Those living in Appalachia have long been accustomed to the idea there are greater risks to our health here than in many other regions. New research from the American College of Surgeons confirms that, while cancer diagnoses and deaths are decreasing in Appalachia, the numbers are still significantly higher here than in other parts of the U.S.

And where are we at greatest risk?

The central subregion — a small part of southern Ohio, Kentucky, Tennessee, West Virginia and Virginia — has the highest rates of cancer incidents and deaths among the larger Appalachian region.

“The experiences of people living in different regions of Appalachia, particularly in the coal mining areas of eastern Kentucky or West Virginia, are vastly different than it is for individuals in other places,” wrote Todd Burus, a data scientist at the Markey Cancer Center of the University of Kentucky and first author of the Journal of the American College of Surgeons study. “With this research, we sought to understand those unique regional differences to learn how we can better improve cancer screening and treatment strategies.”

It’s not just that we have a higher risk of cancers here. We have a higher rate of deaths from cancers that can be caught early.

Access to affordable health care and attitudes about routine screenings are a problem, too.

In fact, central Appalachia has a complex mix of challenges when it comes to cancer instances and deaths, “stemming from limited access to care in rural regions, historical occupational risks from coal mining and other hazardous industries, and higher poverty rates. Other factors, such as higher prevalence of obesity, smoking, and lower HPV vaccination rates, also likely contribute to the widening disparities,” according to the study.

As policy makers focus on improving awareness and access to health care, Dr. B. Mark Evers, senior author of the study and director of the Markey Cancer Center, thinks it is important for that effort to be made at the local level.

“Being able to understand where these disparities exist at the county level within Appalachia allows us to better focus our screening techniques and prevention strategies,” Evers said.

As we do our best to prevent by educating about the risks of smoking, abusing alcohol, living a sedentary lifestyle and eating unhealthy foods, policymakers can focus on reducing our environmental and industrial risks and aim for better access to affordable, quality screening and other healthcare.

“There are reasons for hope and opportunities to increase access to preventive care in at-risk populations throughout Appalachia, especially as we learn from this data where to focus on some of these problems that have been persistent for decades,” Evers said.

We have the data, we know which tools we need to use. Now the question is whether we want to save lives by putting it all to use.