From Surviving to Thriving in Appalachia

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From Surviving to Thriving In Appalachia: Place, Passion, and Possibilities

Edited by Michele Morrone and Tiffany Arnold



From Surviving to Thriving In Appalachia: Place, Passion, and Possibilities Edited by Michele Morrone And Tiffany Arnold


The Appalachian Rural Health Institute Ohio University Athens, OH 45701 Š 2021 by The Appalachian Rural Health Institute For more information contact The Appalachian Rural Health Institute, College of Health Sciences and Professions, Ohio University, Athens, OH 45701 Cover art: Alexander Graham


Table of Contents Part 1: PLACE

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Chapter 1: Black Appalachian History: Community Organizations in SE Ohio Ada Woodson Adams, Elizabeth Williams, and Sarah B. Garlington

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Chapter 2: Out of the Bubble: Service Learning in the Little Cities of Black Diamonds Frans H. Doppen, John M. Winnenberg, Michael H. Kopish, and Bahman Shahri

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Chapter 3: The Buried Past: Uncovering the Cultural Heritage of the Hocking River Valley B. Patrick Fahey

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Chapter 4: In Seeds, We Hold the Future: A Survey of Why Seeds are Saved in Appalachian Southeastern Ohio Lisa Trocchia, Theresa Moran, and Charlene Suggs

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Chapter 5: The Legacy of Appalachian Ohio Coal Mining Natalie Kruse, Jen Bowman, Kelly Johnson, Dina Lopez, Amy Mackey, and Nora Sullivan

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Part 2: PASSION

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Chapter 6: Food, Justice, and the Appalachian Way: Tackling Hunger with Community Food Initiatives Stephen J. Scanlan and Kerrigan Boyd

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Chapter 7: Food as a Strategy for Resilience and Unification Alexandria Polanosky, Joy Kostansek, and Rachel McDonald

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Chapter 8: A Thousand Words: Art Impacting Community Mental Health Josh Birnbaum, Nate Thomson, and Paul Logue

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Chapter 9: Expanding Maternal and Child Health in Appalachia Dawn Graham

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Part 2: POSSIBILITIES

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Chapter 10: Community Focused Programs Designed to Support Children with Autism Spectrum Disorder in Appalachia Joann P. Benigno, Laura Brown, John W. McCarthy, and Sarah Taylor

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Chapter 11: Recovering Appalachian Streams Natalie Kruse, Jen Bowman, Kelly Johnson, Dina Lopez, Amy Mackey, Nora Sullivan, and Danny Twilley

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Chapter 12: Rural Appalachia: Gaps and Progress in Health Cory E. Cronin, Kristin A. Schuller, and Shannon A. Nicks

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List of Contributors

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PREFACE Ohio University’s (OHIO) main campus is in the southeastern part of the state. Along with its regional campuses, OHIO is the major public university in Appalachian Ohio. Established in 1804, OHIO was the first institution of higher education in the Northwest Territory. In the decades since, the university has been a beacon of social justice through activism and education. In 1964, President Lyndon B. Johnson stopped at OHIO as part of his “war on poverty” tour. During his speech, he identified OHIO as a national leader in “attacking problems of area economic development.” This leadership continues today. This compilation of essays and papers represents work by faculty, staff, and students at Ohio University (OHIO) as well as partnerships with community organizations. The intent of this volume is to both highlight OHIO’s impact on the Appalachian region that houses it and to share stories about the importance of relationships and collaboration. The essays here are just a microcosm of the good work that the university has done with a focus on transforming a region from surviving to thriving.



Part 1 PLACE Although the idea of what Appalachia is and who Appalachians are has been debated over time, it is undeniable by the people who live in the region that this is a special place. There is a certain magnetism here that draws people in and makes them want to engage in projects that will improve the overall quality of life in this region. The chapters in this section are just a small sampling of the lengths that people will go to preserve the history and environment of the region. More than just the images of bucolic mountainous countryside or the once coal rich ravaged hills that are now dotted with hydraulic fracturing wells, Appalachia is much more complex in both its current assets and historical struggles. Once referred to as a “strange land and peculiar people” by color fiction writer Will Wallace Harney, this region has proven itself to be strange only to those who have not had the privilege of experiencing its complex beauty. The “peculiarity” of its people is evidenced by the intense, unexplainable, attachment to place that one develops upon spending any time here. Appalachia is a place that its residents want to see thrive rather than merely survive. This desire is the foundation of all the contributions in this book and especially in this section on place. This section first examines both the existing literature on Black Appalachian History, as well as several community organizations in Appalachian Ohio who are working to preserve local Black history. The authors seek to help readers understand the importance of historic preservation and education about this history for rural, Appalachian communities. They maintain that when residents learn about their shared history it leads to a more cohesive, engaged, and resilient community. They look at the important work of the Mt. Zion Baptist Church Preservation Society, who are working to


2 Place

preserve a church in Athens, Ohio and whose history begins as far back as 1872. This chapter also examines the place that the Multicultural Genealogical Center (MGC) in Chesterhill, Ohio holds in the community. The MGC’s main goal is to record and educate the community about multicultural and multiracial family contributions to the Ohio River Valley. The Tablertown, Kilvert Community Center works to keep alive the memory of Tablertown, a prosperous coal mining community later renamed Kilvert, by displaying historical documents and photographs and collaborating with Ohio University so that residents and students alike comprehend the diversity present in the area. Finally, this chapter pays homage to an Emancipation Day ceremony that is held each year to bring awareness to local history. In continuing the theme of historic preservation and education, Chapter 2 shares work to enhance Ohio University students experience through service learning with the Little Cities of the Black Diamonds. This chapter tells the story of a professor in the Ohio University Patton College of Education and how he became acquainted with the Little Cities of Black Diamonds Council in rural Southeast Ohio. The Council was formed in 1995 and is dedicated solely to preserving the history and culture of the coal towns in southern Perry, northern Athens, and eastern Hocking counties in Appalachian Ohio. The discussion details how impactful experiential learning can be for pre-service education students, and the hopes that the college had for using this experience to inspire young teachers to stay in Appalachian Ohio. Chapter 3 chronicles the history of the Ohio University Archeological Field School founded in 1986, and its commitment to uncovering the prehistory of the Hocking River Valley. The author discusses the important role the Field School has played in the discovery of previously unknown farming practices in both the Hocking River Valley and the Eastern Agricultural Complex. The work of the field school has the potential to dramatically impact both food insecurity and economic issues in Appalachia today. In keeping with agriculture in Appalachian Ohio, “In Seeds We Hold the Future: A Survey of Why Seeds are Saved in Southeastern Ohio” shares with readers a 2018 study examining seed saving motivations and practices within six counties. Through the survey, the authors found several reasons for why gardeners in these areas engaged in seed saving. Additionally, the authors discuss how seed saving can be valuable as both a tool to increase biodiversity, and as a method to improve socio-cultural resilience in the community.


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This section on place concludes with a discussion on coal mining, a topic that many people find synonymous with Appalachia. In addition to reviewing the progression of coal mining in Ohio, “The Legacy of Appalachian Ohio Coal Mining� provides a deep look into a specific mine in southeastern Ohio and the environmental impact that the state government had when making decisions related to it. Fortunately, the addition of a lime doser has led to some improvement in the ecology of the area, and there is hope for these sites for the future, showing again that Appalachian Ohio is indeed showing signs of going from surviving to thriving.


Chapter 1 Black Appalachian History: Community Organizations in SE Ohio Ada Woodson Adams Elizabeth Williams Sarah B. Garlington

In current political debate, Appalachia often signifies either the voice of White Americans in all their racist glory (explicit or implicit) or the epitome of poor, rural (White) Americans who consistently vote against their own self-interest. Arguments of cultural deficiencies or entrenched economic oppression battle to explain the persistent rates of poverty and income inequality, unemployment, and, most recently, opioid use and overdose deaths. Most of these public discussions presume a homogeneous Appalachian population—politically, culturally, racially. The authors in this book present compelling evidence challenging the static picture of a passive, culturally deficient (or romanticized), impoverished Appalachia. In this chapter, we discuss the significance of African American/Black history in Appalachia and how community organizations use the preservation of this history to enrich our (Appalachians of all racial identities) present and future. The content and representation in our historical narratives shape the power dynamics of communities and our ability to relate to each other. We have significant research and literature establishing the social, cultural, and empowerment value of inclusive and diverse historical narratives and the


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need for educating ourselves and our communities about these narratives.1 Local organizations that focus on preserving historical documents, buildings, stories, and more. play a crucial role in building relationships among community members—across race/ethnicity, social/economic class, age, and other intersectional identities. While being Appalachian will always mean different things to each of us, building on our shared history contributes to a cohesive, positive community identity and shared resilience. As bell hooks writes, “Shame based memory of both past and present domination and subjugation of Black people by white people has led to a deep silence which must be continually broken if we are to ever create here in our native place a world where racism does not wound and mark all of us everyday.�2 This chapter begins by summarizing key literature on Black Appalachian history and then presents examples of community organizations in southeastern Ohio working to preserve local Black history including the Mount Zion Baptist Church Preservation Society, the Multicultural Genealogical Society-Chesterhill, and Kilvert Community Center (Tablertown). Through the work of these organizations and ongoing conversations with Black elders from the region, we provide insights into the roots of Black communities in Appalachian (SE) Ohio and the experiences of growing up Black in the region. The preservation and education work of these organizations is significant in challenging the narrative of a white, homogeneous Appalachia and in cultivating a shared community identity and resilience. A note about terminology in this chapter: We use the term Black instead of people of color because the history is about families and individuals who identified (and continue to identify) as Black. We need more research and education about the construction of race and ethnicity categories in an Appalachian context, however, this chapter focuses on Black Appalachian history. Black Appalachian History Appalachia is much more racially diverse than is often historically presented. While a small percentage of the overall population, Black individuals play key roles in the cornerstones of Appalachian culture including, education, music, art, literature, and mining.3 Native American experiences and roles in Appalachian communities are even less visible.4 Historians and other scholars also overlook the role of Appalachian communities in major


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historical action towards racial justice such as the Underground Railroad and the Civil Rights Movement.5 The historical work that does exist needs to be brought to the forefront of our dominant historical narratives. As a foundation for this emphasis on the role of Black people in southeastern Ohio, we start with brief examples from mining and anti-slavery history. The significance of resource extraction industries in Appalachian communities is broadly recognized and factors into any discussion of regional culture and history. However, scholars often frame the vibrant union organizing in the mining communities only in terms of socioeconomic class conflict, making Black miners and the interracial collaborations of workers invisible.6 Lewis writes of the segregation enforced by coal companies accompanied by more flexible boundaries in informal social activities because of “the policy of equal pay for equal work.”7 Black miners were active members of United Mine Workers of America (UMWA), though the union did not protect them from disproportionate impacts of the unemployment caused by mechanization of mining work.8 Corbin argues that the rigid company town structure in which power was based on job position allowed for “social and racial parity” by providing or restricting resources equally to workers (housing, public services, water, the company store, etc.), and Black miners were supported in positions of power in local unions.9 Other historians write of the ways mining companies hired workers from white, Black, and immigrant groups in order to use divisions of race and ethnicity to prevent unionizing.10 Certainly Appalachian mining communities were not havens of racial equality and harmony, with Rendville, OH as a complex example.11 During the height of the local mining industry, Rendville had strong Black community organizations, Black leaders in political positions (such as Isaiah Tuppins, the first Black mayor in Ohio), and a vibrant Emancipation Day celebration.12 The community also experienced racism and violence related to white miners’ fears about losing jobs to Black miners. The labor organizing tied to the historical and ongoing industries such as mining, and the related environmental justice work, cannot be fully understood and built on without involving discussions of race.13 Appalachian Ohio, and the counties in the southeastern part of the state particularly, played a major role in helping Black people escape slavery through the Underground Railroad routes. On the other side of the state, Cincinnati was a major center for activists and freedom seekers, but many smaller communities along the Ohio River acted as key points of escape:


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“Fugitive slaves crossing from Kentucky into Ohio found more and better organized sources of aid and comfort on their journey north than in any other region of the borderland.”14 These resources were primarily provided by a network of small Black farming communities, many of whom had their own school and church. Ironton, in southern Appalachian Ohio was home to significant “conductors,” Black community members who served as leaders in the Underground Railroad networks. Rich historical narratives about Appalachia must include the stories of those free Black communities who made escape from slavery possible, along with the collaborations between Black and white Appalachians. Historic Preservation & Community Building in SE Ohio In ongoing conversations with local elders, Black individuals who grew up in Athens, Ohio and the surrounding areas, have many stories that connect the complex regional histories of labor and industry, arts and culture, and activism with the experiences of community members today. For example, while Ohio University graduated its first Black student in 1828, Black community members remember having to leave the Athens area to find teaching positions into the early 1960s because of racial discrimination.15 Others share similar stories of moving away from the region, where they had extensive family connections and histories, because of discrimination-related barriers to employment. Despite this, the fabric of Black communities in Appalachian Ohio remains, and many individuals are working to preserve and tell these stories. We discuss three community organizations in SE Ohio who are engaged in preserving and educating about the local histories of Black and multicultural individuals, benefiting community members of all racial and ethnic backgrounds. Mount Zion Baptist Church Preservation Society Mount Zion Baptist Church began as a group organized by Joseph and Henrietta Miller in 1872, and work on the existing building began in 1905. At its height, the church had more than 200 members and served as the center for the Black community in Athens County. Social life was structured by church activities and relationships, partly because Black community members were not welcome in White public gathering places. Building


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Mount Zion represented the pride and strength of the Black community at the time in Athens. From 1863-1886, the Albany Enterprise Academy served as a school run by and for Black residents. A former student, Olivia Davidson, married Booker T. Washington (founder of Tuskegee University) in 1886 at her sister’s house in Athens. Davidson’s family settled on the west side of Athens where many Black people lived and owned businesses. Edward and Martha Berry built and ran the Berry Hotel from 1893-1921 in the center of town. The Berry Hotel was well known across the region and served white and Black customers, including U.S. President Harding. The Berry’s contributed financially to the community, including giving the land on which the Mount Zion Baptist Church was built. The National Register of Historic Places designated the church as an historic site in 1980 because of its significance as an asset to southeastern Ohio and having been built by the Black community. Founded in 2013, the Mount Zion Baptist Church Preservation Society is actively working to preserve the physical building along with the history it represents and to make the building and history a resource for the local Black community and beyond. The Berry Hotel was demolished in 1973, making Mount Zion Baptist Church one of the last physical spaces representing the vibrant history of the Black community. Multicultural Genealogical Center-Chesterhill The Multicultural Genealogical Center (MGC) in Chesterhill, Ohio was founded in 2000 to record and educate about “the contributions of multicultural and multiracial families to the social, cultural, political, religious, educational and economic development of the Ohio River Valley.”16 MGC members research, collect, and preserve archives, using these historical documents for a variety of educational programming. For example, members bring their history to Community and Campus Day on Ohio University’s Athens campus. In 2019, MGC hosted a showing of “Our Town: Morgan County,” a documentary that covers key parts of Morgan County’s (including Chesterhill) history, with stories from local Black community leaders and involvement in the Underground Railroad activities.17 The archives include a collection focused on Melungeon families, the U.S. Colored Troops project with information on Black men from the area who fought in the Civil War, and the Perdreau Research Collection of data on Black history


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the Ohio River Valley. Melungeon is a term indicating European, African, and Native American ancestry primarily used in Appalachian places.18 The members and leadership of MGC actively collaborate with regional organizations such as the Southeast Ohio History Center and Rural Action, and regional communities like Rendville, Cutler, and Tablertown to organize and promote events that share and build on the historical significance of each. MGC partners with Ohio University to bring awareness and build relationships among students, faculty, and the community members throughout the region. Tablertown, Kilvert Community Center In the 1830s, Michael Tabler, the white son of a plantation owner, moved to southeastern Ohio with the six children he fathered with Hannah, a woman enslaved on his father’s plantation. Tabler emancipated his children before coming to Ohio (and possibly Hannah, depending on the source). Tabler purchased land from the Munn family and the Tabler community grew. Black and White residents interacted with local Native Americans from the Delaware and Shawnee tribes, and built a -prosperous farming and mining community named Tablertown. The town was later named Kilvert after the coal mine operator. A tornado in 1937 destroyed most of the homes and businesses in the town. In recent decades, descendants of the Tabler family compiled genealogical and historical documents to share the story of this multiracial Appalachian community. In 2003, David Butcher and his uncle, Alvin Adams, organized an exhibit entitled, “People of Color,” at Ohio University’s Kennedy Art Museum that displayed the life of the Tabler. The exhibit depicted their military involvement, household items, photographs, and historic documents telling the story of Tablertown. The Kilvert Community Center still displays components of that original exhibit and serves as a place for descendants to stay connected. Organizations in Tablertown and all of the places we highlight here continue to educate the region on the heterogeneity of Appalachian history and culture through activities at educational institutions in the Ohio River Valley.


