Invited Commentary

Commentary on "Trends in Cigarette Smoking Obesity in Appalachian Kentucky"

Authors: Francisco Soto Mas, MD, PhD


In this issue of the Southern Medical Journal, Schoenberg and colleagues not only explore the role of smoking and obesity in mortality and morbidity rates in Appalachian Kentucky but they also present a case that further supports the need for analyzing health problems with socio-ecological lenses.1 This is particularly true in marginalized populations that experience prejudice, discrimination, and racism; barriers to education, public services, and decent housing; and the burden of underemployment, inequalities, and isolation. Marginalized populations experience considerable health disparities that undermine our communities and these disparities can be addressed only through more integrated approaches that include effective responses to their pressing individual, social, environmental, and economic needs.

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1. Schoenberg NE, Huang B, Seshadri S, et al. Trends in cigarette smoking and obesity in Appalachian Kentucky. South Med J 2015;108:170-177.
2. Halverson JA, Byrd RC, Ma L, et al. An Analysis of Disparities in Health Status and Access to Health Care in the Appalachian Region. Charleston: Office of Social Environment and Health Research (OSEAHR)/Prevention Research Center, West Virginia University; 2004.
3. Halverson JA, Bischak G. Underlying Socioeconomic Factors Influencing Health Disparities in the Appalachian Region. Charleston: Mary Babb Randolph Cancer Center/Office for Social Environment and Health Research, Department of Community Medicine, West Virginia University; 2008.
4. Fenelon A, Preston SH. Estimating smoking-attributable mortality in the United States. Demography 2012;49:797-818.
5. Al Snih S, Ottenbacher KJ, Markides KS, et al. The effect of obesity on disability vs mortality in older Americans. Arch Intern Med 2007;167:774-780.
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