The “Sickest Town In America” Short on Facts, Large on Stereotypes

“What we see depends mainly on what we look for.” Sir John Lubbock

On January 22, 2015, The Atlantic published a feature by Olga Khazan – Life in the Sickest Town in America. Ms. Khazan, who lives in Washington, D.C., subtitles her piece with this sentence: “I drove from one of the healthiest counties in the country to the least healthy, both in the same state.” The town she bills as the sickest town in the country is my hometown – Grundy, Virginia.

When I am asked the question: Where are you from? I give the same answer every time. I am from Grundy, Virginia. Although I now live out-of-state, when I think of my hometown I think of the most beautiful, kind, and loyal place. And when I return to Grundy, as I do frequently, I find exactly that. When we go to Grundy, Ms. Khazan and I, we look for different things, and we both find what we are looking for. I find a place to be proud of and she finds a backward, sad, desperate community that time forgot.

Ms. Khazan attempts to illuminate some important issues that many towns in Appalachia struggle with – health and well-being, health care access, the disability system, and the decline of the coal mining industry. Sadly, though, any positive intent and material she may have had or presented were overwhelmed by her exaggerated, inaccurate, and stereotypical portrayal of Grundy as a poor, sick, and backward Appalachian town.

Ms. Khazan, a staff writer covering health for The Atlantic, isn’t the first reporter who has come to our little town from the big city with her own vision of what is in Appalachia. Perhaps colored by visions from old black and white photographs, it appears these reporters come to town to search for old women in aprons standing by outhouses, long lines of coal miners leaving the mine with picks and shovels over their shoulders, or dirt roads populated by nothing but camp houses and trailers. Some of those things still exist in Appalachia, but those visions and pictures are not the predominant way of life in the region or in Grundy. However, as Ms. Khazan has demonstrated, if you look for it, you will find it. This approach to journalism is a disappointment and a disservice to the people of Grundy and the readers of The Atlantic.

Ms. Khazan, in addition to various statistics on unemployment, receipt of disability checks, and some health statistics, supports her claim that Grundy is the sickest town in America with a visit to the Buchanan County Remote Area Medical (RAM) event. RAM is an annual event where hundreds of people are provided free health care, including general medicine, dental, women’s health, and vision services. The event in Grundy draws people from beyond the local area. You can find people from Eastern Kentucky, Southern West Virginia and other counties in Southwest Virginia at the event. The article does not mention that the patients at the RAM event come from a large area; rather it would have you believe that this event is only for local citizens and the immediate surrounding area. This is a misstatement. But let’s give the benefit of the doubt here and assume that Ms. Khazan simply failed to ask the right questions to elicit this information or to perform a basic Google search on RAM.

But that doesn’t explain the bigger misstatements in her article. Ms. Khazan takes the typical Appalachian stereotype one step further. She states “But if this place has the scenery of the Belgian Ardennes, it has the health statistics of Bangladesh.” With little evidence, she pronounces Grundy to be the equivalent of a third world country. She offers no analysis, only a link to the Buchanan County health statistics. It is a sensational line, but it is a shallow and unfair comparison. Health care access is a universal problem, it is in small towns and big cities and everywhere in between.

The RAM event in Buchanan County is held at a large, modern elementary/middle school that serves around 1000 students from kindergarten to eighth grade. The article describes the building as one of the “few buildings, really” in Grundy. In truth, there are new and old buildings within the town limits, including the three-building Appalachian School of Law campus, a brand new Baptist church, a Masonic temple, two new two-story retail and commercial buildings, a two-story parking garage with a Wal-Mart atop it, a movie theatre, a bank building, a historic courthouse, and numerous other buildings.

In order to reach Riverview Elementary Ms. Khazan had to drive past all these buildings.[1] Additionally, outside the town limits, but within the county and on her route into Grundy, she had to drive past the two-building Appalachian College of Pharmacy campus, a 50,000+ SF Food City grocery store, various restaurants, retail stores, and churches. So, for Ms. Khazan’s article to state that the school is one of the few buildings in town is completely and totally inaccurate. However, it does support her vision of an Appalachia that is a desolate, sad, and empty place.

