Grant County, West Virginia

CASE STUDIES

Grant County, West Virginia

CASE STUDIES

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No one has the resources to take care of everything all the time, so we’re 

sharing and helping—and that has been good here. 

—Peggy Bobo-Alt, Grant County Director of Emergency Services

Filled with opportunities for hiking, rock climbing, and countless other outdoor-recreation activities, 

Grant County is described in tourism materials as the “Heartbeat of the Potomac Highlands.” Many longtime residents of this mountainous Appalachian county would agree that the land exudes a sense of health 

and vitality. 

But they would also say that life in the county can be hard, with significant barriers keeping residents 

from pursuing optimal health and well-being. That is the dichotomy of Grant County: a place rich in 

natural resources and nationally recognized wilderness areas, yet lacking in some of the basic elements 

known to contribute to good health, such as reliable access to transportation and healthy food, and steady 

employment. 

In this county spanning 480 square miles, the poverty rate is higher, and the median income lower, than in 

the nation; a greater percentage of residents live with a disability; and the population skews more toward 

older adults. Despite the resplendent landscape that beckons folks to explore the great outdoors, 

maintaining good health is a challenge for residents.

Raeky / Creative Commons 3.0 Unported

Grant County, in West Virginia’s Eastern Panhandle, is known for its natural assets, including Bear Rocks Preserve.
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Grant County is among the ten percent of Appalachian counties—and one of the eight counties in West 

Virginia—identified as a Bright Spot. It performed better than expected on 12 out of 19 health outcome 

measures. Most notably, the county performed better than expected on the following measures:

 Stroke mortality: 40 percent better than expected

 Heart disease hospitalizations: 40 percent better than expected

 Injury mortality: 36 percent better than expected

 Cancer mortality: 29 percent better than expected

 Years of potential life lost: 23 percent better than expected

These better-than-expected results are likely influenced by local conditions and initiatives created by the 

county to improve overall well-being. For instance, field research indicates that committed local health 

providers and sustained cross-sector collaboration may have played a major role in the county’s health. 

Grant County residents have also pooled resources to target specific issue areas such as care and social 

service supports for seniors, and creating transportation networks to overcome the isolation and rugged 

terrain that can be barriers to health. 

Grant County’s classification as a Bright Spot means that, on average, the county performed better than 

expected on a number of health outcome measures, given its characteristics and resources—that is, the 

socioeconomics, demographics, behaviors, health care facilities, and other factors that influence health 

outcomes. It does not mean that all Grant County residents enjoy excellent health. Like other counties 

with limited resources, Bright Spot counties face many challenges to attaining good health outcomes. But 

Grant County’s performance does indicate that certain county conditions or programs may be helping 

generate better-than-expected outcomes—and that other resource-challenged Appalachian counties may 

benefit from adopting similar initiatives.1

 1 See Table 38 in the data appendix at the end of this case study for a full list of actual health outcomes for Grant 

County compared with predicted outcomes. For details on the outcome measures, see the data files accompanying 

the report Identifying Bright Spots in Appalachian Health: Statistical Analysis.
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COUNTY OVERVIEW 

Figure 13: Map - Bright Spot Community Grant County, West Virginia 

Grant County represents a nonmetropolitan county in North Central Appalachia. It is one 

of a cluster of Bright Spot counties in northeastern West Virginia and one of the eight 

identified in the state as a whole. 

Grant County’s abundant natural assets provide a rich array of outdoor-recreation attractions, from 

spectacular mountain vistas to exceptional trout fishing. The county is home to several nationally 

recognized attractions, including the Dolly Sods Wilderness Area, Smoke Hole Caverns, and the North 

Fork Mountain Trail. Located in the western end of West Virginia’s Eastern Panhandle, Grant was 

designated by the Appalachian Regional Commission as a transitional county in fiscal year 2017. The 

county was created at the time of the Civil War from neighboring Hardy County and named for General 

Ulysses S. Grant. The area is rich in history, hosting a variety of historical structures, including Fort 

Mulligan, one of the few remaining Civil War earthen forts. 

Grant County is one of eight North Central Appalachian counties identified as a Bright Spot. Located 

within an eight-county region called the Potomac Highlands, it has just two incorporated municipalities: 

Petersburg, the county seat, and Bayard, a former coal mining community. There are nearly three dozen 

other outlying communities. 

