As the COVID-19 virus swept across the nation in spring 2020, infection and hospitalization rates in states like West Virginia remained relatively low. By that July, each of Appalachia's 423 counties had recorded confirmed cases. The coronavirus pandemic has taken an enormous toll on the health of individuals and institutions throughout the region—a stark reminder that even isolated rural populations are subject to historical, biological, ecological, and geographical factors that have continually created epidemics over the past millennia. In Appalachian Epidemics: From Smallpox to COVID-19, scholars from diverse disciplinary backgrounds assess two centuries of public health emergencies and the subsequent responses. This volume peers into the trans–Appalachian South's experience with illness, challenging the misconception that rurality provides protection against maladies. In addition to surveying the impact of influenza, polio, and Lyme disease outbreaks, Appalachian Epidemics addresses the less-understood social determinants of health. The effects of the opioid crisis and industrial coal mining complicate the definition of disease and illuminate avenues for responding to future public health threats. From the significance of regional stereotypes to the spread of misinformation and the impact of racism and poverty on public health policy, Appalachian Epidemics makes clear that many of the natural, political, and socioeconomic forces currently shaping the region's experiences with COVID-19 and other crises have historical antecedents.

Often referred to as the leader of inspiration in Appalachian studies, Helen Matthews Lewis linked scholarship with activism and encouraged deeper analysis of the region. Lewis shaped the field of Appalachian studies by emphasizing community participation and challenging traditional perceptions of the region and its people. Helen Matthews Lewis: Living Social Justice in Appalachia, a collection of Lewis's writings and memories that document her life and work, begins in 1943 with her job on the yearbook staff at Georgia State College for Women with Mary Flannery O'Connor. Editors Patricia D. Beaver and Judith Jennings highlight the achievements of Lewis's extensive career, examining her role as a teacher and activist at Clinch Valley College (now University of Virginia at Wise) and East Tennessee State University in the 1960s, as well as her work with Appalshop and the Highland Center. Helen Matthews Lewis connects Lewis's works to wider social movements by examining the history of progressive activism in Appalachia. The book provides unique insight into the development of regional studies and the life of a dynamic revolutionary, delivering a captivating and personal narrative of one woman's mission of activism and social justice.

A searing, on-the-ground examination of the coal industry—and the workers left behind—in the midst of an environmental crisis, addiction, and rising white nationalism. The past few years have highlighted the paradox at the heart of coal country. Despite fueling a century of American progress, its people are being left behind, suffering from unemployment, addiction, and environmental crises often at greater rates than anywhere else in the country. But what if Appalachia’s troubles are just a taste of what the future holds for all of us? Appalachian Fall tells the captivating true story of coal communities on the leading edge of change. A group of local reporters known as the Ohio Valley ReSource shares the real-world impact these changes have had on what was once the heart and soul of America. Including stories about the miners striking in Harlan County after their company suddenly went bankrupt, bouncing their paychecks; the farmers tilling former mining ground for new cash crops like hemp and maple syrup; the activists working to fight mountaintop removal and bring clean energy jobs to the region; and the mothers mourning the loss of their children to overdose and despair. In the wake of the controversial bestseller Hillbilly Elegy, Appalachian Fall addresses what our country owes to a region that provided fuel for a century and what it risks if it stands by watching as the region, and its people, collapse.

Richard Drake has skillfully woven together the various strands of the Appalachian experience into a sweeping whole. Touching upon folk traditions, health care, the environment, higher education, the role of blacks and women, and much more, Drake offers a compelling social history of a unique American region. The Appalachian region, extending from Alabama in the South up to the Allegheny highlands of Pennsylvania, has historically been characterized by its largely rural populations, rich natural resources that have fueled industry in other parts of the country, and the strong and wild, undeveloped land. The rugged geography of the region allowed Native American societies, especially the Cherokee, to flourish. Early white settlers tended to favor a self-sufficient approach to farming, contrary to the land grabbing and plantation building going on elsewhere in the South. The growth of a market economy and competition from other agricultural areas of the country sparked an economic decline of the region's rural population at least as early as 1830. The Civil War and the sometimes hostile legislation of Reconstruction made life even more difficult for rural Appalachians. Recent history of the region is marked by the corporate exploitation of resources. Regional oil, gas, and coal had attracted some industry even before the Civil War, but the postwar years saw an immense expansion of American industry, nearly all of which relied heavily on Appalachian fossil fuels, particularly coal. What was initially a boon to the region eventually brought financial disaster to many mountain people as unsafe working conditions and strip mining ravaged the land and its inhabitants. A History of Appalachia also examines pockets of urbanization in Appalachia. Chemical, textile, and other industries have encouraged the development of urban areas. At the same time, radio, television, and the internet provide residents direct links to cultures from all over the world. The author looks at the process of urbanization as it belies commonly held notions about the region's rural character.

Tourism is the world's largest industry, and ecotourism is rapidly emerging as its fastest growing segment. As interest in nature travel increases, so does concern for conservation of the environment and the well-being of local peoples and cultures. Appalachia seems an ideal destination for ecotourists, with its rugged mountains, uniquely diverse forests, wild rivers, and lively arts culture. And ecotourism promises much for the region: protecting the environment while bringing income to disadvantaged communities. But can these promises be kept? Ecotourism in Appalachia examines both the potential and the threats that tourism holds for Central Appalachia. The authors draw lessons from destinations that have suffered from the "tourist trap syndrome," including Nepal and Hawaii. They conclude that only carefully regulated and locally controlled tourism can play a positive role in Appalachia's economic development.

Kentucky has more cancer diagnoses and cancer-related deaths than any other state in the nation, and most of these cases are concentrated in the fifty-four counties that constitute the Appalachian region of the commonwealth. These high rankings can be attributed to factors such as elevated smoking rates, unhealthy eating habits, lower levels of education, and limited access to health care. What is lost in the statistics is just how life-changing cancer can be—something that editors Nathan L. Vanderford, Lauren Hudson, and Chris Prichard have endeavored to address. The Cancer Crisis in Appalachia features essays written by a group of twenty high school and five undergraduate students, all of whom are residents of Kentucky's Appalachian region and are participants in the University of Kentucky Markey Cancer Center's Appalachian Career Training in Oncology (ACTION) program, which is funded by the National Cancer Institute's Youth Enjoy Science Program. These authentic and candid student essays detail the effects of cancer diagnoses and deaths on individuals, families, friends, and communities, and proclaim these cases as more than nameless statistics. The authors shed light on personal cancer stories in hopes of inspiring readers to avoid cancer-risk behaviors, get involved with cancer-prevention initiatives, give generously, and uplift cancer patients and their loved ones.

Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.