To Ms. Khazan’s credit, the article fairly addresses some of the economic and social issues in the area related to health and the decline of the coal industry. However, the article completely misses an opportunity to explore local efforts to improve this economic situation. For example, the article never mentions the local government efforts to revitalize the economy through higher education, which has produced both a fully accredited pharmacy school and law school, or other efforts, which are numerous. If Ms. Khazan had approached this article, and Grundy, with an open mind, she may have gotten a better story – one that showcased ideas that are innovative, progressive, and that showed the enterprising spirit of an unexpected area of the country. The truth is, Grundy is a place that is trying to improve, to change, to survive, in spite of the economic and social issues that Ms. Khazan mentions. But that truth doesn’t fit within the Appalachian stereotype of ignorance and helplessness that she was looking for.

Ms. Khazan is nothing if not committed to impressing her stereotypical beliefs upon The Atlantic readers, even if that proves a difficult task. Relying on Martin Wegbreit, the director of a legal aid society in Richmond, VA (350 miles away), she states, “there are only a few paved roads in the county.” When I contacted the Buchanan County Highway Engineer he reported that 93% (421 miles out of approximately 450 total miles) of the state maintained primary and secondary roads in the county are paved. Ms. Khazan’s route to Riverview Elementary/Middle School for RAM, and assuming she actually went to the law school and social services to conduct her interviews, would have taken her on Routes 83 and 460. Both roads are state maintained paved roads. I confirmed with the county engineer that there are no dirt roads that intersect with Route 460 or Route 83. It is hard to imagine that Ms. Khazan encountered a dirt road while in Grundy, and if she did it was one that she went looking for because they are very hard to find. Instead of relying upon local sources or her own experience she choose to report as fact the remarks of someone sitting behind a desk 350 miles away.

What’s not hard to find in Grundy? Grocery stores. Ms. Khazan relied again on Martin Wegbreit, when he told her that Grundy did not have a grocery store until recently. This is laughable. The chain of Food City grocery stores, which includes 96 locations through Kentucky, Virginia and Tennessee, is owned by a family from Grundy who opened their first store in Grundy in 1955. Grundy currently has three large grocery stores, including Wal-Mart. Ms. Khazan drove by all three of these grocery stores during her visit to Grundy. Yet, she reported totally inaccurate information.

I was not present at the interview with Martin Wegbreit so I am not sure what he said but if he indeed said what he is quoted as saying, I will simply state that Martin Wegbreit lives in Richmond, and is not a journalist purporting to report fact.

In this feature, Ms. Khazan picked few named sources, but instead relies upon generalizations like “the majority of the people I talked to were missing some of their teeth.” She picked her subjects at a free clinic that provides dental services. So, I imagine that was true. But she doesn’t explain that; she would rather imply that Grundy is full of people with no teeth. That is the image she wants to sell.

The bottom line is that the picture Ms. Khazan attempted to paint is not true. It is not true that most people do not have teeth. It is not true that most homes are trailers. It is not true that the only restaurants are Dairy Queen, Long John Silvers, and Pizza Hut. It is not true that everyone has an immediate family member injured in the mines. It is not true that all the women are obese. It is not true that the county started in farming; it was logging. It is not true that the county is devoid of highly educated professionals. It not true that all the people are sad, poor, and trapped. So much of what she said and implied is not true.

I have only mentioned a few of the gross inaccuracies reported by Ms. Khazan, but the unmentioned are no less offensive and untrue.

These misrepresentations are hurtful. It hurts her credibility; what little good she may have been trying to do is overcome by her need to prop up the stereotypes of Appalachia. But Ms. Khazan will move on, she will write more and better pieces, and her career will continue to advance. She will be fine. So, the real pain inflicted by this kind of journalism is inflicted, once again, on the good people of Appalachia, the good people from Grundy.

Yes, the area has problems; it struggles in some ways, like many cities and towns in the U.S. But it is a unique, beautiful, and good place filled with good people. It is a place driven by honor (read Malcolm Gladwell’s book Outliers, chapter six) and family. It is a place that for many is inescapable, not because they are trapped there, but because the love and connection to place and family is too strong to leave or stay gone. The pain is that we cannot make people look at Appalachia and see beyond the negative image and antiquated stereotypes. We cannot make people see what they refuse to look for to find what we know is there.

[1] Grundy is indeed a small town. Three state roads serve as the primary routes in and out of the county (Routes 460, 80 and 83). Routes 460 and 83 are the primary routes into the town of Grundy. The route Ms. Khazan could have taken to reach her Grundy destination is therefore limited and obvious.