GEORGIA

SOUTH 

CAROLINA

NORTH CAROLINA

ALABAMA

MISSISSIPPI

TENNESSEE

KENTUCKY

OHIO PENNSYLVANIA

MARYLAND

VIRGINIA

NEW YORK

WEST

VIRGINIA

Grant County, WV

Northern

Southern

Central

South Central

North Central

0 100 50

Miles
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The county has maintained a relatively stable population of about 11,800 people. Approximately 98 

percent of Grant County residents are white, and 81.9 percent have at least graduated from high school. 

The estimated median household income in 2014 was $41,039, compared with $56,135 nationally. About 

8 percent of county residents receive disability benefits, compared with 5.4 percent nationally; and 17 

percent live in poverty, compared with 15.6 percent nationally.2

The county’s top employers are in health care (Grant Memorial Hospital, Grant County Nursing Home,

and Potomac Highlands Guild), natural resources (Allegheny Wood Products, Inc., Grant County Mulch, 

Dominion Resources’ Mount Storm Power Station), or the government (the Grant County Board of 

Education). A significant number of residents continue to farm (fruit, tobacco, and grain) and breed 

livestock. 

A DEEPER LOOK AT GRANT COUNTY: COMMUNITY STRENGTHS

As in other Bright Spot communities, leaders, organizations, and residents in Grant County are using 

collaboration and resource sharing to provide a range of health care, public health, and social services. 

This includes a commitment to supporting low-income residents and sustaining a task force to discuss 

local challenges and solutions. Strong leadership has helped guide many of the county’s initiatives.

Field work helped identify local practices in Grant County that appear to be contributing to overall health, 

document effective practices that could be replicated in other counties, and identify promising practices 

and strategies that should be explored further.3 Specifically, the research found these characteristics and 

strategies in Grant County:

 Cross-sector collaboration: Government agencies and emergency services as well as nonprofit 

organizations work as a unit to benefit the community in several ways. These collaborations are 

committed to supporting low-income residents. Many of these organizations’ employees pledge 

their time to support and develop county-based services and events. People serve across several 

of the groups in collaboration, thereby increasing the flow of information between them.

 Resource sharing: Several initiatives pool resources to provide services targeted to particular 

population groups, both within the county and adjacent to it. Key areas dependent on resource 

sharing include: support for youth, support for seniors, transportation access, and substance abuse 

and prevention education. 

 Local providers committed to public health: A network of local providers, spanning acute care, 

mental health care, and long-term care, work cohesively to provide county residents with 

comprehensive access to health care. There is a concerted effort to provide these services to all 

residents, including low-income and medically underserved groups, through thoughtful planning, 

volunteer work, and donations. Many of these providers are long-term residents who are familiar 

with, and dedicated to, local health issues.

 Initiatives to combat substance abuse: Recognizing the need to address the threat of substance 

abuse in the community, Grant County is mobilizing its resources through coalitions and trainings 

to prevent drug abuse and overdose, as well as engage in harm reduction.

 2 Table 36 in the Grant County data appendix at the end of this case study provides a quantitative profile of county 

characteristics.

3 For a full explanation of the methodology, see Appendix B: Research Approach. For a list of key informants 

interviewed for this county, see Table 37 in the data appendix at the end of this case study.
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Many of Grant County’s programs fall under four categories: collaboration, resource sharing, local 

providers committed to public health, and initiatives to combat substance abuse.

Cross-Sector Collaboration

Cross-sector collaboration is part of the county’s DNA and addresses many issues, ranging from the 

creation of food pantries to address hunger, to the coordination of health fairs to screen for physical health 

needs. Perhaps the most notable example of this is in the work of the Family Issues Task Force (FITF),

established under emergency conditions to deal with the devastating aftermath of the 1985 Election Day 

floods. Most of the 47 people killed when the Potomac River crested at 22.6 feet were from Grant and 

Pendleton Counties. Since that time, FITF’s purpose has evolved from guiding post-disaster recovery to 

coordinating efforts to identify, assess, and respond to local health issues. The FITF brings together 

leaders from diverse organizations, including the county health department, Community Action, the 

library board, the arts council, United Methodist Family Services, Community Education Outreach 

Services, local schools, the Commission on Aging, the Potomac Highlands Guild, and Grant Memorial 

Hospital. 

