ETSU Health publishes on COVID-19 in Central Appalachia

Dr. Manik Ahuja, Assistant Professor in the East Tennessee State University College of Public Health’s Department of Health Services Management and Policy, is lead author of an article in Humanities and Social Sciences Communications.  The article, “Perceptions of risk for COVID-19 among individuals with chronic diseases and stakeholders in Central Appalachia,” discusses the association of individuals’ actual risk for COVID-19 with their own perception of risk.

Dr. Hadii Mamudu, Professor in the Department of Health Services Management and Policy is a co-author.  Manul Awasthi, student of the Doctor of Public Health program, is also a co-author.  This paper is a collaboration of many authors within ETSU Health including Drs. Florence Weierbach, Karilynn Dowling-McClay, David Stewart, and Timir Paul.  

Coronavirus disease 2019 (COVID-19) pandemic is rapidly evolving and is a serious public health threat worldwide. Timely and effective control of the pandemic is highly dependent on preventive approaches. Perception of risk is a major determinant of health behavior. According to theories of decisions about health behavior, people who perceive greater risks are more likely to engage in preventive behaviors. As such, the perception of risk will likely inform the decisions of individuals to adhere to prevention and mitigation measures including decisions on vaccinations for COVID-19 to reduce risk.

The current study explores the association between actual risk and perceived risk for one’s self, family/friends and friends, and community.  A questionnaire was administered to 102 participants in Central Appalachia. The actual risk was based on the number of chronic conditions of the following conditions: hypertension, heart disease, cancer, diabetes, and chronic obstructive pulmonary disease. Participants were also queried about their perception of risk for COVID-19.  

Individuals’ actual risk was positively associated with the perception of risk of COVID-19 to themselves; however, this was not true when evaluated for family/friends or the community. This indicates that one’s perception of risk for COVID-19 is greater for their own health compared to their family/friends or the community. Monitoring and follow-up with patients suffering from chronic diseases and addressing their lack of awareness of risk to others is needed to prevent and curtail the spread of COVID-19.

Culturally relevant health education is imperative in rural areas, such as Central Appalachia. Providers, public health professionals and other key stakeholders must raise awareness of individuals at high risk for poor COVID-19 outcomes such as those burdened with chronic diseases, their family members, and members of communities with higher rates of health illiteracy.