengths stem from it. The
Appalachian people feel that in order to be a true Appalachian
individual , you have to have individual strengths in areas such as
faith, god, community, family, honesty, independence, and self-
Spirituality reliance.
 Appalachians are a proud to value independence and taking care
of themselves and their family. They are also proud to have good
morals and to always do right for themselves, their family, and
God.
 Spirituality and Health

 In the Appalachian culture, health is defined as "the absence of illness and

the ability to meet their own basic needs". Mothers are the primary care
takers and stand as the gatekeepers for health. They make most of the
decisions such the as the food they eat in the household. Family and
Spirituality church are perceived in similar ways, so if there is a health problem within
the family, it often extends to the church so they can help. Appalachians
rely on support from faith, family, and friends when dealing with a health
problem.
 Physical and mental health are perceived differently in this culture. They
view mental health negatively and really only believe in physical health.
So when someone is having a mental health issues, they view all the
emotional symptoms as physical, seeking medical treatment rather than
therapy.
 Appalachian people may delay getting care for medical problems until
they are debilitating. This may be due to not trusting medical
professionals, lack of insurance, limited access to care, or waiting for