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Historical Narratives & Power The creative and engaging historical preservation work of these examples in southeastern Ohio is not simply focused on telling stories of the past that include Black American’s voices. Each organization provides educational opportunities for the entire region to reflect and build upon shared experiences, while acknowledging the ongoing realities of racism and other oppressions. Dwyer writes …the memorial landscape does not so much seal and settle the movement as it opens a new chapter of struggle intimately associated with the mechanisms of memory—place, narrative, and interpretation. As sites of historic memory, memorials become constitutive of contemporary racial politics.19 We know that our historical narratives reflect power dynamics in the choices of content and voice; who is telling the story and about what serves a set of interests.20 Increasing the representation of marginalized voices and expanding the dimensions of our historical narratives helps trace our power analyses to the present and raises additional contemporary questions. How does racism continue to inhibit community relationships or economic change efforts? And what can “the web of practices (economic, political, and cultural) through which multi-ethnic populations persist, despite difficult circumstances” in the past teach us about our communities now.21 History is an educational tool that builds relationships of social empathy. “Using a socially empathic view of people’s experiences can create the type of insight that makes us want to change social conditions, to move us toward building a better world.”22 Learning about the strengths and challenges of Black communities in southeastern Ohio, and Appalachia in general, helps build positive identity and resilience in Black and multicultural youth, and it can facilitate stronger cross-racial relationships as well. Increased visibility of Black individuals (and other multicultural communities) in Appalachian history as well as the present can strengthen our collective cultural identity, including white Appalachians. Kaufman writes “The language of diversity is not very good at acknowledging injustice, and has little to say about rights, and even less about wrongs . . . the heritage discussion needs also to admit the harder language of race, including phrases like discrimination, inequity, and racism.”23 The ongoing work of the Mount Zion Baptist Church Preservation Society, the


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Multicultural Genealogical Center-Chesterhill, and Tablertown-Kilvert Community Center demonstrates the significance of Black history in Appalachia and the necessity of including conversations about racial justice in our community development efforts. Notes 1. Mary K. Anglin, “Erasures of the Past: Culture, Power, and Heterogeneity in Appalachia,” Journal of Appalachian Studies 10, no. 1/2 (2004): 73-84; Owen J. Dwyer, “Interpreting the Civil Rights Movement: Place, Memory, and Conflict,” Professional Geographer 52, no. 4 (November 2000): 660-671; Stephen Hoelscher and Derek H. Alderman, “Memory and Place: Geographies of a Critical Relationship, Social & Cultural Geography 5, no. 3 (August 2006): 347-355; Ned Kaufman, Place, Race, and Story: Essays on the Past and Future of Historic Preservation (New York: Routledge, 2009); Elizabeth A. Segal, Social Empathy: The Art of Understanding Others (New York: Columbia University Press, 2018). 2. hooks, bell, Belonging: A Culture of Place (New York: Routledge, 2009), 176. 3. Anglin, “Erasures of the Past: Culture, Power, and Heterogeneity in Appalachia;” Marcus L. Harvey, “From the Sacred Sound of the Conch Shell to the Cemetery Dance: Reimagining an Africana Festival Created in a Southern Appalachian City,” Religions 8, no. 8 (August 2017): 149-179; Fred J. Hay, “Black Musicians in Appalachia: An Introduction to Affrilachian Music,” Black Music Research Journal 23, no. 1 (2003): 1-22; William H. Turner and Edward J. Cabbell, eds., Blacks in Appalachia (Lexington, KY: The University Press of Kentucky, 1985). 4. Anglin, “Erasures of the Past: Culture, Power, and Heterogeneity in Appalachia;” Brandon M. Stump, “From Reconstruction to Obama: Understanding Black Invisibility, Racism in Appalachia, and the Legal Community's Responsibility to Promote a Dialogue on Race at the WVU College of Law,” West Virginia Law Review 112, no. 3 (2010): 1095-1137. 5. Myles Horton, Judith Kohl, and Herbert Kohl, The Long Haul: An Autobiography, ( NY: Teachers College Press, 1997); J. Blaine Hudson, Fugitive Slaves and the Underground Railroad in the Kentucky Borderland, (Jefferson, NC: McFarland & Company, Inc., Publishers, 2002); Stump,”From Reconstruction to Obama.”


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6. Fred J. Hay, “Black Musicians in Appalachia;” Ronald L. Lewis, “From Peasant to Proletarian: The Migration of Southern Blacks to the Central Appalachian Coalfields,” The Journal of Southern History 55, no.1 (Feb. 1989), 77-102; Stump, “From Reconstruction to Obama;” Joe William Trotter, “The Formation of Black Community in Southern West Virginia Coalfields,” in Appalachians and Race: The Mountain South from Slavery to Segregation, ed. John C. Inscoe (Lexington, KY: The University Press of Kentucky, 2001), 284-301. 7. Lewis, “From Peasant to Proletarian,” 97. 8. Lewis, “From Peasant to Proletarian;” Herbert R. Northrup, “The Coal Mines,” in Blacks in Appalachia, eds. William H. Turner and Edward J. Cabbell, (Lexington, KY: The University Press of Kentucky, 1985), 159-172. 9. David A.Corbin, “Class Over Caste: Interracial Solidarity in the Company Town,” in Blacks in Appalachia, eds. William H. Turner and Edward J. Cabbell, (Lexington, KY: The University Press of Kentucky, 1985), 93-114. 10. Kenneth R. Bailey, “A Judicious Mixture: Negroes and Immigrants in the West Virginia Mines, 1880-1917,” in Blacks in Appalachia, eds. William H. Turner and Edward J. Cabbell, (Lexington, KY: The University Press of Kentucky, 1985), 117-132; Stephen Brier, “Interracial Organizing in the West Virginia Coal Industry: The Participation of Black Mine Workers in the Knights of Labor and the United Mine Workers, 1880-1894,” in Essays in Southern Labor History: Selected Papers, Southern Labor History Conference 1976,” eds. Gary M. Fink and Merl E. Reed (Westport, CT: Greenwood Press, 1977) 18-43; Herbert R. Northrup, “The Coal Mines.” 11. Jeffrey T. Darbee and Nancy A. Recchie, Little Cities of Black Diamonds, (Mount Pleasant, SC: Arcadia Publishing, 2009); Sherry A. DiBari, “Rendville, Ohio: An Historical Geography of a Distinctive Community in Appalachian Ohio, 1880-1900,” (master’s thesis, Ohio University, 2011), https://etd.ohiolink.edu/pg_10?::NO:10:P10_ETD_SUBID:61807. 12. DiBari, “Rendville, Ohio: An Historical Geography of a Distinctive Community in Appalachian Ohio, 1880-1900.” 13. Michael Honey, “Anti-racism, Black Workers, and Southern Labor Organizing: Historical Notes on a Continuing Struggle,” Labor Studies Journal 25, no. 1: 10-27. 14. J. Blaine Hudson, Fugitive Slaves and the Underground Railroad in the Kentucky Borderland,127.


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15. Ohio University, “History & Traditions,” accessed March 23, 2020, https://www.ohio.edu/student-affairs/students/history-traditions. 16. Multicultural Genealogical Center, “The Multicultural Genealogical Center Home,” accessed March 23, 2020, https://mgcenterchesterhill.org/. 17. Our Town Morgan County, produced by Evan Shaw, aired on March 24, 2019, onWOUB Public Media, https://woub.org/2019/02/08/ourtownmorgancounty/. 18. Melungeon Heritage Association, Melungeon Heritage Association: Frequently Asked Questions, accessed March 23, 2020, http://melungeon.org/frequently-asked-questions-about-melungeons/. 19. Owen J. Dwyer, “Interpreting the Civil Rights Movement,” 668. 20. Paul Connerton, How Societies Remember, (NY: Cambridge University Press, 1989); Stephen Hoelscher and Derek H. Alderman, “Memory and Place.” 21. Anglin, “Erasures of the Past,” 78. 22. Segal, Social Empathy, 5. 23. Kaufman, Place, Race, and Story, 11.


Chapter 2 Out of the Bubble: Service Learning in the Little Cities of Black Diamonds Frans H. Doppen John M. Winnenberg Michael H. Kopish Bahman Shahri

Introduction College students often live in a bubble because they “just go to school [and] then plan to leave.�1 As a result, they are often completely alienated from the local communities that surround their campus. The college bubble is especially concerning in Appalachia where students may not understand or be offered the opportunities to learn about the many positive sociocultural and historical aspects of the region. With this in mind, place-based service learning is becoming part of teacher preparation programs at many universities. As they first venture out into a local community, college students often find themselves in unfamiliar culturally mixed or low-income settings in which they are forced to confront their own stereotypes.2 However, as they become increasingly familiar with the surrounding communities, they learn to appreciate the importance of building reciprocal partnerships based on trust, mutual understanding and shared values. Ultimately, these experiences could inspire them to become advocates for social justice and agents of change.3 Here we detail approaches by faculty in The Patton College of


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Education at Ohio University (Patton College) to engage future teachers with Appalachia. Background The Little Cities of Black Diamonds is a microregion that encompasses Athens, Hocking, Perry and Morgan Counties in southeast Ohio, part of the Appalachia-designated area of the state. Frans Doppen in the Patton College was introduced to this region through a serendipitous encounter with John Winnenberg. After accepting a faculty position in 2003, Doppen began to explore southeast Ohio. In his nineteen years as a social studies teacher in Florida he came to appreciate the importance of knowing and familiarizing students with the history of their local school community. He did this by organizing local field trips for his students to the nearby small communities and engaging a local historian and an architect to tell stories and conduct walking tours of the area. Doppen quickly learned the value of this type of educative experience as students expressed how much they learned. When he came to Ohio University, Doppen was determined to emphasize to teacher candidates the importance of getting to know the local community that is their temporary home. Doppen and his partner quickly immersed themselves in the area when they moved from Florida. After learning about the unique history and architecture of Shawnee, Ohio, one day they took a drive to explore this mining town. As soon as they got out of their car in Shawnee, a man came out of what appeared to be the only local store in town. This man was John Winnenberg who rushed back inside the store and re-emerged with a key. He gave Doppen and his partner a tour of the three floors of an amazing opera house built in 1907 by the Fraternal Order of Red Men. This chance encounter was the beginning of a mutual journey whose purpose it is, in the words of in Winnenberg, “to give voice to under-voiced people,� rediscover the history of the Little Cities, and engage in preservation projects.4 Service Learning Service learning is a form of experiential education. Influenced by the school of John Dewey, the most fundamental aspect of this type of education is the role of experiences in learning. Faculty members who incorporate service-learning into their classes offer their students an opportunity to


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deeply engage in a series of activities and assignments targeting community needs in particular and human needs in general.5 Learning by addressing real-world issues leads to personal growth, enhanced critical thinking abilities, deepened understanding of social justice, experiences with diversity, and improved problem-solving and communication skills.6 As students benefit, so does the community. Several studies have confirmed the effectiveness of service-learning on communities. For example, service-learning may revitalize a community through developing social capital.7 This is because participants in service learning develop a deeper sense of responsibility and greater awareness of community.8 Ultimately, what was their temporary home, may become permanent. Aside from enhancing skills and boosting a sense of community, service learning is also an effective way for students to learn local history and put current issues into historical context. In Appalachia, there are many local stories of discrimination, poverty, and oppression. These stories are important to understand the region, but when they are ignored, distorted, or forgotten, we lose a sense of both the struggles and victories here. When students are immersed in a community through service-learning projects, they can excavate such stories, examine them from an insider’s perspective, and gain firsthand knowledge of history.9 Teachers in Appalachia are critical to helping the region thrive. It remains a challenge to recruit teachers to rural areas in general, and Appalachia in particular. Perhaps experiential learning is one way to expose student teachers to the likely rewards and impacts they might have here. Many studies suggest a pertinent role for service-learning in teacher education. Through innovative projects, service learning offers a more engaging environment than traditional classroom instruction. Additionally, teachers may find unique opportunities to engage with local people beyond their institutions to more deeply involve students. “Place-based education is one form of service learning in which the community is the classroom allowing students to learn foundations and concepts in social studies, science, language arts, and mathematics.”10 Place-placed education originated from “a thirty-year foundation of environmental education in the United States” and “builds on the work of diverse community-based initiatives.”11 The key assumption in this approach is that education must not be limited to school settings.12 Teachers and students also benefit from experiencing place in a deeper way and reflecting on “the societal norms and power structures that surround them.”13


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Appalachian scholars argue that the focus on deficits perpetuates stereotypes and masks the role powerful institutions and extractive capitalism play in producing inequality. In these narratives assets are not celebrated, neither are women, people of color, and others who exemplify all that is good in Appalachia.14 Stories of progress and agency from early labor union movements and progressive coal-mining towns integrated in the Jim Crow era, are overlooked in history and replaced by tropes that portray images of corrupt people, downtrodden communities, and resource inequality. This is not true in the Little Cities which has its own a unique economic, political, and social history intimately connected to the boom to bust story of coal mining.15 Asset-based service-learning provides a different lens. Over the past decade, most research in service-learning in teacher education has emphasized the use of community assets in their programs. This type of service learning focuses on community assets as pivotal partners in education.16 In this approach, the community and university become partners in addressing community needs and challenges. Such partnerships may lead to “changing an educational paradigm to promote civic engagement and leveraging community knowledge and expertise in the preparation of future teachers through service-learning.”17 Despite all its benefits, service-learning has challenges as well. According to Iverson & James, students typically differ in their “readiness for transformative learning experiences.”18 Therefore, it is important for project designers, faculty members, and community contacts, to prepare their students for such experiences. Also, for a service-learning project to be mutually beneficial for all partners, it must be a reciprocal, continuous and sustainable process. Iverson & James emphasize that “one class and one opportunity for service-learning, while a powerful starting position, is insufficient.”19 It is when service learning is sustained over time that there are deeper effects on and more benefits for the community. Another obstacle is that service-learning projects can be expensive and time consuming.20 This is especially true in rural areas where students might have to travel long distances and lack resources to fully engage. It is not possible to assess these challenges without a clear understanding of how each community differs in terms of its resources. While one rural community might have a need for a project that is locally funded, another might