I no longer live in Grundy, VA. However, I lived in Appalachia for 30 years and 25 of those years were in Grundy. While I left most recently in 2011 for a career opportunity in the Midwest I return at least 5 times a year to visit my immediate family. The mountains of Southwest Virginia are part of my identity. The love, loyalty, respect, and hard work that those mountains taught my parents and grandparents lives on in me. In the words of Hazel Dickens “can’t you feel those hills around you, can’t you feel that touch of home, don’t you wish you’d never gone, there are some things memories can’t bring home.” I miss Southwest Virginia everyday. There’s nowhere else like it.

Whitney Caudill

94 thoughts on “The “Sickest Town In America” Short on Facts, Large on Stereotypes

  1. Excellent rebuttal. Good use of factual evidence to counter the author’s Incomplete facts and analysis. Small town USA needs a voice, and you provided it.


  2. Thank you for the eloquently written rebuttal. So sad to always see the negative aspects of a truly wonderful culture.

    Wish Ms. Kazan also knew about the Thompson Foundation’s dental program that provides free dental care for children in our area. The program goes into the schools, dental technicians check the student’s teeth and even seal them, and parents do not have to transport the children anywhere. Dental care by local dentists is also provided, if needed.

    People all over the state have problems affording dental care, not just in Buchanan County. In the future, this program may make a huge difference in defeating the stereotype of the toothless residents of Appalachia.

    • I have lived in Grundy and Arlington I find people are about the same if you look in the right places. She could go to places where people exist on welfare and social programs and find very little difference. This stereotype began with the War on Poverty and some how people continue to perpetuate the myth. Did she actually drive through from Arlington to Grundy.? I have my doubts. Oh well, maybe it was an attempt to have the current administration pour more Federal dollars into the coalfields. If so Grundy will benefit financially from her article.

  3. When I read the original article, you were the first person I thought of– if you had written an article addressing the same exact issue, the tone would have been so different. Good job. You wrote exactly what most of us have been feeling since reading about Ms. Khazan’s opinion of the “Sickest Town in America”.

  4. You go girl! Eloquent and true with your facts unlike Ms. Khazan. Thanks for being someone who stays up for the community and the town and for writing a truthful article. Great job on your response. You make me proud to know you and call you friend!

  5. Thanks for your response to Ms. Kazan’s prevarications and out right false statements. This was sadly, a feeble attempt at self promotion at the expense of many.

    • Dana – The Atlantic did read the article, as I received an email from a reporter, and they wanted to do a correction on the grocery store inaccuracy only. They don’t care about getting it right. But thank you for your comment and for believing in the truth.

  6. Thank you Whitney. I am so appreciative of you and everyone that has responded to this piece of “Yellow Dog Journalism”. Your response could be Chapter 1 of a book titled the Real Story of Grundy and Buchanan County. On your next visit please give me a call and I will take you to lunch at the best Mexican Restaurant north of Dallas, TX. Just call me on my cell phone, we do have cell service provided by the largest network in America.
    James Keen
    Town Manager

    • James – It was my great pleasure to write it. I have been overwhelmed by the response to it and am so grateful for all the kind and loving people from home. I’d be happy to write that book! I look forward to lunch the next time I am in Grundy.

  7. grundy va is a GREAT place to live, people from all over the world are here for the school, so why do they put down Buchanan County, the people are just wonderful, friendly, they are just GREAT people. Ms. Khazan, you are wrong for putting down Buchanan County, shame on you

  8. THANK YOU, Whitney! I am SO PROUD of you. This is incredibly well-written and accurate. Thanks for standing up for Grundy.

  9. Thank you so much for beautifully stating what so many of us both know and feel about Grundy. Even though you are not living here now, you were given the skills and self-confidence to take your Grundy values and use them elsewhere. When I travel, it is rare that I do not meet someone who knows of Grundy. We appreciate the uniqueness of Grundy, but are not so backward that we can’t or won’t go out into the world.

    • You are welcome, Toni. It was a pleasure and I am honored by the reception the article has received. I agree, I am who I am because of what I learned in Grundy. What a gift it was to be raised there.