The oldest and most extensive collaboration is Community 

Education Outreach Services (CEOS), which has five separate 

clubs in the county. According to the West Virginia University 

Extension Service website, the members of CEOS have helped 

“strengthen individuals, families, and communities across the 

state of West Virginia since 1914.” In collaboration with the 

extension service, CEOS develops programs centered on service, 

continuing education, and leadership development. In Grant 

County, CEOS members coordinate the health fair offered to 

county residents and collaborate with the county courthouse to 

hold a breast cancer awareness event. 

There are considerable cross-sector collaboration efforts that aim 

to support youth. Grant County schools work with the extension 

service to hold the Energy Express program and teach a 

nutritional science course. The schools also collaborate with 

Grant Memorial Hospital to offer a course on careers in health. 

(To benefit residents of all ages, Grant Memorial also 

collaborates with a local, privately owned pharmacy to provide 

blood tests in support of its diabetes prevention program, which is sponsored by the federal Centers for 

Disease Control and Prevention (CDC).)

The Prevention, Intervention, Treatment, Anti-Stigma, and Recovery (PITAR) coalition is a fairly 

new cross-sector collaboration organized to address behavioral and mental health issues. The coalition 

brings together people from the criminal justice system, treatment organizations, and patient advocacy 

groups. According to Dr. Raj Masih, regional health promotion and wellness coordinator for the Potomac 

Highlands Guild, the group focuses on solutions and actions to help people in various stages of need.

Resource Sharing

Grant County uses collaboration and resource sharing in almost all of its efforts to improve the health of 

residents and the larger community. The county funnels pooled resources into support for its youth and 

elderly populations, transportation support, and meal distribution. Eric Schena / Creative Commons 3.0 Unported

The Grant County Courthouse, in 

Petersburg, West Virginia
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Recently, the Grant County Commission donated land, funding, and services worth about $125,000 for

construction of a new multipurpose center for the county’s elderly population. The top two outcome 

measures on which Grant County does better than expected are stroke mortality and heart disease 

hospitalization. These outcomes may be related, in part, to the extra support the county provides to its 

senior population.

Grant County has also partnered with the 4-H national youth development and mentoring program for 

decades, with about 200 youth formally enrolled in multiple 4-H programs. Young people involved in 4-

H typically study agriculture and related environmental issues in ways that incorporate an element of 

physical activity.

The Eastern West Virginia Community Action Agency partners with Warm the Children, serving as a 

social service referral center for more than 800 economically distressed families in the county, providing 

children with winter coats, gloves, and boots. It reflects a local commitment to supporting the well-being 

of residents in the most vulnerable segments of the county’s population.

Transportation

Transportation is a real challenge for some Grant County residents. Steep, unpaved roads make parts of 

the county hard to reach when the weather is bad. Reaching residents of Mt. Storm during a medical 

emergency can be especially difficult. Although there is a helipad at Grant Memorial and emergency 

helicopter services are available, it can still be a challenge to access the more remote areas of the county. 

Reaching these areas as fast as possible is the goal of the county’s strategic ambulance location plan and 

its “grassroots mapping system.” By stationing ambulances at strategic locations around the county and 

incorporating local knowledge about roads and geography (often provided by hunters and fishermen) into 

its mapping system, Grant County has been able to steadily improve its emergency response times. 

The health department also subsidizes transportation for women who need to travel to a neighboring 

county for cancer treatment, using a Susan G. Komen grant to help cover the costs of transportation, 

lodging, and incidentals. Church group volunteers often provide transportation for medical appointments 

and pharmacy visits. 

The county still faces serious health-related transportation challenges, yet coordinated grassroots efforts 

use local resources to address these challenges as effectively as possible. 

Food

For 28 years, the Commission on Aging Family Services has offered comprehensive support for seniors 

throughout the county. Major services include a nutrition program that offers meals at locations in 

Petersburg, Mt. Storm, Maysville, and Dorcas, and as well as transportation to the four meal locations.

The commission also provides in-home services to assist with food preparation, personal care, and light 

housekeeping, and transportation assistance for medical appointments, shopping, and banking. 

Approximately 47 people now receive in-home services, and approximately 142 receive meals at the four 

nutrition sites each month.
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Local Providers Committed to Public Health

Grant County has a network of local providers offering comprehensive health care services. These 

providers include Grant Memorial Hospital, a county health department, a behavioral health facility (the 

Potomac Highlands Guild), a 110-bed nursing home, an outpatient Veterans Health Administration clinic, 

and private physicians. While their primary focus is on health care services, these providers are 

committed to using resources to addressing burgeoning health issues, such as obesity and opioid abuse. 

