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