18 Out of the Bubble

have the same need but no resources. One way to overcome these resource challenges is to include community leaders in defining, managing, and performing service-learning projects.21 In general, research consistently indicates that service-learning has a positive effect on communities. Teachers and students also benefit from their experience with these projects. Because of the essential and critical role that teachers play in Appalachia, service learning should continue to play a pivotal role in the future of teacher education. Our Story The chance encounter between Doppen and Winnenberg led to a continuing close collaboration between The Patton College’s Department of Teacher Education and Sunday Creek Associates. Based the dissertation work of Ivan Tribe, Sunday Creek Associates adopted the name Little Cities of Black Diamonds.22 Tribe adopted the name for the Little Cities microregion from an article in The Athens Messenger that reported on the celebration in 1869 of the first trainload of coal that was shipped from Nelsonville, “the little city of Black Diamonds,� to Columbus. Sunday Creek is a local community organization, co-founded by Winnenberg in 1990 and dedicated to promoting the historic, cultural, civic and environmental assets of the region. The first hurdle to overcome to cement the partnership was the process of building trust, the need for which was notably pointed out by Winnenberg. Communities in the Little Cities historically harbor a distrust of outsiders, including faculty at Ohio University. They see faculty repeatedly coming into their towns and use them for their own purposes, such as research required for the tenure process. Once they get what they need, they leave and move onto other projects. Consequently, Doppen decided that his commitment to the Little Cities would be longterm rather than ephemeral. Soon after meeting Winnenberg, Doppen began to explore using the Little Cities as an experiential classroom for the teacher candidates in his social studies methods course. In the spring of 2005, he organized the first of a series of field trips into microregion. The trips took his students out of the Athens bubble into the coal towns of Haydenville, Nelsonville, New Straitsville, Shawnee, and Rendville. Each field trip was preceded by a class reading of a school version of The Story of Our Community: Little Cities of Black Diamonds written by Winnenberg in 2000. Students were required to develop a weeklong lesson unit plan based on the fieldtrip experience.23


Surviving to Thriving 19

Since these assignments and experiences took many students out of their classroom comfort zone, some of their typical comments on these field trips included: • •

My first college field trip! It was a nice change of pace from the classroom. I was unaware of all the local history I have a new respect for the old towns that I have always driven through. I’m glad I had this experience because it broadened my knowledge of the areas surrounding Ohio University. Every student, regardless of his or her major should travel outside Ohio University territory and see exactly where he or she is living. I just felt very connected and at the same time such a sense of discovery. I have been here in Athens for five years; why hasn’t anyone else shown and talked to us about this?

What began as a field trip and a unit plan requirement for Doppen’s social studies methods students, soon grew to involve more than fifteen faculty members at Ohio University. This effort became known as the Region as A Classroom collaborative. In 2006, under the leadership of Doppen and Winnenberg several place-based learning practitioners from both Ohio University and the local technical college (Hocking College) shared projects at a symposium at the Wayne National Forest headquarters near the university. Based on their positive experiences, Doppen and Winnenberg, together with Cheryl Blosser of the Little Cities of Black Diamonds Council, developed and co-taught a week-long field-based Southeast Ohio: The Appalachian Experience course from 2008-2012. Students from various degree programs across campus participated in this summer course. There was a great deal of interest in this course and students evaluated it very highly. This course had a strong service-learning component based on requests by community partners and served well to build trust. Unfortunately, this course had to be discontinued due to changes in university summer class and budgeting policies. In 2010, Doppen was awarded a planning grant from the National Endowment for the Humanities to attract civic and heritage tourism to the Little Cities microregion. This project included various faculty members at


20 Out of the Bubble

Ohio University and Hocking College, most notably Bernhard Debatin, Professor in the E.W. Scripps School of Journalism and Ken Bowald, an Assistant Dean at Hocking College. Their explorations into the field resulted in several service-learning engagements. Unfortunately, the proposal for the subsequent implementation grant was rejected, largely due to competition from historically endowed urban regions with large population centers. During the long-term experiential learning activities, Doppen’s students have made some significant contributions to Little Cities. For example, Rendville, the smallest incorporated community in the state of Ohio, unveiled an Ohio Historical Marker next to the Town Hall, inscribed with Rendville: Breaking the Color Barrier. Eight years later, because of additional student contribution and as part of a university Little Cities as a Classroom grant, we were able to unveil a second marker dedicated to Richard L. Davis: The Sage of Rendville. Together the two markers tell the story of Rendville’s Mighty Five: Richard L. Davis, an African American mine labor organizer who served on the National Executive Board of the United Mine Workers of America; Adam Clayton Powell, who “found the Lord” in Rendville and became the founder of the Abyssinian Church in New York City during the Harlem Renaissance; Isaiah S. Tuppins, the first African American to graduate from the Columbus Medical College and first elected African American mayor north the Mason-Dixon line; Sophia Mitchell, the first African American woman mayor in Ohio; and Roberta Preston, the first African American woman postmaster in Ohio. The Richard L. Davis marker was inspired Doppen’s research on the remarkable life of this courageous leader in the mine labor. His book Richard L. Davis and the Color Line in Ohio coal. A Hocking Valley Mine Labor Organizer, 1862-1900 (2016) seeks to highlight part of largely forgotten but rediscovered history of the Little Cities.

From Teacher Education to Community Impact In April 2014, under the leadership of Doppen and Winnenberg, partners across campus, organized and delivered a well-attended two-day conference to commemorate the 50th anniversary of President Lyndon B. Johnson’s historic “War on Poverty” speech in Athens.24 The 50th Anniversary of the War on Poverty: A Region Reflects & Looks Forward was an event organized by teams of community and campus partners around eight themes ranging from anti-poverty programs and health care to cultural arts, economic


Surviving to Thriving 21

development and creative community development initiatives. This crosscurricular activity drew more than two hundred fifty students, faculty and community members together for speakers, small group discussions, artistic performances, and a guided tour of the region. Support from the Ohio Humanities Council, the Scripps School of Journalism, University College, The Patton College of Education, Rural Action, the Little Cities of Black Diamonds Council, and Hocking-Athens-Perry Community Action widened and further strengthened campus-community collaboration. In 2015, Doppen decided to fully shift his focus in the Little Cities to the preservation of Rendville. It was at that time that Doppen and Winnenberg decided to reach out to Rendville natives and create the non-profit Rendville Historic Preservation Society. While Doppen became its Treasurer/Secretary and Winnenberg remained involved as a board member, Jerry Jackson, a former Bobcat basketball player who, in 1964 was member of the team that made it to the NCAA Elite Eight, and Harry Ivory, who spent his youth in Rendville, became its President and Vice-President. Other members from Rendville’s African American community who serve on the board are Anita Jackson, Janis Ivory, Jean Harris, and Denver Norman. The Rendville Historic Preservation Society has three major goals: To leave a legacy for future generations through the preservation of the history, heritage and physical structure of Rendville; to revitalize and economically develop Rendville through civic tourism; and to collaborate with regional institutions of education and local history and cultural community organizations to create both formal and informal educational opportunities for all stakeholders. Since its foundation, the Rendville Historic Preservation Society has been dedicated to saving one of the remaining coal miner’s houses and to convert it into an education center for Ohio University students, local K-12 school students, and roadside tourists. This house is named the “Little White House” after its last inhabitant. In addition, the society revived and now annually organizes an Emancipation Day in commemoration on the third Saturday of September. The first annual Emancipation Day which was celebrated on September 22, 1883 and, in the words of Richard L. Davis, included an “old fashioned southern barbeque.” To demonstrate the influence of the community-university partnerships that formed throughout the Little Cities projects, Winnenberg was


22 Out of the Bubble

recognized by the Dean of the College of Arts and Sciences as a key community liaison. In 2016, Winnenberg assumed the responsibilities of Interim Director at Ohio University’s Center for Campus and Community Engagement. Part of the Center’s mission is to serve as “a central point of contact in the connection of learning, serving, and engagement” to mutually benefit students, faculty and staff at Ohio University and the surrounding communities. Winnenberg served in this capacity until 2018, when he returned to dedicate his time to Sunday Creek Associates. After Doppen became chair of the Department of Teacher Education in 2012, Michael Kopish, began teaching the social studies methods courses. Because Kopish believes that Appalachian Ohio offers a unique setting to employ asset-based service learning in a teacher education program, he continued the commitment to community outreach and engagement. In his vision of teacher preparation, teacher candidates engaging with members of communities in Appalachian Ohio represents a shift in epistemology from simply valuing academic knowledge to focusing on community-based knowledge through relationships among academics and community members. Kopish further leveraged community partners in educating prospective teachers.25 In his social studies methods course for teacher candidates seeking to teach grades 7-12, Kopish requires his teacher candidates to participate in a minimum of twenty hours of service through projects focused on historical preservation and community development. To prepare his teacher candidates for the service-learning projects he requires them to visit local historical societies and engage in local historical inquiry.26 At the historical societies, they work with local community members to explore archives and develop original inquiry projects to learn about the rich history of the region. This type of research engages candidates with community experts, offers opportunities for candidates to explore local archives, and provides necessary background knowledge for future curriculum development and participation in two class-based service-learning projects in those communities. The Emancipation Day celebration in Rendville is the first servicelearning project for teacher candidates. In partnership with several local historical organizations, students learn about the rich African American history of Rendville by collecting oral histories and helping community members digitize historical artifacts and primary sources. The second servicelearning project involves teacher candidates in Little Cities Day in Shawnee. In this project, students work with additional local historical organizations


Surviving to Thriving 23

and members of AmeriCorps. The project promotes historic preservation and restoration of the Tecumseh Theater. For both events, the teacher candidates collaborate with community partners to provide input, assist in the development of programming, and participate in all aspects of the event days, including developing and delivering TED talks, which all support historic and cultural preservation as well as economic renewal. Bahman Shahri, at the time a doctoral student leader, has led groups of domestic and international students who participated in Emancipation Day and Little Cities Day. “These amazing experiences helped me to better understand the history of the community,� he wrote, and helped him gain firsthand knowledge about the challenges the Little Cities face. Furthermore, that new knowledge helped him develop his cross-cultural competence through various teamwork projects. Typical of other students’ experiences, of his first encounter with Rendville and Shawnee, he wrote: I was amazed by the rich history of the region. I was also impressed with how some community members were deeply involved with preserving their historical legacy. My first impression was that there was much room for developing sustained educational content by strengthening the relationship between the community and Ohio University to the benefit of both. Conclusion Getting students and faculty out of the bubble and into surrounding local communities has been both a success and a challenge. Collaboration between Ohio University and community organizations in the Little Cities has solidified during the past fifteen years based on trust-building and a long-term commitment to the work. In addition, experiential service learning has proven to be an effective method to engage, educate, and empower students who are completing their degrees to become teachers. Successful student projects can also benefit communities that have many needs but few resources. As such, service learning can be a valuable teaching method in Appalachia, especially in rural places. On the other hand, service learning requires a great deal of planning and relies on at least some resources from the university partner. Field trips and other expenses that are not typically part of classroom budget could


24 Out of the Bubble

constrain using this method. In addition, while playing host to numerous students and faculty from the university, the Little Cities continues to struggle to find the financial resources to address its priorities. These include saving the Little White House as an education center for public school and university students, as well as a civic tourism destination. With a struggling economy and small population, most significantly in Rendville, the challenge remains to preserve the microregion’s history and physical structures for future generations. Notes 1. Marilynne Boyle-Baise, “Preparing Community-Oriented Teachers: Reflections from a Multicultural Service-Learning Project,” Journal of Teacher Education 56, no. 5 (November 2005): 446–58, doi:10.1177/0022487105282113. 2. Shelia C. Baldwin, Alice M. Buchanan, and Mary E. Rudisill, “What Teacher Candidates Learned About Diversity, Social Justice, and Themselves from Service-Learning Experiences,” Journal of Teacher Education 58, no. 4 (September 2007): 315–27, doi:10.1177/0022487107305259. 3. Boyle-Baise, “Preparing Community-Oriented Teachers;” Rahima Wade, Handbook of Research in Social Studies Education, eds. Linda S. Levstik and Cynthia A. Tyson (New York: Routledge, 2008): 109-23 4. Cheryl Blosser and John Winnenberg, Agents of Change: The Pioneering Role of the Miners of the Little Cities of Black Diamonds in the Nations Labor Movement, (Shawnee, OH: The Little Cities of Black Diamonds Council, 2006); Frans H. Doppen, Richard L. Davis and the Color Line in Ohio Coal: A Hocking Valley Mine Labor Organizer, 1862-1900, (Jefferson, NC: McFarland & Company, 2016); Frans H. Doppen and H. Perko, “All History is Local: Teaching about Southeast Ohio,” presented at Ohio Council for the Social Studies Annual Conference, Columbus, OH, April 2008; Frans H. Doppen and John Winnenberg, “Taking Charge of Change: The Untold Story of Southeast Ohio,” presented at Ohio Council for the Social Studies Annual Conference, Columbus, OH, September 2011. 5. Barbara Jacoby, Service-Learning Essentials: Questions, Answers and Lessons Learned, (San Francisco, CA: Jossey-Bass, 2015). 6. Baldwin et al., “What Teacher Candidates Learn;” Wade, Handbook of Research.” 7. Bruce A. Miller, Service-Learning: Applications from the Research, ed. Alan S. Waterman, (Mahwah, NJ: Lawrence Erlbaum Associates, 1997).