  10. This article was beautifully written “from the Heart”. Twenty years of my life was nurtured in Grundy, Va. There’s never a day that goes by that I don’t think of my wonderful Family, my irreplaceable Friends, my wise and caring school teachers, the unforgettable business people who watched over us in downtown Grundy and knew us all by name. Growing up in Grundy, Va was God’s Gift to us. I will be forever grateful for that gift.
    Lura Colley Henard

  11. I was born and raised here,there isn’t anywhere in the world that I would want to be,but here,people are honest,hardworking people ,that are trying to make a living for their children,come visit our beautiful town and then right the truth about us and our way of life,you might get surprised


  13. You did a fantastic job! Great job using supporting facts to tell the story of the place we love and call home. You make us proud!

  14. I was born and raised in Buchanan County and a graduate of Grundy Senior High, class of 1992. I actually appreciated the article Ms. Khazan wrote. I thought it was nice to have someone from Washington D.C. tell of the hardships we suffer rather than continually being ignored by people in D.C. We need more and more nationwide coverage of just how we are suffering due to policies coming out of D.C., instead of only reading about it in our local newspapers. Maybe if more people knew about our struggles, then we might gain some support and force policy change to save our Appalachian hometowns instead of the administration continuing trying to destroy us. I know that’s probably a delusional thought on my part, but it’s a hopeful thought.
    As far as the law school and pharmacy school, these schools have done very little if anything to help the average Buchanan County resident. I actually think they have done more harm than good. Average rent went up outrageously after the law school went in and since the average Buchanan County native is not a college professor, the schools haven’t created jobs for lifelong residents. The schools can be a good thing in the future, but we need coal or equivalent blue collar jobs for our residents or native residents are going to still struggle and our kids are still going to leave.

    • I also appreciated her article and took no offense to anything she had to say. I am a resident here and found most of what she said to be accurate, except for the unpaved roads and grocery stores. We have beautiful town but we are isolated and have a terrible economy and our health care system sucks. People saw the title of this article and immediately took offense.

    • Agreed!! I also appreciated the article, having been born and raised in southwest Virginia. After finishing my PhD, I had hopes and dreams of coming back to this beautiful region. However, after contacting several organizations in the area for over a year, I came to the very sad realization that there is very little job or economic opportunities for me. Though eloquently and sincerely written, this rebuttal cannot change reality.

  15. Way to go, Whitney! I too am from Buchanan County and was so sad to see it trashed in “The Sickest Town In America”..I have a wonderful education that I received there and believe it or not, I have teeth too..

  16. I lived and raised four children in children are well educated . One has a MBA accounting one is in banking one is a certified pharm. technician and my son works for North Southern is married to a Dr. Who was raised in Hurley and they have all their teeth! Their daddy is a retired coal miner.I have lived other places.the people of Grundy are the salt of the earth. One more thing my grandfather E. Edwards was a mine Forman at Buchanan Coal and owned a country store there were five in our community at Big Rock, yes there were stores in the fifths. Enjoyed Whitney’s article! Sherry Ooten Bowman

  17. I grew up in Russell County, VA (my dad in Buchanan) lived there for 29 years, moved to Reston in Fairfax County VA, lived there one year then moved to Falls Church for 2 years, then moved to Sterling for 2 years, from there moved to Fredericksburg, VA, Spotsylvania County lived there 11 years. I now live on my grandfathers old home place in Buchanan County Va. My property is mostly in Buchanan and some in Russell, when I look out my living room window I can see all the way across Russell to the south, when I look west I can see all the way across Buchanan county. As a friend of mine from Northern VA came to visit he said to me don’t tell the people from Northern VA about your beautiful area of Southwest Virginia, if you do they will come down here and screw it up just as they have done to the DC area. So I have lived in both places, give me Buchanan County and Southwest Virginia.