Grant Memorial Hospital is a countyowned critical access hospital established in 

1958. With more than 350 employees and a 

professional medical staff of approximately 

15, it provides 25 acute-care beds and 20 

long-term and/or skilled-nursing beds, and 

offers a variety of services, such as ob-gyn;

pediatrics; general surgery; general 

orthopedics; internal, family, and emergency 

medicine; imaging services; and temporary 

coverage in ophthalmology and urology. The 

hospital also conducts a community health 

needs assessment to guide and support 

needed population health initiatives identified 

by residents. 

“We recognized several years ago that we 

had to go beyond the four walls of the hospital,” says Grant Memorial CEO Mary Beth Barr. She adds 

that the hospital’s mission is to serve the entire community, even if the preventive services provided are 

not always reimbursed. One example of this commitment to community health is Grant Memorial’s 

monthly “Healthy Saturdays” health fair, at which staff and volunteers perform, on average, 300 blood 

panel workups at a nominal cost of about $35 each. Every Healthy Saturday event features both general 

health information and information on a specific topic (e.g., diabetes, obesity, and congestive heart

failure). 

Grant Memorial also offers a diabetes prevention program certified by the CDC. One of only four such 

programs in the state, it provides free counseling and support to prediabetic patients to help keep them

from becoming diabetic. A local pharmacy provides hemoglobin A1C tests. The program lasts one year, 

after which participants “graduate” and receive another year of follow-up support. 

Over the years, the hospital has also offered physician and other care provider rotations. The hospital’s 

openness to teaching has enabled it to offer a wide range of specialty care services.

Providers with the Grant County Health Department and the Potomac Highlands Guild actively focus on 

meeting residents’ needs outside of the hospital. The health department offers a wide range of clinical, 

educational, environmental, and emergency preparedness services. It is sometimes the sole provider for 

low-income residents of the county. 

The Potomac Highlands Guild is one of 13 comprehensive behavioral health providers in the state. It 

operates satellite offices in five Eastern Panhandle counties, including Grant County. Many credit it with 

being an innovator in addressing the issues of methamphetamine and opioid addiction. 

Grant Memorial Hospital

Grant Memorial Hospital
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Grant County’s public and private health care providers are committed to making a difference in people’s 

lives. 

Initiatives to Combat Substance Abuse

Substance abuse is a public health issue that the local community is vigilant about— with good reason. 

West Virginia’s overdose mortality rate, double the national rate, is the highest in the country. The crisis 

in the county seat of Petersburg is so acute that it is the subject of a documentary film, “Petersburg,” 

which chronicles how drugs took hold in this small city of 2,500 people (Allott and Allott 2017).

Grant County has launched several initiatives to try to get ahead of this public health battle. The county 

and local organizations are collaborating to form coalitions; considering needle exchange programs; and 

offering training in the administration of naloxone, which can rapidly reverse an opioid overdose. The 

Prevention, Intervention, Treatment, Anti-Stigma, and Recovery (PITAR) coalition4 is helping 

coordinate an effort that spans all aspects of addressing addiction, from education to mental health 

counseling to treatment and recovery services. PITAR comprises upwards of two dozen participating 

organizations, including the Potomac Highlands Guild, the Russ Hedrick Recovery Resource Center, the 

Grant County Health Department, and local media organizations. Here is greater detail on some of the 

organizations and their initiatives:

The Potomac Highlands Guild is the regional agency providing intensive outpatient treatment for 

substance use disorder. With offices in Petersburg, Moorefield, Romney, Franklin, and Keyser, the guild

provides counseling (individual and group) for people with addiction and substance use disorders. It

facilitates placement in detox and inpatient rehabilitation programs, and in long-term treatment facilities. 

Staff are on call 24/7, 365 days a year, to respond to the emergency room for any crisis related to 

substance use disorders. The guild runs the regional DUI education and treatment program for the DMV, 

and has an after-hours crisis line to help with issues related to substance use disorders. 

Additionally, the guild provides mental health counseling and treatment for people with mental health 

issues such as depression, anxiety, bipolar disorder, schizophrenia, and post-traumatic stress disorder. 

Providing assistance in this way can help people deal with mental health issues effectively and avoid

using drugs and alcohol to self-medicate. 

