title: Social and cultural factors influencing health in southern West Virginia: a qualitative study.
abstract: BACKGROUND
  Social, cultural, and economic environments are associated with high rates of disease incidence and mortality in poor Appalachian regions of the United States. Although many historical studies suggest that aspects of Appalachian culture (e.g., fatalism, patriarchy) include values and beliefs that may put Appalachians at risk for poor health, other cultural aspects may be protective (e.g., strong social ties). Few recent studies have explored regional cultural issues qualitatively. The purpose of this study was to examine social and cultural factors that may be associated with health and illness in an Appalachian region.
  
  
  METHODS
  Ten focus groups were conducted in southern West Virginia and included five groups of men and five groups of women. Cultural norms associated with residents of rural Appalachia, such as faith, family values, and patriarchy, were examined.
  
  
  RESULTS
  Both men and women in the focus groups have a sense of place, strong family ties, and a strong spiritual belief or faith in God. Patriarchy as a cultural value was not a strong factor.
  
  
  CONCLUSIONS
  There are limits to how qualitative data may be used, but findings from this study help increase understanding of the social and cultural environments of people living in rural Appalachia and how these environments may affect health.
authors.affiliation: Department of Community Medicine, School of Medicine, West Virginia University, PO Box 9190, Morgantown, WV 26506, USA. ccoyne@hsc.wvu.edu
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Coyne
authors.forename: Cristina
authors.initials: C
authors.lastname: Demian-Popescu
authors.forename: Dana
authors.initials: D
authors.lastname: Friend
mesh_terms: D000328:Adult; D001061:Appalachian Region; D019058:Community Networks; D003469:Culture; D005191:Family Characteristics; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D036301:Qualitative Research; D012067:Religion; D012423:Rural Health; D012424:Rural Population; D012933:Social Identification; D014903:West Virginia