Surviving to Thriving 25

8. Hamdan Said, Iqbal Ahmad, Zainudin Hassan, and Zubaidah Awang, “Service Learning as Critical Pedagogy: Implications for Student Community Awareness and Citizenship Development,” Mediterranean Journal of Social Sciences 6, no. 2 (2015): 472-78, DOI:10.5901/mjss.2015.v6n2p471. 9. Boyle-Baise, “Preparing Community-Oriented Teachers.” 10. David Sobel, Place-Based Education: Connecting Classrooms & Communities, (Great Barrington, MA: Orion Society, 2004). 11. Amy L. Powers, “An Evaluation of Four Place-Based Education Programs,” The Journal of Environmental Education 35, no. 4 (2004): 17–32, DOI:10.3200/joee.35.4.17-32. 12. Ethan Lowenstein, K. Grewal Imandeep, Erkaeva Nigora, Lisa Voelker, and Rebecca Nielsen, “Place-based Teacher Education a Model Whose Time Has Come,” Issues in Teacher Education 27, no. 2 (2018): 36-52. 13. S. Anthony Deringer, “Mindful Place-Based Education: Mapping the Literature,” Journal of Experiential Education 40, no. 4 (2017): 333–48, doi:10.1177/1053825917716694; M. Hollstein and Frans H. Doppen, “Teaching Sustainability: Hydraulic Fracturing and the Legacy of Coal,” presented at Ohio Council for the Social Studies Annual Conference, Columbus, OH, October 2012. 14. William A. Schumann and Rebecca A. Fletcher, eds., “Appalachia Revisited: New Perspectives on Place, Tradition, and Progress” West Virginia History: A Journal of Regional Studies 11, no. 1 (2016), https://doi.org/10.1353/wvh.2017.0004; Stephen L. Fisher and Barbara E. Smith, eds. Transforming Places: Lessons from Appalachia, (Urbana, Chicago, and Springfield, IL: University of Illinois Press, 2012): 267-291; Rachel Terman, “Intersections of Appalachian identity,” in Appalachia revisited: New perspectives on Place, Tradition, and Progress, eds. William Schumann and Rebecca Adkins Fletcher, (Lexington: University Press of Kentucky, 2016): 7390. 15. Geoffrey L. Buckley, Nancy R. Bain, and Donald L. Swan, "When the Lights Go Out in Cheshire," Geographical Review 95, no. 4 (2005): 53755; Blosser and Winnenberg, Agents of Change. 16. Nadinne Cruz, and Dwight Giles, “Where’s the Community in Service-Learning Research?” Michigan Journal of Community Service Learning (2000): 28-34; Lisa Garoutte, and Kate McCarthy-Gilmore, “Preparing


26 Out of the Bubble

Students for Community-Based Learning Using an Asset-Based Approach,” Journal of the Scholarship of Teaching and Learning 14, no. 5 (2014): 48-61, DOI: 10.14434/josotlv14i5.5060. 17. Jacoby, Service-Learning Essentials; Garoutte and McCarthy-Gilmore, “Where’s the Community in Service-Learning Research?” 18. Susan V. Iverson, and Jennifer H. James, “Becoming ‘Effective’ Citizens? Change-Oriented Service in a Teacher Education Program,” Innovative Higher Education 35, no. 1 (2009): 19–35, https://doi.org/10.1007/s10755-009-9127-y. 19. Iverson and James, “Becoming ‘Effective’ Citizens?” 20. Said et al., “Service Learning as Critical Pedagogy.” 21. Jacoby, Service-Learning Essentials. 22. Ivan Tribe, Little Cities of Black Diamonds: Urban Development in the Hocking Coal Region, 1970-1900, (Athens, OH: Athens County Historical Society & Museum, 1988); Ivan Tribe, Sprinkled with Coal Dust: Life and Work in the Hocking Coal Region, 1870-1900, (Athens, OH: The Athens County Historical Society, 1989). 23. John Winnenberg, The Story of our Community: Little Cities of Black Diamonds, (Shawnee, OH: Sunday Creek Associates, 2000). 24. Frans H. Doppen, M. Carlstrom, and D. Yoder, “Everything is Local: Service-learning in Southeast Ohio,” presented at the Ohio Council for the Social Studies Annual Conference, Columbus, OH, March 2009; Frans H. Doppen, John M. Winnenberg, and Jennifer K. Hinkle, “Southeast Ohio Reflects on the 50th Anniversary of the War on Poverty,” Ohio Social Studies Review 54, no. 1 (2017): 7-15. 25. Michael A. Kopish, “Advancing Democracy in Teacher Education: Service-Learning in Thirdspace Partnerships,” Service-Learning to Advance Access & Success: Bridging Institutional and Community Capacity, (Charlotte, NC: Information Age Publishing, 2018): 241-82; Michael A. Kopish, “Third Space Partnerships for Teacher Education in Rural Communities,” Innovation and Implementation in Rural Places: School-University-Community Collaboration in Education, eds. R. Martin Reardon and Jack Leonard, (Charlotte, NC: Information Age Publishing, Inc., 2018): 135-59. 26. Margaret S. Crocco and Michael P. Marino, “Promoting InquiryOriented Teacher Preparation in Social Studies Through the Use of Local History,” The Journal of Social Studies Research 41 (2015): 1-10, DOI: 10.1016/j.jssr.2015.11.001


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27. Frans H. Doppen, et al., “Southeast Ohio Reflects on the 50th Anniversary of the War on Poverty.” 28. Karen Goodlad and Anne E. Leonard. “Place-Based Learning Across the Disciplines: A Living Laboratory Approach to Pedagogy,” InSight: A Journal of Scholarly Teaching 13 (2018): 150-164.


Chapter 3 The Buried Past: Uncovering the Cultural Heritage of the Hocking River Valley B. Patrick Fahey Before the creation of Ohio University’s Archaeological Field School in 1986, the prehistory of the Hocking River Valley was virtually unknown. This chapter discusses how Ohio University has been a leader in reconstructing the past of southeastern Ohio. Most of the research from the field school’s excavations focused on the pre-Columbian populations who were the first humans to inhabit the river valley. Recent work focuses on the interactions between their rich culture and the native plants of the area. This work shows that prehistoric communities domesticated native crops, collectively called the Eastern Agricultural Complex, and sustained themselves through small-scale farming. Knowledge of these ancient native crops has been propelling ideas about re-domesticating them for modern consumption. Introduction The Ohio University Archaeological Field School (OUAFS) has been uncovering the forgotten prehistory of the Hocking River Valley for more than thirty years. The program is an intensive course in archaeological field methods offered in the summer to interested undergraduates at Ohio University. Unlike most classes, students of OUAFS are directly involved in collecting primary data on important archaeological sites. In addition to reviewing the literature on what archaeologists have already discovered in the


Surviving to Thriving 29

region, these students are engaged with the unanswered questions of the Hocking River Valley’s ancient populations as they gain real experience excavating artifacts. OUAFS has trained more than 350 students, many of whom have gone on to become professional archaeologists. The excavations have also produced a considerable amount of archaeological data that has led to the publication of dozens of articles in peer review journals, as well as a book on the Hocking River Valley’s prehistory.1 The work of Ohio University’s faculty and students has resulted in the discovery of thousands of years of human activity and cultural heritage, rewriting the history of southeast Ohio’s foothills, and recapturing the life histories of forgotten populations. In this chapter, I describe the history of archaeology within the Hocking River Valley and the OUAFS’s important role in collecting influential archaeological data. This data has led to important insights into a suite of forgotten crops that were once cultivated in the region. The Lost Crops Garden Network, a collective of academics including Ohio University faculty and students, is using evidence of these lost crops to reevaluate their past significance and future potential. History of Archaeology in The Hocking River Valley The Hocking River Valley has been known to be home to pre-Columbian populations long before white settlers entered the region. The name Hocking itself comes from the Delaware Indian word Hakhakkien (meaning “bottle” or “fertile land,” depending on interpretation).2 However, archaeological research within the Hocking River Valley was infrequent, sporadic, and focused only on the excavations of prehistoric ritual sites prior to the creation of OUAFS. Such sites were typified by burial mounds, associated circular structures made from wooden posts, and large earthen ceremonial circles surrounded by a ditch that can be seen throughout eastern North America,3 and are amongst the most conspicuous architectural structures that remain from the pre-Columbian cultures. These burial mounds and ritual sites have been the focus of archaeologists since the publication of the influential Ancient Monuments of the Mississippi Valley by the Smithsonian Institute in 1848.4 Allured by the prospect of elaborate grave goods, archaeologists studied these mortuary and ritual sites to the exclusion of other sites that could speak more to the daily lives of the


30 The Buried Past

prehistoric communities. This attention to mound research has potentially led to misleading interpretations of past cultures that overstress the importance of ritual culture while ignoring cultural and social structure clues that can only be seen in domestic (village or hamlet) settings.5 Prehistoric investigation during this time was also hindered by the use of poor excavation methods causing archaeologists to overlook data and destroy sites in the process. One archaeological study within the Hocking River Valley conducted by E. B. Andrews between 1875-1880 found that an extensive amount of looting had occurred to the burial mounds by collectors who would trench through graves in search of artifacts.6 Early mound excavations conducted by both looters and professional archaeologists often consisted of tunneling or trenching by digging a hole straight down from a mound’s center or tunneling in through the side. These methods are incongruous with the precision of modern standards. Tunneling and trenching miss a great deal of archaeological data and make the use of statistical analysis impossible. Often, the sole focus of these excavations was the recovery of interesting artifacts to be displayed in museums or sold to collectors. This work added little knowledge about the populations that created them. The Scioto and Hocking River Valleys are in Appalachian Ohio and contain the highest density of prehistoric earthworks in eastern North America, represented by large earthen mounds. These architectural marvels attracted a considerable amount of attention from archaeologists. Despite its proximity, the Hocking River Valley was largely overlooked by archaeologists, with only a handful of surveys and excavations taking place before the 1950s.7 The Hocking Valley contains the Plains earthworks, located several miles northwest of Athens, Ohio. This is the largest mound center in the Hocking River Valley with up to 30 mounds and one of the largest collections of Adena mounds in the United States.8 Mounds within the Hocking River Valley attracted considerably less research interest than those of the Scioto. Squier and Davis, authors of Ancient Monuments of the Mississippi Valley, reference the excavation of two mounds within the Hocking River Valley, including one belonging to the extensive Plains earthworks. They conclude, “an examination of the valley with a view of bringing to light its ancient monuments would, without doubt, be attended with very interesting results.�9 Their call for further exploration in the Hocking was not met with action, however, and the Hocking remained unstudied by scientists for decades.10


Surviving to Thriving 31

A comprehensive study of the prehistory of the Hocking River Valley did not begin until the mid-1960s. James Murphy conducted excavations around Athens, Ohio, and drew from the mound excavations of previous archaeologists. Cultural Resource Management (CRM) firms were involved in several archaeological projects through surveys and salvage excavations on construction sites. Murphy’s own excavations and those of CRM firms culminated in the publication of the most complete review of Hocking Valley prehistory of that time, Archeological History of the Hocking Valley.11 In it, Murphy describes that state of the Hocking Valley archaeological record being inadequate and quickly depreciating due to looting. He observed that “much more work remains to be done before we may be said to have even a good overview of the valley’s archaeological remains . . . Without a detailed survey of the region, followed by careful excavation of the major sites discovered, much of the Hocking’s archaeological history will be lost forever.”12 The Ohio University Archaeological Field School In the summer of 1986, the OUAFS was formed by Dr. Elliot Abrams to train Ohio University students in archaeological field methods and collect data on Hocking River Valley habitation sites. Unlike the burial mound sites that were the focus of previous Hocking archaeological excavations, OUAFS focused on excavating and analyzing habitation sites to recreate a picture of how humans conducted their daily life. In its first 30 years, OUAFS extensively excavated 19 sites in the Hocking River Valley, only one of which was a mound.13 OUAFS excavated this mound to salvage its contents before it was destroyed due to construction. Because of OUAFS’s dedication to excavating habitation sites, it has contributed a more holistic picture of ancient life in the Hocking River Valley. This work has moved prehistoric knowledge of the Hocking River Valley beyond categorizing burial artifacts to understanding the demographic and settlement trends,14 domestic architecture,15 food,16and land use17 of ancient populations. Between 2013-2017, excavations by OUAFS under the direction of Dr. Paul Patton focused on understanding how prehistoric populations interacted with native crops. This research agenda led to novel insights into prehistoric farming in eastern North America. For example, many sites across eastern North America, including those within the Hocking River Valley,18


32 The Buried Past

contain evidence of native domesticated plants. Within archaeological literature, however, there has been a robust debate as to the degree to which prehistoric populations cultivated and relied upon farming. While some argue for the existence of a prehistoric economy based on the cultivation of native plants,19 others argue that populations remained more reliant on foraged foods while cultivation of wild species was more supplemental.20 Prehistoric Domestication in the Hocking River Valley Over the last half century, analysis of plant remains found at archaeological sites throughout eastern North America have codified the region as an independent center of plant domestication, with evidence of domesticated plants entering the archaeological record during the Late Archaic Period (ca.5950-2650 BP) and becoming the dominant botanical ecofact in the Middle Woodland Period (ca. 2650-2150 BP).21 Prehistoric populations of this region cultivated a suite of native plants that is referred to collectively as the Eastern Agricultural Complex (EAC). Numerous sites, most of which are described as domestic or habitation sites, indicate the prehistoric domestication of at least five annual plants: chenopods (Chenopodium berlandieri ssp. jonesianum), sunflower (Helianthus annuus var. macrocarpus), marshelder (Iva annua var. macrocarpa), squash (Cucurbita pepo),22 and erect knotweed (Polygonum erectum).23 Two of these plants, sunflower and squash, have remained a popular part of the modern diet and are grown on large, industrial agricultural farms. All other plants of the EAC are no longer cultivated and the domesticated varieties have gone extinct. It is likely that maize supplanted these crops after it entered eastern North America through trade with Mexico, becoming the cornerstone of a new agricultural economy of the Hocking River Valley beginning 1,300 years ago.24 With humans no longer tending to them, the domesticated EAC plants returned to their wild morphologies and make up the “lost crops� of eastern North America. Some of these lost crops’ wild varieties, such as chenopods and marshelder, are considered weeds today and the targets of herbicides to prevent growth in agricultural fields. The evidence that this suite of crops once existed can only be found buried in archaeological contexts, as there is no reliable ethnographic or historical record of humans cultivating them. The EAC may have first been domesticated along the western edge of Appalachia. This is where the earliest evidence of domesticated erect knotweed,25 sunflower, and chenopods26


Surviving to Thriving 33

have been discovered in Late Archaic contexts. Southeast Ohio sits at the eastern edge of the EAC’s ancient extent. Research by Ohio University faculty and students, with data obtained during excavation of the OUAFS, has revealed previously unknown farming practices within the Hocking River Valley and unknown details of the EAC. The County Home site, excavated by OUAFS in 1998, yielded the earliest evidence of domesticated chenopods and marshelder in the mid-Ohio Valley, and suggests an early adoption of plant cultivation by populations within the Hocking River Valley.27 Excavations by OUAFS in the summer of 2016 and 2017 of an upland site revealed that prehistoric populations had been caching thousands of domesticated chenopod seeds, as well as smaller quantities of other EAC crops and lithic tools, in buried ceramic vessels.28 These cache pits were located on a high elevation ridge, outside the natural habitat of plants below in the floodplains. This suggests prehistoric populations were using upland environments for cultivation in previously unknown ways and encourages further research of often ignored ridgetops. Reviving the Lost Crops Studying lost crops not only provides information about prehistoric life and subsistence strategies but may offer opportunities to domesticate these crops as native alternatives to modern cash crops grown in Appalachia. A group of anthropologists from across the Midwest, including Patton and Ohio University alumnus Daniel Williams, formed the Lost Crops Garden Network to better understand the EAC. The group was formed at the 2016 Southeastern Archaeology Conference as a collaborative network between several researchers studying the domestication and cultivation of the EAC through the archaeological record and experimentation. The lost crops of the EAC offer an unorthodox solution to food insecurity and diminishing agrodiversity that plagues Appalachia today. Across the entire United States, agriculture diversity decreases every year as field crop production becomes more centralized in only a few crops, with agrodiversity being particularly low in many parts of central Appalachia.29 This increasingly homogeneous crop system poses risks to food security as an increasingly unpredictable climate escalates the chance for widespread crop failure. Farmers growing a wider variety of crops reduce economic risks posed by low yields of a single crop.


