Health Behaviors in Rural Appalachia

Aasha I. Hoogland, Charles E. Hoogland, Shoshana H. Bardach, Yelena N. Tarasenko, Nancy E. Schoenberg

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


s To better understand the disproportionate burdens from cancer, cardiovascular disease, diabetes mellitus, stroke, and other chronic conditions related to energy balance, we studied diet and physical activity patterns in younger and older adults in rural Appalachia by using a nonclinical, cross-sectional, community-based sampling approach. Methods A total of 651 younger (ages 18-59) and 254 older (ages ≥60) Appalachians were recruited from 43 churches or community organizations. Participants answered questions about fruit and vegetable intake and physical activity. Analyses were adjusted for clustering within churches. Results Compared with older Appalachians, younger Appalachians consumed significantly fewer fruits and vegetables (P = 0.01) and reported significantly more moderate-to-vigorous physical activity (P = 0.01). Regardless of age, engagement in healthy behaviors was suboptimal and well below national averages. Conclusions This community-based sample demonstrated elevated behavioral risk factors that likely contribute to some of the nation's highest rates of premature mortality. Despite suboptimal dietary intake and physical activity, results indicate some potential leverage points between the generations that may be used to improve health. For example, the older generation could benefit from engaging with their younger relatives in physical activities while advocating for a better-rounded diet. Given traditions of intergenerational connectedness, mutual aid, and self-reliance, transmission of healthier behaviors across the generations may be beneficial in the rural Appalachian context.

Original languageEnglish
Pages (from-to)444-449
Number of pages6
JournalSouthern Medical Journal
Issue number8
StatePublished - Aug 1 2019

Bibliographical note

Publisher Copyright:
© 2019 Lippincott Williams & Wilkins.


  • Appalachia community-based
  • diet
  • nutrition
  • physical activity

ASJC Scopus subject areas

  • General Medicine


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