Citizen, Heal Thyself   Poor health in coalfield communities is a national disgrace. Citizens need to mobilize schools, churches and government agencies to instruct children in healthier lifestyles.   For more than 100 years the coalfield communities of Southwestern Virginia have been characterized as economically depressed, politically oppressed, chronically impoverished, and brutally raped of their natural resources. The term “Third World” comes up often when the coalfield region’s health care system, economic see-saw and environmental degradations come into focus.   While there is plenty of historical and current data to support these negative images, inhabitants need to take matters into their own hands. There is a new sense of urgency for improving roads and public schools, high-speed Internet, public water and sewer access, enhanced mine safety and reclamation and pro-active economic development.   Despite gains in many areas, our region’s health care statistics remain shameful. Images of huge crowds at annual Remote Area Medical (RAM) health care events in Wise and Grundy are not acceptable in one of the richest states in the world’s richest nation. When under-served citizens stand in line for hours and sleep in cars overnight to have a throbbing tooth pulled or to obtain life saving medicines, it's very clear that something is very wrong.   The region’s citizens cannot entirely blame the government or health care facilities, although medical schools, health care groups and medical societies have yet to muster enough forces to adequately address the region’s critical lack of family practitioners.  Rather, the region’s poor health statistics are largely preventable. More than almost any other national sub-group, coalfield residents eat too much of the wrong foods, fail to exercise, and abuse drugs, alcohol and tobacco at alarming rates.   For example, adults in Central Appalachia use tobacco at three times the national average, squandering spending power on that expensive and deadly commodity instead of nutritious fruits and vegetables, or dental care for their children. Pregnant Appalachian women smoke at the nation’s highest rate and too often consume alcohol and drugs to the detriment of their unborn children.   It will take a mixture of increased help from the outside and self-discipline, education and action from within to change these self-destructive behaviors. A combined effort of nurses, nutritionists, naturopaths and self-taught health care advocates can make a difference. Schools can instruct children in healthy lifestyles, reduce fat and calories in school meals, allow time for recess and exercise, and get tobacco, drugs and alcohol off school property. Holding parents and caretakers more accountable for harming children with second hand smoke, drug use and alcohol abuse would make a difference as well.   The throngs of adults who attend coalfield higher education institutions should follow the examples of the Appalachian School of Law and the University of Appalachia College of Pharmacy. These graduate schools located in Buchanan County are national leaders in requiring students to engage in community services that promote healthier living, leadership and  guidance to the young generations.   It is clear that many parents and guardians will not or cannot guide their children properly regarding life-and-death issues of good health and appropriate lifestyles. Schools, colleges, state agencies, federal agencies and enlightened churches must make health education and preventative health care a priority. We cannot allow another generation of coalfield youth to become national poster children for bad choices.  Thousands of lives and billions of taxpayer dollars in treatment expenses hang in the balance.        -- December 10, 2007