34 The Buried Past

Because the native EAC crops evolved in local soils with local pests, they are naturally adapted to thrive in this environment. They would likely require less industrial maintenance that alters the ecosystems. Less fertilizing chemicals would need to be supplied to fix the soil, as these plants are accustomed to the marginal soils that are present in parts of the region. These plants would also be less intrusive to local ecosystems as they are already woven into the complex ecology of the wilderness surrounding agricultural fields. We expect that encouraging their growth rather than foreign tropical grasses, such as corn, would promote the biodiversity of the pollinators and other fauna that have evolved to be attracted to these plants. Lost Crop Garden Network researchers are growing the wild EAC crops in experimental gardens to demonstrate how wild EAC plants react to cultivation and to better understand prehistoric selection for these plants and the potential for redomestication.30 Research at Ohio University has focused on chenopods (Chenopodium berlandieri var. jonesianum) due to its prevalence in archaeological sites and abundant modern wild populations in the Hocking River Valley. Through their archaeological and experimental investigations, Patton and Williams aim to raise awareness that the weeds growing along the field’s edge may be more beneficial if allowed into the field center. Chenopods, colloquially called goosefoot or lambs quarters, are a tall, leafy perennial plant that produces an abundance of small seeds. Although today this plant is little known for its economic value, its close relative has a considerable reputation. Quinoa (Chenopodium quinoa) is a South American cultivar that is closely related to eastern North American chenopods. Quinoa has recently become one of the most economically prized crops in the world, with the United Nations declaring 2013 to be the “International Year of Quinoa.� Valued for its high protein and micronutrient content, sales of quinoa have drastically increased over the past three decades. Demand for the food began to skyrocket in 2007, when the United States imported 7.3 million pounds of quinoa. By 2012, the US was importing nearly 60 million pounds of the seed.31 The sudden demand for quinoa has caused an economic boom in the central Andes, where the majority of quinoa is produced.32 Due to its increasing economic significance, farmers have attempted to produce quinoa within the United States. The USDA has recently funded research to find ways to grow quinoa productively in North America.33 Quinoa production has been focused in the Colorado Rockies34 and


Surviving to Thriving 35

the Pacific Northwest. American producers are, however, struggling to fulfill the demand for quinoa in America. Growers are finding quinoa, native to equatorial alpine deserts, to be a difficult plant to grow in temperate North America.35 Williams believes the solution to growing quinoa in the United States should focus on looking at endemic species of chenopods already thriving in the United States rather than finding a suitable variety of South American quinoa.36 Ohio University established experimental gardens to better understand the growing conditions and harvesting of chenopod varieties within Appalachia.37 Williams analyzed chenopod varieties from all over the eastern U.S., as far north as Maine and as far south as the Gulf of Mexico, looking at morphological diversity. He discovered a great deal of seed diversity existed within the region, which will be beneficial in re-domestication processes, as more options are available to crossbreed. Williams observed the growth of these seeds in controlled conditions, observing the functionality of different varieties, both wild and domesticated, of Chenopodium seed coat thickness and shape during germination. An individual wild chenopod plant will produce seeds with a variety of seed coat thicknesses (seed polymorphism). This behavior, often described as bet hedging behavior, creates a diversity of seed types per plant to hedge bets against different risk factors. For example, seeds with thicker coats may survive harsher conditions, but may take longer to germinate. Domestication discourages bet hedging and favors a reduction in seed polymorphism, as has been seen in the archaeological record of the EAC crop erect knotweed as it underwent domestication in prehistory.38 The result is a plant that produces a consistent variety of seeds that are valuable for human consumption. Understanding the mechanisms in which a wild plant will consistently produce seed with large fruits and thin seed coats is beneficial to quickly domesticating a plant. Harvesting experiments have revealed that eastern North America varieties of chenopods have the potential to produce quantities of seed comparable to crops such as quinoa, and selective breeding could further increase these.39 Appalachian farmers could benefit greatly from the re-domestication of chenopods. Low value crops, such as animal fodder, are the main product of many Appalachian farms. Today, corn grown for livestock feed is one of the principal crops grown in southeast Ohio. In 2015, feed corn in southeast


36 The Buried Past

Ohio covered 65,000 acres, second only to hay in crop landcover in the region.40Introducing a high value crop, as chenopods are expected to be, could revitalize the agricultural economy. Ohio University researchers working on the lost crops, such as Patton, Williams, and former students of OUAFS, are employing knowledge of the past gained through the archaeological record to address contemporary problems of food insecurity in Appalachia. The discovery of ancient cultivars native to the region have added potential new food sources for modern humans. These plants have the potential to revive elements of a lost prehistoric culture while giving Appalachia a stable food source that can be economically important, resilient to climate change, and work with the local ecology. Conclusion The OUAFS and its collaborators have exposed a holistic prehistory of the Hocking River Valley. The excavations of habitation and hunting sites help to reconstruct the human experience within the prehistoric Hocking River Valley. Previous research that exclusively focused on mound excavations missed these data that inform archaeologists about daily life. The OUAFS has left a legacy of domestic archaeological data and analysis that has reshaped our understanding of the Hocking River Valley’s extensive human history. The recent focus of the OUAFS on prehistoric plant cultivation within the river valley has led to the discovery of thousands of domesticated chenopod seeds within archaeological contexts. These data add novel insights about prehistoric plant use, such as the cultivation of plants on ridgetops far above the plant’s natural habitat. Further research into prehistoric farming land use will help archaeologists better understand the way in which humans domesticated, propagated, and harvested the lost crops of the EAC. Further, this research into past plant domestication has led efforts in better understanding a potential for future development of new agricultural practices based on farming native crops. If re-domesticated, chenopods native to Appalachia offer a local resource that can be beneficially exploited. Lost crops native to Appalachia offer nutritious alternatives to mono-cropping, with the added benefit of potentially invigorating the region’s economy.


Surviving to Thriving 37

Notes 1. Elliot M. Abrams and AnnCorinne Freter, The Emergence of the Moundbuilders: The Archaeology of Tribal Societies in Southeastern Ohio, eds. Elliot M. Abrams and AnnCorinne Freter (Athens, OH: Ohio University Press, 2005). 2. James L. Murphy, “Hakhakkien: Origin of the Name for the Hocking,” in An Archeological History of the Hocking Valley (Athens, OH: Ohio University Press, 1989), 15–20. 3. R Berle Clay, “The Essential Features of Adena Ritual and Their Implications,” Southeastern Archaeology 17, no. 1 (1998): 1–21. 4. Ephraim George Squier and Edwin Hamilton Davis, Ancient Monuments of the Mississippi Valley, Comprising the Results of Extensive Original Surveys and Explorations (Washington, D.C.: Smithsonian Institution Publications, 1848). 5. Clay, “The Essential Features of Adena Ritual and Their Implications.” 6. James L. Murphy, “Nineteenth Century Archeology in the Hocking Valley,” in An Archeological History of the Hocking Valley (Athens, OH: Ohio University Press, 1989), 47–60. 7. Murphy, “Hakhakkien.” 8. James L. Murphy, “Early Woodland: The Wolf’s Plains Mound Group,” in An Archeological History of the Hocking Valley (Athens, OH: Ohio University Press, 1989), 195–214. 9. Squier and Davis, Ancient Monuments of the Mississippi Valley, Comprising the Results of Extensive Original Surveys and Explorations. 10. Murphy, “Nineteenth Century Archeology in the Hocking Valley.” 11. James L. Murphy, An Archeological History of the Hocking Valley (Athens, OH: Ohio University Press, 1989). 12. Murphy, “Hakhakkien,” 60. 13. Elliot M. Abrams, “Archaeological Investigation of the Armitage Mound (33-At-434), The Plains, Ohio,” Midcontinental Journal of Archaeology 17, no. 1 (1992): 80–111. 14. Nicole I. Stump et al., “A Preliminary GIS Analysis of Hocking Valley Archaic and Woodland Settlement Trends,” in The Emergence of the Moundbuilders, eds. Elliot M. Abrams and AnnCorinne Freter (Athens, OH: Ohio University Press, 2005), 25–38.


38 The Buried Past

15. Elliot M. Abrams and Paul E. Patton, “The Ecology of Indigenous Domestic Archecture in the Hocking Valley, Ohio,” in Building the Past: Prehistoric Wooden Post Architecture in the Ohio Valley-Great Lakes, eds. Brian G. Redmond and Robert A. Genheimer (Gainesville, FL, 2015), 63–84; Sarah A. Weaver et al., “Middle Woodland Domestic Architecture and the Issue of Sedentism: Evidence from the Patton Site (33AT990), Hocking Valley, Ohio,” Journal of Ohio Archaeology 1 (2011): 22–37. 16. Paul E. Patton and B. Patrick Fahey, “Moving Beyond the Question: Were the Hopewell Really Farmers? Evidence from the Hocking Valley, Ohio,” in Ohio Hopewell, eds. Redmond Brian and Albert Tonetti (Akron, OH: University of Akron Press, 2019). 17. Dee Anne Wymer, “Late Prehistoric Agriculture and Land Use in the Hocking Valley,” in The Emergence of the Moundbuilders, eds. Elliot M. Abrams and AnnCorinne Freter (Athens, OH: Ohio University Press, 2005), 151--162. 18. Bruce D. Smith, “Chenopodium Berlandieri Ssp. Jonesianum: Evidence for a Hopewellian Domesticate From Ash Cave, Ohio,” Southeastern Archaeology 4, no. 2 (1985): 107–33; Patton and Fahey, “Moving Beyond the Question: Were the Hopewell Really Farmers? Evidence from the Hocking Valley, Ohio.” 19. Patton and Fahey, “Moving Beyond the Question.” 20. Richard Yerkes, “Middle Woodland Settlements and Social Organization in the Central Ohio Valley: Were the Hopewell Really Farmers?,” in Recreating Hopewell, ed. Douglas K. Charles and Jane E Buikstra (Gainesville, FL: University Press of Flordia, 2006), 50–61. 21. Paul E. Patton and Sabrina Curran, “Archaic Period Domesticated Plants in the Mid-Ohio Valley: Archaeobotanical Remains from the County Home Site (33at40), Southeastern Ohio,” Midcontinental Journal of Archaeology 41, no. 2 (2016): 127–58, https://doi.org/10.1080/01461109.2016.1153180. 22. B. D. Smith, “Eastern North America as an Independent Center of Plant Domestication,” Proceedings of the National Academy of Sciences 103, no. 33 (2006): 12223–28, https://doi.org/10.1073/pnas.0604335103. 23. Natalie G. Mueller, “The Earliest Occurrence of a Newly Described Domesticate in Eastern North America: Adena/Hopewell Communities and Agricultural Innovation,” Journal of Anthropological Archaeology 49 (2018): 39–50, https://doi.org/10.1016/j.jaa.2017.12.001.


Surviving to Thriving 39

24. Joseph E Wakeman, “The Impact of Maize on Settlement Patterns in the Hocking Valley,” in The Emergence of the Moundbuilders, eds. Elliot M. Abrams and AnnCorinne Freter (Athens, OH: Ohio University Press, 2005), 163–73. 25. Mueller, “The Earliest Occurrence of a Newly Described Domesticate in Eastern North America: Adena/Hopewell Communities and Agricultural Innovation.” 26. Smith, “Eastern North America as an Independent Center of Plant Domestication.” 27. Patton and Curran, “Archaic Period Domesticated Plants in the Mid-Ohio Valley: Archaeobotanical Remains from the County Home Site (33at40), Southeastern Ohio.” 28. Patton and Fahey, “Moving Beyond the Question: Were the Hopewell Really Farmers? Evidence from the Hocking Valley, Ohio.” 29. Jonathan Aguilar et al., “Crop Species Diversity Changes in the United States: 1978-2012,” PLoS ONE 10, no. 8 (2015): 1–14, https://doi.org/10.1371/journal.pone.0136580. 30. Natalie G. Mueller et al., “Growing the Lost Crops of Eastern North America’s Original Agricultural System,” Nature Plants 3, no. October (2017): 1–5, https://doi.org/10.1038/nplants.2017.92. 31. Lydia DePillis, “Quinoa Should Be Taking over the World. This Is Why It Isn’t.,” The Washington Post, July 11, 2013. 32. Tanya M. Kerssen, “Food Sovereignty and the Quinoa Boom: Challenges to Sustainable Re-Peasantisation in the Southern Altiplano of Bolivia,” Third World Quarterly 36, no. 3 (2015): 489–507, https://doi.org/10.1080/01436597.2015.1002992. 33. Scott Weybright, “$2M Grant Funds Continuing WSU Research of Organic Quinoa,” WSU Insider, October 31, 2016. 34. Alastair Bland, “Quinoa Craze Inspires North America To Start Growing Its Own,” NPR, November 29, 2012. 35. Adam J. Peterson and Keven M. Murphy, “Quinoa Cultivation for Temperate North America: Considerations and Areas for Investigation,” in Quinoa Improvement and Sustainable Production, eds. Kevin M. Murphy and Janet Matanguihan (Hoboken, NJ: John Wiley & Sons, Inc., 2015), 173–192. 36. Daniel R. Williams, “Seed Polymorphism and Domestication in the Lost Crop Chenopodium Berlandieri” (Ohio University, 2019).


40 The Buried Past

37. Williams, “Seed Polymorphism.” 38. Natalie G. Mueller, “Documenting Domestication in a Lost Crop (Polygonum Erectum L.): Evolutionary Bet-Hedgers under Cultivation,” Vegetation History and Archaeobotany 26, no. 3 (2017): 313–27, https://doi.org/10.1007/s00334-016-0592-9. 39. Williams, “Seed Polymorphism and Domestication in the Lost Crop Chenopodium Berlandieri.” 40. Cheryl Turner and Brooke Morris, “Ohio Agricultural Statistics 2017-2018 Annual Bulletin,” United States Department of Agriculture National Agricultural Statistics Service, 2017, https://doi.org/10.1520/G0001-03R11.2.


