This study assesses the relationship between access and outcomes related to health care services across five central Appalachian states. Statistical techniques examined the availability of accessibility to health care services in comparison to mortality rates and several socioeconomic variables across five central Appalachian states. The analyses revealed underserved areas in eastern Kentucky and West Virginia are associated with areas of high mortality and high levels of socio-economic deprivation.

Detailed assessment reveals that a complex set of relationships exists among health service availability. Health service providers and facilities are unevenly distributed across the study areas. The areas with the least access are located in south and central Appalachian Kentucky and West Virginia. Residents of the underserved areas are traveling as long as 75 minutes for appropriate services. The analysis shows a close relationship between travel time and mortality, poverty and education.

The results indicate that hospitals are unevenly distributed and longer travel times impact health status. Some of the highest death rates in the nation are clustered in Kentucky and West Virginia.