  18. I was impressed by the quality of this article. It did not become a personal issue or lead to backbiting which says a lot about small town folks…. I agree with this writer wholeheartedly!
    Coming from a small town myself, close by Grundy, I believe small towns are the best kept secret. I say let her stay in the city. We want the small towns to stay like they are, where people care about each other. I’ve lived in several cities and what she writes of is probably to make her feel better about where she lives but the truth is there is no place like the mountains. The place I come from is very much like she describes, however, she misses the point of all that is good.
    This writer seems to understand.
    I come from a humble place, it is not arrogant it is not puffed up and it is where I return when I need to
    Remember Who I Am.
    I call it home ♡

  19. I grew up in Grundy, my parents had business’s there, I got the best education you could possibly want. I have lived from California – Colorado-Utah-Florida-Texas and back to Virginia in my 78 year (healthy) lifetime. If its the sickest town, it has some very wealthy, prosperous, talented, healthy people who are proud to be from Grundy and I am one. My mother is 98 and is more healthy than anyone I know from a big city. I lived there in the 1940s and 50s and I don’t ever remember being on dirt roads, Rt 460 was and is a very busy and improved road going through Grundy. I think Ms Khazan must have either ‘thought’ she was in Grundy or had been brainwashed to think what it was going to be so that’s what she saw. We formed friendships in Grundy that still exist today even via Facebook because it was like Andy Griffith’s portrayal of Mayberry. You have neighbors who you can trust with your life. Granted since I left, a lot of changes have been made to try to make it a more progressive town but we always had good Doctors, hospitals, dentists, theaters, good grocery stores, jewelry, furniture, clothing and drug stores. We have several locals who have become Authors; Teachers; Musicians; and of course grocery store chain, Food City which started in Grundy. I don’t know of any place else I would rather have grown up in and as stated above, I have lived in several states and had a very good career based on the education I received in Grundy High School. I hope Ms Khazan will visit again without the blinders and see the beautiful town we have pictured in our answers here. Thank you Whitney for your wonderful tribute to ‘our hometown’.

  20. This is a wonderful response to some very poor and misguiding information. Unfortunately, in today’s society many “journalist” do not accurately seek the truth, but only what they wish to portray. You have painted a wonderful and honest picture of our hometown. While I no longer live there myself, it will always be home and I also miss those mountains and that wonderful place each and every single day! Thank you, Whitney!

  21. I so enjoyed reading this article, it certainly lifted my spirits. I read other article mentioned here and was so disappointed at the image that was portrayed. Thank you for taking the time to share and give people an opportunity to see another viewpoint.

  22. I grew up in Grundy VA. I joined the military after graduating Grundy High School. I hated it when I wasn’t taken serious by my piers, I was looked at as being a “backwoods”, uneducated hillbilly. I had the highest scores of all my classmates when I graduated my military classes in culinary arts then again later in the advanced culinary arts. I was a sought after chef my whole military career. I catered to many presidents, congressmen, and even royalty in other countries. After my military career I moved away from Honalulu HI, I passed up opportunities to take jobs elsewhere, I came home to Grundy. I am currently the resident chef at one of the local stores. Even now when I’m away from Grundy I am still stereotyped as being backwoods or uneducated because of my accent. I just laugh and tell people I have been all over the world, lived, been places and done things that most people dream of, but there is no place I would rather live, than right here in my little “backwoods” town (lol) of Grundy VA.

  23. I too am from Buchanan County I live in Northern Virginia I’m very proud of where I came from I had to have heard some words about being a hillbilly but I’m very proud of it a lot of the people from that area have no idea how lucky they are they can say what they want we are very smart people and if the percentage was checked the people that build their fancy houses up here about 75% of the people are from the mountains all that area and at least we’ve got common sense and we know how to treat one another we originated from good people all of us in that area and again I’m very proud of where I come from

  24. I was brought up near Pocahontas, Va and agree that the mountain heritage is rich and pure and offers a sense of security full of genuine, good people. I have lived in several cities in the Eastern states, but Virginia will always be home, because that is where my heart is. Whitney, your article was very well done and I appreciate your candor. Grundy is a very unique place nestled between the mountains.

  25. Thank you Whitney…I was just introduced to this article…I have done home health in Grundy as a Nurse and Administrator…it is a place to be proud of. I believe these people (journalists) to not have spent time with the people to learn the culture of harvest (canning and gardening), or that the community takes care of one another. In the city spheres you don’t find that and often the destitute are ignored…unlike in Appalachia where we become a highlight. My primary problem and question is this: are the eyes opened equally to other areas…to give a fair chance?

  26. As someone whose adopted hometown of Huntington Wv is often well cited as the fattest/most depressed/et al. I agree with you on the “portrayal” of Appalachia by media.

  27. Pingback: Thank you, 1A and NPR, for doing right by Appalachia. | Coalfields to Cornfields

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s