Chapter 4 In Seeds, We Hold the Future: A Survey of Why Seeds are Saved in Appalachian Southeastern Ohio Lisa Trocchia Theresa Moran Charlene Suggs

Nourish beginnings, let us nourish beginnings. Not all things are blest, but the seeds of all things are blest. The blessing is in the seed. Muriel Rukeyser, Elegies of Joy Background of the Study As the story goes, a West Virginia man, Marshall Cletis (M.C.) Byles, loved gardening. He was a mechanic by trade, known as “Radiator Charlie,� but in the 1930s, with the Great Depression creating economic pressures for people in Appalachia, he had an idea. He wanted to breed a tomato that would feed families and be a good value. His goal was to produce a fruit that would be both large and tasty. Starting with a few seeds from available open-pollinated varieties, he saved seeds each year from plants he cross-pollinated in his garden. Eventually, he created a stable variety he was satisfied with. The plant became instantly popular because it produced flavorful tomatoes averaging 2 to 4 pounds apiece. They were disease resistant, low in


42 In Seeds

acid, and had a higher meat-to-seed ratio than many other varieties. Byles began to sell the seeds and within a few years, had earned enough money to pay off the $6000 mortgage on his home. In the 1980s, he shared the seeds, now known as “The Mortgage Lifter,” with Southern Exposure Seed Exchange.1 The Mortgage Lifter is a favorite variety of heirloom tomato for seed savers today in Appalachia and the story illustrates many of the complex relationships between seeds and people in the region. While the story of the Mortgage Lifter tomato demonstrates the potential value of seed saving, in our contemporary American industrial food system, the traditional practices of seed saving are not necessary for food production. Instead, seed saving is gaining attention as a strategy to promote biodiversity, protect against food insecurity, and ensure food sovereignty. In 2018 we completed a survey of seed saving motivations and practices in Appalachian Ohio. The research was part of a larger project into seed saving practices in the Andean Highlands undertaken with Ohio University’s (OHIO) institutional partner, Pontifical Catholic University of Ecuador.2 The goal of the larger project was to create a comparative pilot project for building capacity and resilience in Appalachian and Ecuadorian communities by establishing an inventory of seed saving activities. Using quantitative and qualitative approaches, we aimed to identify best practices and challenges to implementing seed saving practices. The larger goal was to align the project with the UN Sustainable Development Goals.3 These goals have seed saving at the core of efforts to address hunger and health through maintaining food system genetic diversity and promoting associated traditional knowledge. This chapter presents the findings from the Appalachian Ohio survey, demonstrating how seed saving, harkening back to Byles’ tomato, can be a strategy for building capacity and resilience in Appalachia. We begin with a historical overview of agriculture and seed saving in Appalachian southeastern Ohio, followed by a look at the relevance of seed saving today both locally and globally. We offer some findings of unique factors affecting Appalachia. We then describe the study methodology, discuss further the quantitative and qualitative findings, and conclude with the implications for seed saving initiatives in Appalachia and beyond.


Surviving to Thriving 43

Agricultural History of Appalachian Southeastern Ohio Southeastern Ohio lies within the federal designation of North Central Appalachia, part of the Appalachian Mixed Mesophytic Forest, one of the most biodiverse temperate ecoregions in the world.4 Perhaps due to the diversity of plants found in the region, familial communities began to inhabit the area, gathering food from wild resources, some twelve thousand years ago.5 Scholars suggest the microclimates and complex riverine ecologies found within the Ohio Valley provided an advantage for some of the earliest experiments with cultivation in North America.6 In southeastern Ohio, recent discoveries of species of chenopodium (a relative of quinoa), marshelder, and other cultigens, dating to 3000 to 3600 BC, are indicative of seed saving for staple food domestication occurring earlier than previously documented.7 In more modern times, during the late 18th and early 19th centuries, the culture of saving seeds in Appalachian Ohio was influenced primarily by European immigrants, who were subsistence farming with seed stock originally brought from their native lands. Because of relative isolation due to geography, generations of families and communities in this bioregion retained strains of original seed, while also developing distinct and acclimatized varieties of open-pollinated crops. About these agricultural practices, Elmer Gray asserts the tradition of saving seed “enhanced an already rich and varied environment” and acted as a traditional expression of pride and independence.8 Seed Saving Today Seed saving has never been more relevant. With its 12,000 years of history of improving agricultural production, seed saving was championed in the New York Times by celebrity chef and best-selling author, Dan Barber. Barber who co-founded a small seed company dedicated to biodiversity and emphasizing taste, not yield, writes that the security of our global food supply is threatened by the fact that 60% of the world’s seeds are controlled by just 4 companies. He calls for public action against this unprecedented level of consolidation, urging individuals to take up “seed stewardship” and calling for investment in land-grant universities to support the development of crop diversity.9


44 In Seeds

Barber applauds the work of small-scale seed organizations, such as the Organic Seed Alliance and Seed Savers Exchange, among others, that are dedicated to helping farmers and gardeners alike save seeds to expand biodiversity, crop variety and improve both nutrition and taste. He advocates for change in the current industrial food system—a system which has contributed to obesity and other health crises—and argues that this must begin with reclaiming seeds “not as commodities but as a vital part of our cultural commons.” Of course, seed saving practices have been integral in the “cultural commons” of many regions across millennia and around the globe. Preliminary findings of our study point to distinctive motivations for, and challenges to, seed saving in the Appalachian context. That context includes what Appalachian food activist and author Ronni Lundy calls “kinship and hardship.”10 For her, these twin markers of rural Appalachian culture have fostered generations of sharing both seeds and whatever the harvest produced. The Appalachian “cultural commons,” with a history of extractive industries taking profits from the region and leaving environmental degradation behind, now faces a new resource challenge related to seed saving. So here we see that the regions long acknowledged technological limitations impact an unexpected arena—the centuries-old tradition of seed saving. Lack of broadband is likely a significant factor in hampering the development of communities of seed savers, inhibiting access to critical information about seeds themselves, and limiting the exchange of community knowledge and expertise. In another example, echoing historical culturally distinctive Appalachian characteristics, the practice of seed saving represents personal independence and self-sufficiency regardless of any actual monetary differential in saved versus commercial seed. On the global stage, the United Nations Sustainability Development Goals, a set of 17 areas for action to encourage prosperity and protect the planet, include seed saving as a strategy to end poverty and enhance sustainability. Specifically, seed saving can tackle food insecurity, improve nutritional status, and promote food sovereignty. And in fact, Radiator Charlie’s Mortgage Lifter demonstrates how this once common practice can do just that. The Mortgage Lifter also proves that growing food from saved seeds can provide a degree of economic independence. Paradoxically, the rich tradition and history of seed saving in Appalachia, North America's most biodiverse region, exists in contrast with the region’s well-documented contemporary challenges with food access. Scholars


Surviving to Thriving 45

such as the ethnobotanist Gary Nabhan (with his Renewing America’s Food Traditions—RAFT—and subsequent establishment of RAFT Alliance), along with botanists and social justice activists, write of the pressing need to preserve the unique biodiversity of our region’s vegetables, fruits, and grains.11 This biodiversity is threatened by extractive industries, outmigration, conventional agricultural practices, and environmental degradation. Bill Best’s Saving Seeds, Preserving Taste: Heirloom Seed-Saving in Appalachia,12 speaks to Appalachia’s rapidly disappearing seeds and to the loss of taste and knowledge that those seeds represent. In addition to the superior taste found in produce from saved seeds as documented by Best, saved seeds often have greater climate resilience and are more adaptable to environmental challenges such as soil depletion. The Study: Motivation to Save Seed Against this backdrop of rich history and contemporary challenges, we specifically wanted to find out why seeds were being saved in Appalachian Ohio. As suggested by Gray and others,13 the value in saving seed and the motivation to maintain this practice in the Appalachian Ohio bioregion has been attributed to preserving cultural identity, building community, cultivating self-sufficiency, creating alternative currencies, and enriching natural ecologies. The Ecuadorian study (conducted in 2017 and partially funded through a joint project grant with Ohio University) indicates that Andean communities are motivated to save seeds for reasons related to food sovereignty, the desire to preserve family gardens, and to save specific seeds as family or community legacies. Informed by this study, a team of researchers associated with Food Studies at Ohio University framed preliminary research to establish a baseline assessment of motivational factors for seed savers in Appalachian southeastern Ohio. We used a non-probability sampling methodology study to elicit information from seed savers. In semi-structured interviews, conducted from January 2018 through November 2018, we engaged 46 participants representing 7 counties (encompassing 15 townships): Athens, Highland, Hocking, Meigs, Morgan, Vinton, and Washington. The average age of the participants was 53, with the youngest being 29 and the oldest 81. The study was relatively gender balanced, with just over half (25) identifying as male, and just under half (21) identifying as female.


46 In Seeds

As part of the interview, participants were asked to rate their motivation to save seeds in response to eight statements. To evaluate these, they were given a 1 to 5 scale with 5 = very strong motivation, 4 = strong motivation, 3 = some motivation, 2 = very little motivation, 1 = slight to no motivation. Participants rated the following statements: I am motivated to the save seeds of the food crops I grow for: 1) taste; 2) appearance; 3) plant resilience; 4) contribution to increased biodiversity; 5) family or community legacy; 6) self-reliance; 7) cost of seeds; and 8) personal well-being. The eight statements are intentionally subjective and left to the interpretation of the participants, while encouraging discussion. We categorize the statements to learn the perceived value of taste and appearance of food items (1 and 2); focus on perceptions of sustainability and changing environment (3 and 4); and compare with the Ecuadorian study (5, 6, and 8). Statement 8 was derived from commonly held values of the positive effects of engagement with nature and gardening. If requested, we provided interviewees statements to clarify terms. In these cases, interviewers provided the following guidelines: •

•

Plant resiliency: Selecting for seeds that come from the most robust plants, come from plants that grow well in local (and changing) conditions, or demonstrate resistance to pests and disease. Self-Reliance: A measure of independence; having control over your food source.

The top three motivational factors for seed saving are to cultivate plant resiliency, establish self-sufficiency, and promote biodiversity. A narrative analysis of the semi-structured interviews supports the ranking. During our conversations with survey participants, they describe seed saving as valuable knowledge that more people should be aware of. They also tend to agree that seed saving is understood to be a skill that enables independence and self-sufficiency and sustains the environment. Quantitative Results We first discuss the quantitative results and then the qualitative results from the interviews. Figure 1 summarizes the average rating of motivation statements from all respondents. The average response indicates that all the statements, except the cost of seeds, motivate participants to practice saving


Surviving to Thriving 47

seeds. Five of the eight statements were strongly motivating factors (average greater than 4.0): taste, plant resilience, maintaining biodiversity, self-reliance, and well-being. 5

4.7

4.3

4.3

4

4.1

4 3.5

3.1

3

2.7

2 1 0

>4.0 (strong)

3.9 - 3.1 (some)

<3.0 (very little)

Figure 1: Average Rating of Motivation Statements (1: slight to no motivation --- 5: very strong motivation)

Figure 2 shows the rating of the motivation statements by the number of respondents. The statement that most people rated the highest was related to plant resilience. Sixty-five percent of all respondents gave this statement a top score of 5. Second to plant resilience, 63% of participants rated self-reliance as being their strongest motivating factor, and third was biodiversity with 54%. Next came taste with 52% and well-being with 43%. The statements that garnered the fewest number 5 ratings were family/community legacy (28%), appearance (24%), and cost (22%). However, combining numbers 4 (strong motivation) and 5 (very strong motivation) together as a measure of the significance of motivating factors gives a slightly different rating. As you can see in the figure, cost, appearance, and legacy where the least motivating individual factors for saving seeds, while plant resilience and self-reliance are the most motivating factors.


48 In Seeds

35 30 # of respondents

25 20 15 10 5 0

5 (very strong)

4 (strong)

3 (some)

2 (not strong)

1 (slight to none)

Figure 2: Individually Rated Motivations

Qualitative Results “Through seed saving, I have met people who have become great friends. Food connects people--and seeds are even more powerful than food, I think, because you are holding hope for the future." Study participant We also engaged with participants by encouraging narrative responses and storytelling as qualitative methods for evaluating what motivates people to save seeds. The protocol for the semi-structured interviews included asking for responses to specific questions, as well as encouraging stories through open inquiry through active listening. Participants describe individual practices and establish many effective elements in the experience of saving seeds. The intent of the researchers is that these qualitative data might be used, together with the preliminary quantitative data, to form the basis for more in-depth analysis, future study, and lead to community/university-based initiatives concerning food studies and seed saving education.


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On issues concerning the economics of saved seed (and the fruits, vegetables, and herbs grown from them), the narratives provided insightful details. Because non-probability methodology was used to establish the sample, we need to identify some limitations in our results. For instance, nearly half of those in the study have sold seeds (or produce from the seeds) at local retail venues is likely skewed by the number of participants being associated with the local farmers’ market (Athens Farmers Market) or local CSAs (Community Supported Agriculture). However, a significant number of individuals report that saved seed (or produce) is highly regarded as social capital. In many cases, this was expressed in terms of the Appalachian tradition of hospitality, cited as the custom of bringing small gifts to others when you visit or sending gifts, often food, home with visitors when they leave. Packets of saved seeds were mentioned as valuable in this context, as well as homemade jams or canned goods. Several stories included saving seeds as part of creating value in the process of nurturing community, in particular commenting on how alternative economies that involve the trade or barter of seeds, or food from saved seeds, have traditionally helped people in the region “get by.” Participants also describe how they use saved seeds in their gardens. This information suggested that participants plant about one-half of their gardens with saved heirloom, or open pollinated seeds, versus hybrid conventional seeds. Individuals in the study did not favor local retail sources over online sources for those seeds that are purchased annually, although several local businesses were mentioned repeatedly as primary sources. Generally, participants seemed interested in the “story” of the seed, when buying heirloom or open-pollinated seeds, as well as when they sought out unique varieties. For conventional varieties, proven traditional hybrids were favored, primarily for issues of yield and pest/disease resistance. Most participants conceded they only save seed from “easy to save” plants. Plants that require special pollination techniques or segregation from other varieties were too technically difficult or requiring too much time. Limits on garden space and available resources were also mentioned in this context. Education was a unanimous response to the question regarding what would make seed saving more popular. Access to land was mentioned several times, but all participants suggested more hands-on education should


50 In Seeds

be available to everyone who is interested. Highlights from these responses are listed below:     

  

“There is not enough education on the value of saving heirloom seeds.” “We need hands-on education. People just don’t know how to do it [save seeds].” “Access to land is important but we need to embrace our cultural orientation toward saving seeds.” “There should be seed saving social clubs!” “We need more education--maybe something like a collective people could be part of--something where each party would save one kind of seed and then share between the group. I think people would feel more responsible to do a good job and be consistent if people were depending on you.” “Seed-saving education is needed. So many people are disconnected from source of their food, and also brainwashed about needing GMOs to feed the world.” “We need more education and seed swaps in public locations, like the library or cafes.” “Seed saving education should come to the people; more hands-on workshops appropriate to place.” “People need education on the subject. They need initial exposure on the existence of the subject, most are unaware.”

Also noted were comments that spoke to both a lack of awareness of seed saving and lack of knowledge or interest in food itself. These echo Dan Barber’s arguments about the public’s disconnection between food consumed and seed, the origins of that food. 

“People have not passed this down as a family skill or have direct experience. Maybe a celebrity could help let people know about this topic?” “Lack of information and cultural awareness that seed saving is even done. If you don't any know that people do this, it's not on people's minds.” “People don't generally understand the importance of this process. They are generally disconnected from their food.”


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   

“We have super-busy lives. Things fall by wayside, got to get the idea going somehow.” “Most people don't know that you can save seeds; they are used to purchasing them.” “The time it takes is prohibitive to many considering that seeds are relatively cheap.” “People would benefit from having blog posts as well as a database of seeds being saved.”

One factor emerging from the interview and data collection process was limited broadband access. Both interviewers and survey participants expressed frustration with weak internet infrastructure including, in some areas, poor mobile phone service. Rural America’s inadequate internet infrastructure, the so-called digital divide is well-documented and is the subject of political discussion and legislation at both the federal and state level. Weak and inconsistent internet and cell service affects among other things access to health and government services, the ability to work remotely, and online shopping. Overall access to information and social media is also constrained. So, implementation of a seed saving education outreach relying on broadband would face this challenge in reaching a potential target population. Conclusion While seed saving in Appalachian southeastern Ohio has a long history, a significant number of individuals who were contacted for this study declined to participate, stating they are no longer practicing. Vegetables, fruits, and herbs from heirloom and open-pollinated traditional varieties are easier to buy at both major retail groceries as well as farmers’ markets. Time pressures, age, and the ease with which these types of seeds can be sourced were also mentioned as reasons why the individuals contacted no longer practice seed saving. Although this information is not formally included as part of the study, it is worth considering. The primary motivations to save seeds for participants in this study are interesting to compare to the results of the Ecuadorian study. The priorities for saving seed in the Appalachian southeastern Ohio seem to have less of an overt connection to community than Ecuadorian respondents.