The Russ Hedrick Recovery Resource Center is a nucleus for recovery activities in the area. The center 

serves as a drop-in site to help people with substance use disorders get into treatment, begin recovery, and 

find the resources they need to re-establish their lives. Center coordinator Wade Rohrbaugh and five other 

certified peer recovery coaches are available to help individuals navigate the pathway through recovery 

and also serve as a resource for families and loved ones of individuals dealing with addiction issues. The 

center facilitates 12-step recovery meetings almost daily. Additionally, it provides training in 

administering naloxone to reverse opioid overdose to the general public and to first responders through 

the West Virginia Office of Emergency Management Services. To date, more than 2,800 people have 

used the center’s services, and more than 200 people have been trained in naloxone administration.

The Grant/Hardy Recovery Group is a driving force behind the recovery movement in Grant County. 

The group conducts 56 recovery meetings a month in Petersburg, Moorefield, and Franklin. The meeting

groups include Narcotics Anonymous, Nar-Anon, Smart Recovery, and Dual-Recovery Anonymous.

 4 A list of organizations participating in the coalition is available at http://potomachighlandsguild.com/pitarinfo.html
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The Grant County Health Department has also approved a harm reduction program and is considering 

providing training in administering naloxone for overdoses.

Grant County schools are actively engaged in promoting healthy behaviors and preventing substance 

abuse among students. Two effective programs include Too Good for Drugs and Students Against

Destructive Decisions (SADD). Too Good for Drugs seeks to educate students from elementary school 

through high school about the dangers of drugs, the risks of addiction, and the long-term consequences of 

substance abuse. SADD is a student-led effort to discourage behaviors such as smoking, abusing drugs 

and alcohol, and having unprotected sex. The school system also offers a class on healthy eating, as well 

as a health-careers club. 

CREATING A CULTURE OF HEALTH IN GRANT COUNTY

Grant County’s actions—whether they’ve evolved organically through a volunteer effort or been 

established through the work of a coalition or health care system—indicate that county leaders and 

residents place a high value on health. This is reflected in the range of assistive transportation services 

offered county-wide, including the emergency medical transport subsidized at a cost of $200,000 per 

year. The level of investment of money and time in holding county-wide health events, as well as in 

providing prompt emergency response and transport, conveys that health is important and that protecting 

it is a shared responsibility.

This message is reinforced by the sustained focus on support for youth, seniors, and those battling 

addiction. Grant County is putting resources into educating its young people about healthy behaviors and 

giving them opportunities to practice those behaviors. Seniors are provided with fitness opportunities and, 

when needed, communal and in-home meals, counseling on Medicare plans, and subsidized assistance 

with transportation. This support for seniors may contribute to Grant’s better-than-expected rates of stroke 

mortality and heart disease mortality.

Grant County has put together a wide range of services that address the health of both body and mind, and 

community leaders continue to develop innovative ways to help residents live healthy lives. 
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REFERENCES

Allott, Daniel and Jordan Allott. 2017. “The Race to 2020: The people and places that will define a 

presidency.” Washington Examiner. Accessed May 15, 2018. 

http://2020.washingtonexaminer.com/

Centers for Disease Control and Prevention, National Center for Health Statistics. 2017. Drug Overdose 

Deaths in the United States, 1999–2016. 

https://www.cdc.gov/nchs/products/databriefs/db294.htm

Charleston Gazette-Mail. 2015. “Video: Gazette-Mail reporters, photographers reflect on covering 1985 

flood.” Charleston Gazette-Mail, November 4, 2015. Accessed May 15, 2018. 

https://www.wvgazettemail.com/news/video-gazette-mail-reporters-photographers-reflect-on-coveringflood/article_6eb2e9bc-3a87-572a-8771-9a0ba4c285bf.html

Grant County Commission on Aging Family Services. 2014. “Our History.” Accessed May 15, 2018. 

http://www.gcscwv.org/history.html

Grant County West Virginia Convention and Visitors Bureau. 2016. “Grant County: The Heart Beat of 

the Potomac Highlands.” Accessed May 15, 2018. 

http://www.grantcountywva.com/ 

Holmes, G. Mark, Nancy M. Lane, Thomas A. Arcury, Michael L. Schawlbe, Randy Randolph, John 

Frank, Sharita Thomas, et. al. 2018. Identifying Bright Spots in Appalachian Health: Statistical Analysis. 

