Publication Date



Nursing (B.S.N.)

Primary Subject Area

Health Sciences, Public Health; Health Sciences, Nursing


diabetes, Appalachia, socioeconomics, health literacy, nursing


Public Health and Community Nursing


Appalachia is a region of the United States that is characterized by high rates of poverty, low levels of education, elevated incidence of chronic disease, and inadequate healthcare. Compared to the national average, the area has an elevated incidence of Type 2 diabetes. Though this disease process is an issue that must be addressed by healthcare providers, these providers face many challenges and barriers to providing adequate care for this disease in the Appalachian population. Barriers to care include geography with limited transportation, an inadequate number of healthcare personnel, patient inability to afford healthcare, patient attitudes toward diabetes care, and the depressed economy of the region. This thesis will examine such barriers and provide suggestions for improving the education and care of patients with diabetes who reside in Appalachia.