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Expressions of community food sovereignty or family legacy are not expressed as often by Appalachian than by Ecuadorian respondents, although these motivations were mentioned in the narrative portions of the interviews. This difference might be inferred as reflecting normative American social constructs of individualism. Arguably, saving seed that has been selected for resiliency, a characteristic that enhances production capacity, results in a benefit enjoyed exclusively by the seed saver grower. Likewise, the desire to acquire the knowledge of how to save seed as a method of achieving self-sufficiency also could signify more independent, individual concerns, in contrast to community-centered motivations reported by the Ecuadorian study. That said, most Appalachian participants did express a commitment to the practice of sharing produce and saved seeds with friends, family, and neighbors. In conclusion, saving seeds in Appalachian southeastern Ohio is worthy of much more comprehensive study. Motivational priorities provide some insight into ways to maintain and grow the practice, and with it, the biodiversity represented in regional food crops. Studies that assess the economic impacts of this activity, and the potential of seed saving in developing inclusive diverse economies could provide rich areas of research. The theme that emerged most strongly from this study as an area of great interest is place-based seed saving education. To date, some work has been carried out in Ohio. For five years, a local non-profit, Community Food Initiatives (CFI) has been developing a state-wide alliance to educate and support seed-saving. CFI received financial support and technical assistance to hold educational workshops from Ohio University’s Food Studies Theme and the Ohio State Extension program. CFI, with technical support from faculty, held seed saving workshops in Cleveland, Yellow Springs, and Athens in 2016-2017. These hands-on workshops drew diverse participants from urban neighborhood farmers to rural town dwellers. While this initiative is no longer active due changes in leadership and funding, the success of the workshops speaks to the public demand for this information. Promoting place-based seed saving education as an area for future research is particularly well suited to the location and established networks of Ohio University in Athens, Ohio. Drawing upon its resources including the interdisciplinary strengths of its Food Studies program and long-standing community food systems partners, Ohio University is well-positioned to advance Barber’s call to “save our food” and nurture seed saving in our region.


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Notes 1. “Mortgage Lifter Tomatoes,” Living on Earth, produced by Jeff Young, aired on September 23, 2005, http://www.loe.org/shows/segments.html?programID=05-P13-00038&segmentID=8. 2. In 2017, Ohio University awarded faculty Dawn Bikowski and Theresa Moran an Innovation Strategy Planning Grant for a qualitative case study on seed saving in the Andean Highlands and Appalachian Southeastern Ohio. Rommel Montúfur from the Pontifical Catholic University of Ecuador and Central University’s Michael Ayala conducted the Andean research. Lisa Trocchia, Lauren Sudimack and Charlene Suggs conducted the survey interviews in Southeastern Ohio. Bikowski and Moran’s Planning Grant was awarded in support of Vice Provost for Global Opportunities Lorna Jean Edmond and Director, Infectious and Tropical Disease Institute Mario Grijalva’s Innovation Strategy INTENT proposal. 3. United Nations, “Sustainable Development Goals, SDG Indicators,” accessed May 18, 2020, https://unstats.un.org/sdgs/indicators/indicators-list/. 4. “Appalachian Mixed Mesophytic Forests,” World Wildlife Federation, accessed May 18, 2020, https://www.worldwildlife.org/ecoregions/na0402. 5. Elliot M. Abrams and AnnCorinne Freter, The Emergence of the Moundbuilders: The Archaeology of Tribal Societies in Southeastern Ohio (Athens: Ohio University Press, 2005). 6. Paul E. Minnis, ed., People and Plants in Ancient Eastern North America (Washington, DC: Smithsonian Books, 2003); Abrams and Freter, The Emergence of Moundbuilders. 7. Paul E. Patton and Sabrina Curran, “Archaic Period Domesticated Plants in the Mid-Ohio Valley: Archaeobotanical Remains from the County Home Site (33at40), Southeastern Ohio,” Midcontinental Journal of Archaeology 41, no. 2 (2016): 127-158, https://doi.org/10.1080/01461109.2016.1153180. 8. Elmer Gray, “Preservation and Utilization of Appalachian Crop Germ Plasm,” Appalachian Heritage 27, no. 4 (1999): 35-43, https://www.heirlooms.org/preservation-of-appalachian-crop-germplasm.html.


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9. Dan Barber, “Save Our Food, Free the Seed,” New York Times, June 13, 2019, https://www.nytimes.com/interactive/2019/06/07/opinion/sunday/dan-barber-seed-companies.html?searchResultPosition=1. 10. Bob Bowles, “WNC Wine Trail,” April 7, 2015, http://wncwinetrail.com/2015/04/cornbread-nation-ronnie-lundy-traditional-essential-seeds/. 11. Gary Paul Nabhan, ed. Renewing America’s Food Traditions: Saving and Savoring the Continent’s Most Endangered Foods (White River Junction, VT: Chelsea Green, 2008). 12. Bill Best, Saving Seeds Preserving Taste: Heirloom Seed Savers in Appalachia, (Athens, OH: Ohio University Press, 2013). 13. Gray, “Preservation and Utilization.”


Chapter 5 The Legacy of Appalachian Ohio Coal Mining Natalie Kruse Jen Bowman Kelly Johnson Dina Lopez Amy Mackey Nora Sullivan Appalachian Ohio has a long history of coal mining dating back to 1800. Early mining exploited easy to access coal through outcrops and shallow underground mines. Coal mining grew alongside the industrial revolution. With the rise of resource demands from railroads, mechanized mining methods, and World War I, Ohio coal production increased to nearly 50 million tons at its early peak in 1918 (Figure 1).1 Coal production plummeted during the Great Depression, then rose again as World War II and increasingly mechanized surface and underground coal mining practices boosted productivity. Production continued to increase with demand until the 1970s, when environmental regulation and increased reliance on natural gas led to the substantial decline in Ohio coal mining which persists today. For most of Ohio’s coal mining history, environmental legislation has been either non-existent or sparse. Abandoned mines led to significant impacts to Ohio streams and rivers due to both land alteration and the production of acid mine drainage (AMD), as mine operators were not responsible for reclaiming or restoring exploited sites. The earliest mining law in Ohio


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Figure 1. Coal production and drivers of production in Ohio from 1850 – 1995 (data from USGS 1997). dates to June of 1947 when the Strip Coal Mining Act gave the Chief of the Division of Mines in the Department of Industrial Relations authority to regulate coal mining operations; however, this law only applied to surface mines. The mine operator paid the government a bond of $100 per acre, refundable upon completion of surface reclamation, including contouring, liming, capping, and revegetating closed surface mines. The first underground coal mining laws followed in 1949 and required only that the mine opening be closed or fenced upon completion. Mining and reclamation laws continued to change over the next three decades requiring stricter land conservation measures and increased monetary bond amounts per acre.2 By 1972, Ohio was leading the way in surface mine regulations in what became known as the Ohio Strip Mine Law which would become a model for other Appalachian states. This regulation was the first time mine operators were required to submit a detailed mining and reclamation plan prior to starting operations for review by state regulators. This change shifted regulatory authority to proactive oversight of the mining process rather than solely reactive review after the fact. Landmark federal legislation was passed by U.S. Congress in 1977, called the Surface Mining Control and Reclamation Act (SMCRA), and was partly based on Ohio’s Strip Mine Law of 1972. This law formed the Office of Surface Mining Reclamation and Enforcement (OSMRE) in the Department of Interior. Additionally, the law established funding for reclamation


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and mitigation of damage from abandoned mines prior to the law (“prelaw” mining). This law requires states to meet or exceed the federal laws, and access to Abandoned Mined Land (AML) funds is contingent upon states’ compliance with federal regulations. After a State’s program is accepted by OSMRE, the State has control (officially called primacy) over coal mining and reclamation within its border. In Ohio, the state program is run by the Ohio Department of Natural Resources (ODNR). In 1981, Ohio amended some provisions of SMCRA, requiring the landscape be returned to original pre-mining contours. In addition, stricter standards were placed on separation of topsoil, spoil, and acid forming materials. The reclamation activities had to occur simultaneously with mining, and revegetation efforts had to meet standards under the law for five years post mining and reclamation. In 1982, the Secretary of Interior approved Ohio’s AML program and the State gained primacy to regulate mining and reclamation in Ohio. Ohio Revised Code Chapter 1513 contains the laws for coal mining and reclamation in Ohio. Today, in addition to the mining and reclamation laws, mine operators must comply with other local, state, and federal laws to maintain a mining permit in Ohio. These laws include the Clean Air Act, Clean Water Act, Federal Coal Mine Safety and Health Act, Endangered Species Act, Fish and Wildlife Coordination Act, National Historic Preservation Act, the Archaeological and Historic Preservation Act, and Executive Order 11593 which relates to the protection of both historic and pre-historic sites.4 Implementation of environmental and mining regulations reduced the environmental footprint of mining operations, but also contributed to a decline in coal mining in the United States. Pre-Law Mining Impacts Pre-law mining left broad and far-reaching environmental impacts that are still evident today. There are more than 4000 abandoned mines in Ohio that were mined prior to laws identifying operators as the responsible party. Figure 2 shows both the pre- and post-law underground and surface mines in Appalachian Ohio. About 1300 miles of streams in Ohio showed moderate to severe impairment by these mines in the form of reduced fish


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Figure 2. Coal mines in Appalachian Ohio, including those from before and after SMCRA. and macroinvertebrate diversity and the accumulation of the characteristically orange and yellow iron and sulfur precipitates.5 While some residents in watersheds affected by mines were accustomed to seeing these visual reminders of the mining legacy, others were increasingly aware of the negative impacts of the lingering environmental damage on public perception and local economies. Partnerships between agencies like ODNR, Ohio Environmental Protection Agency (OEPA), and


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OSMRE and local communities began to grow. By the early1990s, community-based watershed groups had become more organized, coordinating not only education and outreach to landowners and residents, but also technical expertise from universities and state agencies. The environmental problems caused by abandoned mines were complex, and restoration of streams often required incremental efforts to reduce erosion, sedimentation, and sources of acid mine drainage into waterways. Initial surveys of water chemistry and biology were often done by teams of volunteers organized by watershed groups. As key problem areas and their impacts were identified, interdisciplinary teams of engineers, hydrologists and biologists from agencies partnered with watershed groups to prioritize and plan restoration efforts. Between 2000 and 2016, 66 treatment and reclamation projects were installed in five watersheds to treat the impacts of abandoned mines in the eastern coal bearing areas of Ohio. Unlike many federal environmental cleanup efforts, which can be top down and run by outside experts, the restoration of abandoned mines in Appalachian Ohio involved long term partnerships between watershed groups familiar with landowner and community concerns and local professionals with technical expertise and engineering interests. The proximity of Ohio University and commitment of an interdisciplinary group of university faculty supported a long-term interest in developing and testing new remediation approaches. Nearby project sites provided training opportunities for undergraduate and graduate students interested in water quality and environmental restoration. These acid mine remediation projects spent more than $30 million from 2000 to 2016, removed more than 10,000 pounds per day of acidity, and improved the pH in 193 miles of streams. Streams that were once too acidic for fish now support a diversity of fish and macroinvertebrates, and an estimated 93 miles of stream are meeting state biological standards for healthy streams (Warm Water Habitat).6 Ohio coal tends to have a high content of iron sulfide, commonly known as pyrite or, fool’s gold. When exposed to both oxygen and water, pyrite weathers. This weathering reaction produces acidity-, metal-, and sulfate-laden water, called Acid Mine Drainage (AMD), which can then flow into waterways, turning them unnatural colors, and creating an environment that cannot support aquatic life. Underground mines can produce


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surface subsidence, in which the land collapses when as the mine workings, no longer able to support the land above, cave in. Subsidence from shallow mines can form an opening for streams and surface water to flowing directly into abandoned underground mines. AMD can form anywhere the three ingredients come in contact including in underground mines, surface mines, and waste rock heaps, locally called gob piles. Abandoned surface mines, surface processing facilities that prepared coal for use, and gob piles look like moonscapes against the backdrop of the green Appalachian hills. Creeks and streams flowing with AMD provoke local school children to reach for orange crayons when drawing their environment. Scarce fish populations are unable to provide recreation or nourishment for local wildlife or human residents. These consequences are extensive and are costly to fix. The intent of the current mining regulations is to prevent these impacts of mining, to avoid long-term alteration of the landscape and to prevent fish kills and other biological impacts of AMD that are widespread in streams across Appalachian Ohio. Modern mining practices in Ohio are more environmentally friendly than in prior decades, and certainly less destructive than some strip mining or mountain top removal practices still used in neighboring Appalachian states. Most of the mining in Ohio is underground using two key methods: 1) room and pillar; or 2) longwall mining (see Figure 3). While room and pillar mining has been used traditionally, it is implemented using more mechanized equipment in modern coal mines. In a room and pillar mine, a continuous mining machine is used to mine ‘rooms’ of coal leaving ‘pillars’ of remaining coal in a grid pattern to support the roof of the mine. In modern room and pillar mining, between 50 and 70% of the coal is removed.7 Due to the discontinuous and undulating nature of coal seams in Ohio, most post-SMCRA underground mines are mined using this room and pillar methods. However, several large mines in Ohio have used longwall mining methods. Longwall mining is most efficient for thicker seams of coal or those that maintain a consistent plane.


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Figure 3. Room and pillar and longwall methods of mining are used in modern underground coal mines.

During longwall mining, main roadways are cut from the entrance shafts, situated on either side of a rectangular section of coal to be mined. The longwall machine consists of a large rotating cutter head that passes back and forth along a section of coal, called the face, cutting incrementally before advancing to cut the next panel of coal. Coal falls to a conveyer and is transported from the face to the roadways, and eventually the surface. Hydraulic supports behind the longwall machine brace the roof, enabling miners to safely operate the mining equipment. As the longwall machine removes the coal face and advances, the hydraulic supports are also advanced and the mined-out area behind the supports collapses, this collapsed area is referred to as the goaf. About 80% of the coal is extracted using longwall methods.8 The highly mechanized nature of longwall mining has allowed some mines to remain in business despite falling coal prices. In Ohio, there are four longwall mines including the Meigs No. 31 mine in the Leading Creek Watershed, a tributary of the Ohio River in the Appalachian region of Ohio.


