Disability in Appalachia

By: Marcus J. Hopkins

July 30th, 2026

This month, in honor of Disability Pride Month, the Appalachian Learning Initiative (APPLI, like "apply") is examining disability statistics in the Appalachian Region.

Did you know that nearly 1 out of every 5 (19.2%) adults living in Appalachia is living with a disability?

This is significantly higher than the national average of 13.5% (PLACES, 2024).

In APPLI's research, we have found that each of the 13 states comprising the Appalachian Region has disability prevalence rates higher than the national average. We arrive at these calculations by isolating each state's counties and independent cities designated by the Appalachian Regional Commission (ARC) as part of the Appalachian Region, averaging the prevalence rates for those counties, and comparing them against both the statewide and national prevalence rates.

Using this methodology, we found the following regional rates for each state's respective Appalachian Counties:

State	Regional Disability Prevalence Rate	Statewide Disability Prevalence Rate
Alabama	19.0%	16.2%
Georgia	15.8%	12.7%
Kentucky	24.0%	17.6%
Maryland	17.5%	11.3%
Mississippi	18.8%	17.2%
New York	15.7%	11.9%
North Carolina	17.2%	13.3%
Ohio	18.4%	14.1%
Pennsylvania	16.4%	14.1%
South Carolina	16.4%	14.3%
Tennessee	20.8%	15.3%
Virginia	20.0%	12.1%
West Virginia	20.7%	20.7%

As this chart shows, not only do the regional disability prevalence rates for each Appalachian state outstrip the national rate, they are also higher than the statewide prevalence rates in every state, and in several cases—including Kentucky, Maryland, North Carolina, Tennessee, and Virginia—being significantly higher. In West Virginia, those rates are identical, as every county is included in the Appalachian Region.

These statistics are nothing new. The Appalachian Region has long had higher rates of disabilities than the national average, with counties located in central Appalachia—those located in eastern Kentucky, northeastern Tennessee, southwestern Virginia, and southwestern West Virginia facing the highest burden.

Nearly 1 out of every 5 adults living in the Appalachian Region is living with a disability. The counties with the lowest and highest prevalence of disabled people are Holmes County, Ohio, and Dickenson County, Virginia, respectively.

The Social Determinants of Health are existing circumstances that may serve as barriers to accessing healthcare services and impact health outcomes.

In the Population Level Analysis and Community EStimates (PLACES) interactive tool, data are derived from the Behavioral Risk Factor Surveillance System, the U.S. Census, and the American Community Survey (Centers for Disease Control and Prevention, 2025), which is, in and of itself, problematic.

We at APPLI don't view disabilities as characteristics to be pathologized, as if a disability is something that needs to be "cured." Viewing disabilities in this manner is commonly referred to as the "Medical Model of Disability" (Olkin, 2022), wherein disabled people should be working toward "fixing" their disabilities to become "normal."

Rather, we consider disabilities to be social determinants of both health and learning. By this, we mean that disabilities are, for those living with them, "their" normal, and how they navigate the world around them, including living, learning, working, loving, and accessing healthcare, is just a part of their lives.

When we view disabilities through this lens, it helps us to develop tools, resources, and standards that allow us to provide every type of opportunity, including educational, employment, entertainment, and healthcare access opportunities, in ways that allow for equitable access to them.

For example, people living with vision disabilities—a disability that renders them blind or makes it difficult to see, even when wearing glasses—often use screen readers or other assistive technologies to help them access digital materials, like this blog. Whenever we include images on our website, in our reports, or share them across our social media channels, APPLI works to ensure that every image includes embedded Alternative Text, or "Alt-Text," providing a brief description of what is contained within the images.

APPLI utilizes a similar framework to the Social Determinants of Health, called the Social Determinants of Learning. This model shows that the same circumstances that may impact health outcomes may also impact educational outcomes.

In the image to the right of this paragraph, the embedded alt-text reads: "Infographic titled "Barriers to Learning in Appalachia" by APPLI, featuring five yellow rounded boxes. Categories include Geographic (rural areas, terrain, school funding, consolidation, staff retention), Transportation (distance, costs, lack of vehicles or transit, weather), Communication (low tech/internet, mail, stigma, language), Income (affordability of materials, tutoring, housing, utilities, food), and Health & Ability (disabilities, mobility, chronic illness, isolation)."

That said, APPLI isn't perfect 100% of the time. We are still actively working to adapt our website to make it more accessible and easy to navigate for people living with disabilities.

This Disability Pride Month, APPLI celebrates everyone living with a disability, and we hope that you will join us in working to ensure that everyone, regardless of their ability, has equitable access to the world around us.