Washington, D.C.: Appalachian Regional Commission.

Marshall, Julie L., Logan Thomas, Nancy M. Lane, G. Mark Holmes, Thomas A. Arcury, Randy 

Randolph, Pam Silberman, et al. 2017. Health Disparities in Appalachia. Washington, D.C.: Appalachian 

Regional Commission.
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APPENDIX: GRANT COUNTY DATA

Table 36: Grant County Characteristics

Characteristic Grant County United States

Population, 2010–2014 11,829 314,107,084

Percent population change, 2010–2015 -1.40% 4.10%

Median age, 2015 44.9 37.8

Percent of persons over age 65, 2015 23.00% 14.90%

Median household income, 2014 $41,039 $56,135 

Per capita income in past 12 months (in 2015 

dollars), 2011–2015 $20,052 $28,930 

Unemployment rate, 2014 7.7% 6.2%

Percent persons in poverty, 2014 17.0% 15.6%

Percent white alone, 2015 97.70% 77.10%

Percent black alone, 2015 1.00% 13.30%

Percent adults with at least some college, 2010–

2014 33.74% 63.27%

Distance to nearest large population center from 

county center Fairmont, WV – 84.8 mi. N/A

ARC designations, fiscal year 2017

Transitional

North Central 

Appalachia

N/A

Source: These data are compiled from the U.S. Bureau of Labor Statistics, Local Area Unemployment Statistics, 

2014, and the U.S. Census Bureau American Community Survey Selected Social Characteristics, General Economic 

Characteristics, Demographic and Housing Characteristics, and Educational Attainment Tables for years 2010–2014 

and 2011–2015.
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Table 37: Grant County Key Informants

Name Location Title Organization Interview 

Date

Barb Carr Public Library Librarian Grant County Public 

Library 5/8/2017

Dr. Raj Masih

Russ Hedrick 

Recovery Resource 

Center

Regional Health 

Promotion and Wellness 

Coordinator

Potomac Highlands 

Guild, Inc. 5/8/2017

Gina Hinkle Public Library Office Coordinator WIC Nutrition Program 5/8/2017

Aimee Cardot Community Action

Grant County 

Community 

Development Director

Eastern WV Community 

Action Agency 5/8/2017

Rick Smith Community Action Executive Director Eastern WV Community 

Action Agency 5/8/2017

Sandy Glasscock Health Department. Nurse 

Director/Administrator

Grant County Health 

Department 5/9/2017

Peggy Bobo-Alt 911 Center Director 911 / Office of 

Emergency Services 5/9/2017

Alex Coffman Extension Office 4-H / Extension Agent WVU Extension Service 5/9/2017

Teresa Nazelrodt Extension Office Secretary WVU Extension Service 5/9/2017

Rich Cardot Presbyterian 

Church Petersburg President Grant County Ministerial 

Association 5/10/2017

Mary Beth Barr Grant Memorial CEO Grant Memorial Hospital 5/10/2017

Charlotte Reel Grant Memorial Dietary Manager Grant Memorial Hospital 5/10/2017

Gayann Veach Grant Memorial Chief Quality Officer Grant Memorial Hospital 5/10/2017

Paula Combs Grant Memorial Director, Social Services Grant Memorial Hospital 5/10/2017

Teresa Snyder Grant Memorial Director, Imaging 

Services Grant Memorial Hospital 5/10/2017

Julie Kesner Grant Memorial Community Resources 

Coordinator Grant Memorial Hospital 5/10/2017

Malinda Turner Grant Memorial Compliance and Privacy Grant Memorial Hospital 5/10/2017
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Table 38: Grant County Health Outcomes – Actual vs. Predicted

Outcome Measure Actual Predicted

Percentage 

Difference

(negative = 

better)

Stroke mortality per 100,000 people, 2008–2014 28.45 47.73 -40.4%

Heart disease hospitalizations per 1,000 Medicare 

beneficiaries, 2012 36.00 60.34 -40.3%

Injury mortality per 100,000 people, 2008–2014 37.42 58.87 -36.4%

Cancer mortality per 100,000 people, 2008–2014 130.53 184.16 -29.1%

Years of potential life lost, 2011–2013 7,387 9,550 -22.6%

Opioid prescriptions as a percent of Part D claims, 

2013 4.28 5.52 -22.5%

Percentage of excessive drinkers, 2014 10.5% 12.7% -17.3%

Poisoning mortality per 100,000 people, 2008–2014 14.65 17.67 -17.1%

Suicide mortality per 100,000 people, 2008–2014 13.95 16.38 -14.8%

COPD mortality per 100,000 people, 2008–2014 48.11 56.18 -14.4%

Average Medicare condition score, 2013 0.87 0.99 -12.0%

Percentage of Medicare beneficiaries w/ depression, 

2012 15.20% 16.08% -5.5%

Percentage of obese adults (>30 BMI), 2012 36.90% 36.74% 0.4%

Mentally unhealthy days per month per person, 2014 4.60 4.56 0.8%

Infant mortality per 1,000 births, 2008–2014 7.76 7.63 1.6%

Heart disease mortality per 100,000 people, 2008–

2014 226.11 216.66 4.4%

Physically unhealthy days per month per person, 2014 4.70 4.48 4.9%

Percentage of adults with diabetes, 2012 16.1% 14.6% 10.2%

Low birth weight births (<2,500g) per 1,000 births, 

2007–2013 9.40 8.49 10.7%

Notes:

Percentage Difference = 100 * [ (Actual / Predicted) – 1]

Green = County value was better than predicted

For details on the outcome measures, see the data files accompanying the report Identifying Bright Spots in 

Appalachian Health: Statistical Analysis.
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Table 39: Grant County Health Drivers vs. National Median

Driver Measure Lower is 

Better?

National 

Median

Grant 

County

Air pollution (average daily particulate matter 2.5), 

2011 Yes 11.87 13.14 

Average travel time to work in minutes, 2010–2014 Yes 22.82 25.75 

Chlamydia incidence rate per 100,000, 2013 Yes 287.16 169.26 

Dentists per 100,000 population, 2014 No 37.45 42.74 

Economic index, fiscal year 2017 Yes 108.79 126.71 

Full-service restaurants per 1,000, 2012 No 0.68 0.68 

Grocery stores per 1,000 residents, 2012 No 0.20 0.25 

Median household income, 2014 No $45,226.00 $41,039.00 

Mental health providers per 100,000 population, 2015 No 80.00 68.49 

Percentage of adults currently smoking, 2014 Yes 17.8% 22.1%

Percentage of adults not physically active, 2012 Yes 27.7% 38.4%

Percentage of adults with at least some college, 

2010–2014 No 56.3% 33.7%

Income inequality ratio,

5 2010–2014 Yes 4.4% 3.9%

Percentage of diabetics with A1C testing, 2012 No 85.4% 78.6%

Percentage of doctors who e-prescribe, 2014 No 65.0% 40.0%

Percentage of eligibles enrolled in SNAP, 2014 No 78.0% 83.0%

Percentage of households with income below poverty, 

2014 Yes 15.8% 17.0%

Percentage of Medicare women with recent 

mammogram, 2013 No 61.0% 65.0%

Percentage of population with access to places for 

physical activity, 2011 and 2014 No 61.9% 51.3%

Percentage of total population in social assistant jobs, 

2013 N/A 0.01% 0.02%

Percentage receiving disability OASDI and/or SSI, 

2014 Yes 5.4% 7.9%

Percentage spending >30% of income on housing, 

2010–2014 Yes 29.0% 18.7%

Percentage w/ no car, low access, 2010–2014 Yes 19.7% 18.9%

Primary care physicians per 100,000 population, 2013 No 48.54 51.02 

 5 Income inequality is the ratio of household income at the 80th percentile to that at the 20th percentile. A higher 

ratio reflects greater division between the top and the bottom of the income spectrum.
CREATING A CULTURE OF 

HEALTH IN APPALACHIA Grant County, West Virginia | CASE STUDIES

181

Driver Measure Lower is 

Better?

National 

Median

Grant 

County

Social associations per 10,000 population, 2013 No 12.68 15.31 

Specialist physicians per 100,000 population, 2013 No 25.93 25.36 

Students per teacher, 2013–2014 Yes 14.13 --

Teenage births per 1,000, 2007–2013 Yes 39.96 50.32 

Uninsured rate for people under 65, 2013 Yes 17.24 19.09 

Notes:

Green = County value was better than national median

For details on the driver measures, see the data files accompanying the report Identifying Bright Spots in 

Appalachian Health: Statistical Analysis.