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A Mining Disaster The conflict between economics and the environment in mining is particularly clear in mine flood that occurred in 1993 in Meigs No. 31. A discharge of about one billion gallons of acidic water resulted in a fifteenmile fish kill and additional long-term damage.9 Most coal seams mined in Ohio are below the water table, creating a need for dewatering. Dewatering is the process of pumping water out of a mine during mining to keep the mine dry, the miners safe, and to avoid production of AMD during mining. Dewatering is critical to the continued success of a mine operation. Worldwide, dewatering failures, or inundation from nearby mines that are no longer being dewatered, have forced many mines to close. In Leading Creek Watershed in Meigs County, Ohio, the last commercial underground coal mines closed in 2002. Meigs County had been a major coal producer in Ohio, extracting more than 100 million tons between 1806 – 1993.10 The Southern Ohio Coal Company (SOCCO), a subsidiary of American Electric Power, operated the Meigs mine complex of three interconnected mines, Meigs Mine #2, and Meigs Mine #1 and Raccoon Mine #3, which combined are referred to as Meigs No. #31 (Figure 4). Situated within the Leading Creek watershed, and into neighboring Raccoon Creek watershed, the Meigs mines are also interconnected with abandoned workings. In order to aid dewatering and allow continued mining, a portion of Raccoon Mine No. 3 was walled off with a bulkhead designed to retain AMD produced within the inactive portions of the older mine workings. In mid-July of 1993, the bulkhead failed and billions of gallons of acidic mine water flooded into the operational portion of the mine. The flood halted mining operations and put miners out of work. SOCCO immediately requested emergency authorization to pump the AMD out of the mine and discharge it, untreated, into Leading Creek tributary Parker Run, and Raccoon Creek tributary Strongs Run.11 Two weeks later, the Ohio Environmental Protection Agency granted permission to discharge the untreated water in violation of the mine’s discharge permits, basing their decision on the priority to save 500 jobs in a region with few employment options.


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Figure 4. The Meigs Mines underlie both Leading Creek and Raccoon Creek Watersheds

Two days after SOCCO began pumping about 35,000 gallons of water per minute out of the mine,12 the Office of Surface Mining Reclamation and Enforcement (OSMRE) issued an order to stop discharging, contradicting Ohio EPA’s decision. SOCCO responded with legal action against OSMRE, arguing that the economic impacts would be worse than the environmental damage. The judge decided in SOCCO’s favor and operators resumed pumping untreated AMD into Leading and Raccoon Creeks. The following week, the United States Environmental Protection Agency (USEPA) issued an order to immediately stop discharging untreated water, with the threat of administrative or legal action. In response, SOCCO amended its legal challenge to include the EPA, and continued pumping AMD out of the mine.13 By mid-August 1993, the courts had again ruled in favor of SOCCO and dewatering continued. The lower court decisions were challenged, and


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finally elevated to Sixth Circuit Court of Appeals, where, September 23, 1993, the USEPA’s administrative order to stop discharging untreated AMD was upheld. SOCCO complied and began treating their discharges in compliance with their permits. Throughout this legal battle however, SOCCO pumped and discharged untreated AMD to both Leading and Raccoon Creeks for more than two months, causing long-term damage to both streams. During the months of pumping AMD from Meigs #31, witnesses said that the Ohio River ran orange from the AMD.14 In the final consent decree, SOCCO was ordered to create the Leading Creek Watershed Improvement Plan which established a strategy for watershed restoration and a partnership with the Ohio EPA to develop a remedial plan.15 This plan was meant to create corrective measures for biological, physical, and chemical impacts. The key provisions of the plan included a thorough evaluation of the aquatic ecology of Leading Creek Watershed and the establishment of a fund for ongoing water quality improvement. The goal of the fund was to restore Leading Creek Watershed to the aquatic use attainment level documented before the Meigs #31 discharge. SOCCO spent almost $2 million on improving the ecological quality in Leading Creek Watershed. In addition, they paid more than $400,000 in fines for violating the Clean Water Act and SMCRA. The U.S. Fish and Wildlife Service implemented the Improvement Plan in partnership with the Meigs Soil and Water Conservation District. The remainder of the funds set aside to improve Leading Creek were spent installing two lime dosers, silos which deliver continual doses of powdered lime to neutralize AMD, in 2012 and 2015. Prior to the bulkhead failure and resulting discharge from Meigs #31, and despite existing impacts from sedimentation and mining, particularly in the Thomas Fork tributary to Leading Creek, the streams met Ohio EPA criteria for warm water habitat.16 These criteria define the aquatic biology expected in the healthiest stream sites in the state of Ohio. In fact, Leading Creek was considered a high-quality reference stream for the Western Allegheny Plateau ecoregion, supporting high quality fish and macroinvertebrate populations, including the state endangered silver lamprey.17 Several studies conducted following the Meigs #31 discharge into Leading Creek and Raccoon Creek Watersheds showed that discharge primarily affected Parker Run in Leading Creek, with some impairment in Strongs Run, a tributary to Raccoon Creek.19


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The discharge from Meigs #31 degraded about one-half of the 31 miles of the mainstem of Leading Creek. The discharge was rich in metals including iron, manganese, aluminum, and copper, had a low pH and high conductivity. These contaminants are toxic to many organisms and impaired aquatic life in the mainstem of Leading Creek. After three years, fish communities had improved towards pre-discharge levels, but the macroinvertebrates that indicate stream quality were still impaired in many places. Stations along Leading Creek were monitored by the Ohio EPA to assess the recovery after the discharge. Typically, recovery after a major event or fish kill begins with pioneer fish species that repopulate soon after an event followed by slow reestablishment of pre-impact species.19 Pioneer fish species in Ohio include creek chub, silverjaw minnow, fathead minnow, bluntnose minnow, green sunfish, Johnny darter, and orangethroat darter.20 Recovery of impaired fish populations in Parker Run after the Meigs #31 discharge was slowed due to the lack of refugia or places for fish to shelter from the impairment, lack of upstream fish populations to repopulate the impacted section, and low water level leading to fragmentation of the stream habitat. Before the Meigs #31 discharge, Leading Creek’s fish population was not dominated by pioneer species, but rather had dominant insectivore populations. This exacerbated the lack of upstream pioneering communities to repopulate the impacted stream reaches. Instead of the expected fish species being the first to repopulate the impacted zone, fish that migrate seasonally upstream from the Ohio River to spawn established first; channel shiners and gizzard shad were the first fish to reestablish in the impacted area of Leading Creek. These factors meant the pioneering species took more than one year to reestablish at a sampling location ten miles from the mouth of Leading Creek, five miles downstream of Parker Run. Four years after the Meigs #31 discharge, the mass of fish collected from that sampling location was lower than that collected prior to the discharge.21 The slow recovery had several drivers including lack of upstream populations, but also the continued discharge from the Meigs #31 mine.22 After normal mining operations resumed, Meigs #31 continued to discharge treated wastewater from coal processing into Parker Run. The coal is treated with quick lime and sodium hydroxide to neutralize the acidity of any resulting waste, but leads to high conductivity, sodium and sulfate. Mining ceased at the end of 2003, but the


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mine continues to pump treated waste with elevated sulfate and conductivity to Parker Run. The fish recovery in Strongs Run, a tributary of Raccoon Creek, differed from Parker Run and the mainstem of Leading Creek. During the Meigs #31 discharge, acidity reduced Strongs Run to pH 2, leading to a devastating fish kill. However, unlike Parker Run, unimpaired tributaries upstream of Strongs Run did supply populations of pioneer species. This allowed pioneer species to return to Strongs Run within several months. Within a few years, more sensitive fish species, including southern redbelly dace had also repopulated Strongs Run. The differences in rate of recovery between Strongs Run and Leading Creek include the length of exposure to the mine discharge, the flow regime, and the availability of source populations for reestablishment of fish communities.23 As with many instances of environmental degradation in Appalachian Ohio, the varied topography and unique local characteristics determine the rate and pattern of ecological resilience. In Leading Creek, aside from the catastrophic discharges from the Meigs #31 mine, the mining impairment in the watershed is isolated to one major tributary, Thomas Fork. Significant funds from the SOCCO settlement were used for recovery and monitoring of Parker Run and the mainstem of Leading Creek. However, some funding was also directed at Thomas Fork with a watershed-wide approach that aimed to restore the biological community of Leading Creek as a whole. After the impacts of the Meigs #31 discharge were ameliorated, restoration efforts in Leading Creek Watershed were directed towards Thomas Fork. Thriving After the Disaster In 2009, researchers at Ohio University initiated annual monitoring using the Macroinvertebrate Aggregate Index for Streams (MAIS) in Thomas Fork. Chemical monitoring in Thomas Fork commenced in 2010. In 2009, most sites sampled for macroinvertebrate populations had low MAIS scores of 5 or 6/20 (the target score for healthy streams is 12). In 2010, all 7 miles of the monitored stream fell below the pH target of 6.5, but by 2016 all met or exceeded the target. In 2009, several key tributaries contributed acidity to Thomas Fork including Unamed Tributary, Ball Run, Venoy, and Casto. Downstream of these acid sources, the East Branch of Thomas Fork contributes higher water quality. Further downstream, Baily and Hysell contribute additional acidity to Thomas Fork. The highest


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contributions of acidity and metals, however, are from the most upstream tributaries. In 2012, Ohio University and partners installed a lime doser in the Unnamed Tributary (Figure 5). This installation led to marked biological improvement at some sites, but not enough to meet restoration goals. In 2013, the season after the doser was installed, macroinvertebrate index scores improved from low scores of 2 and 5 to a range of 8-10, a strong improvement but still well below the target score of 12 which is indicative of warm water habitat conditions. One reason for the limited effectiveness of the Thomas Fork Doser was that at low flows during summertime, there was insufficient water in the stream channel to transport the lime downstream from the doser to reach acidic water. So, while the discharge from the Unnamed Tributary was treated, other acidic inputs were not. Therefore, we installed a second lime doser at Casto in 2015 (Figure 6). This project tapped out the settlement funds paid by SOCCO over the Meigs #31 discharge. The express purpose of the second doser was to treat the acid sources downstream of the Unnamed Tributary during low flow conditions when the initial doser was ineffective. In 2016, one year after the Casto doser became operational, three sites monitored downstream in Thomas Fork, representing 4.3 miles of the stream, finally met the target macroinvertebrate score for warm water habitat. Summary Coal mining remains a culturally important occupation and industry in Appalachia, even as demand for Appalachian coal declines precipitously. As coal mining revenue diminishes, so too does the funding for treating abandoned mine lands and chances of coal company defaults increases. This opens the possibility for both untreated legacy impacts of coal mining and underfunded treatment and reclamation from regulated coal mining. The Meigs #31 discharge was a clear example of the tough choices between jobs and the environment that occur with some regularity in Appalachia. In this


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Figure 5. Thomas Fork doser in the background, AMD treated by the Thomas Fork doser in the foreground. Orange iron hydroxide can be seen settling out of the treated water.


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Figure 6. Casto doser installed on State Route 143 in 2016 to treat Thomas Fork at low flow.


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case, the economics of coal mining and the perceived benefit of saving hundreds of jobs in rural Appalachian Ohio weighed more heavily on state government and regulators than the potential environmental impact of pumping one billion gallons of AMD into the streams of Raccoon Creek and Leading Creek. Despite the severe environmental impacts from the discharge, over time and with investment from the settlement with SOCCO, fish populations recovered to their pre-discharge levels, however their rate of recovery varied. The money directed to Leading Creek Watershed from the Meigs #31 settlement has facilitated treatment of Thomas Fork which had already been highly impacted by pre-law mining. Treatment in Thomas Fork has improved both chemistry and macroinvertebrate communities and is likely to support fish passage and improved fish communities, although we need to collect more data. Decisions made in the aftermath of flooding Meigs #31 mine maintained jobs in a rural community for another decade, while creating a 15-mile-long fish kill. Now, 25 years later, the direct impacts of the discharge have been recovered and further stream recovery has been enabled.

Notes 1. Douglas L. Crowell, “History of Coal Mining in Ohio,” Ohio Division of Geological Survey GeoFacts 14, (2005), http://geosurvey.ohiodnr.gov/portals/geosurvey/PDFs/GeoFacts/geof14.pdf. 2. Shari L Zook, et al., (1990) “Division of Reclamation,” in A Legacy of Stewardship: The Ohio Department of Natural Resources 1949-1989, ed. C.C. King ( Columbus, OH: Ohio Department of Natural Resources), (1990), 161-168, http://ohiodnr.gov/portals/0/pdfs/stewardship/chapt_12_reclam.pdf. 3. "History of Coal Mining and Regulation in Ohio," Ohio Department of Natural Resources (ODNR), accessed April 20, 2020, http://minerals.ohiodnr.gov/citizen-resources/history-of-ohio-coal-mining#. 4. "Laws and Regulations," Ohio Department of Natural Resources (ODNR), accessed April 20, 2020, http://minerals.ohiodnr.gov/laws-regulations/laws-regulations#COAL. 5. “Acid Mine Drainage Abatement Program,” Ohio Department of Natural Resources (ODNR), accessed April 20. 2020, http://minerals.ohiodnr.gov/abandoned-mine-land-reclamation/acid-mine-drainage.


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6. Jennifer Bowman, Nora Sullivan, and Kelly Johnson, 2016 Stream Health Report, (Athens, OH: Voinovich School of Leadership and Public Affairs, 2017), http://www.watersheddata.com/userview_file.aspx?UserFileLo=1&UserFileID=207. 7. Douglas L. Crowell, “Coal Mining and Reclamation,” Ohio Division of Geological Survey Geofacts 15, (2014), http://geosurvey.ohiodnr.gov/portals/geosurvey/PDFs/GeoFacts/geof15.pdf. 8. Crowell, “Coal Mining and Reclamation.” 9. “Southern Ohio Coal Company to Restore Ohio River Tributaries Devastated by Discharges of Mine Wastes,” US Department of Justice Press Release (1996), https://www.justice.gov/archive/opa/pr/1996/February96/034.txt. 10. Douglas L. Crowell, “History of Coal Mining in Ohio,” ODNR Division of Geological Survey Bulletin 14, (1995, revised 2005), http://minerals.ohiodnr.gov/portals/minerals/pdf/coal/geof14.pdf. 11. “Southern Ohio Coal Co. Meigs Mine No. 31,” Consent Decree and Settlement Agreement, U.S. Department of the Interior (1995), https://www.cerc.usgs.gov/orda_docs/CaseDetails?ID=148. 12. Rebecca J. Currie, “Identification of Ecosystem Stressors in Developing an Enhancement Plan for the Leading Creek Watershed, Meigs County, Ohio,” (PhD diss., Virginia Tech, 1999), https://vtechworks.lib.vt.edu/handle/10919/27138. 13. Southern Ohio Coal Co. Meigs Mine No. 31. 14. Thomas P. Simon, Biological Response Signatures: Indicator Patterns Using Aquatic Communities (Boca Raton, FL: CRC press, 2002). 15. Cynthia Bauers, et al., Acid Mine Drainage Abatement and Treatment (AMDAT) Plan for the Leading Creek Watershed. (Athens, OH: Ohio University, 2006), http://www.watersheddata.com/AMDATView_Report.aspx. 16. Rebecca J. Currie, “Recovery and Reconnaissance of the Leading Creek Watershed, Meigs County, Ohio, following a dewatering of Meigs #31 coal mine,” (US Department of Energy, 1995), https://www.osti.gov/biblio/452115-recovery-reconnaissance-leading-creek-watershed-meigs-countyohio-following-dewatering-meigs-number_sign-coal-mine. 17. Currie, “Recovery and Reconnaissance of the Leading Creek Watershed;” Simon, Biological Response Signatures.


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18. AJ Kennedy, DS Cherry, and RJ Currie, “Field and Laboratory Assessment of a Coal Processing Effluent in the Leading Creek Watershed, Meigs County, Ohio,” Archives of Environmental Contamination and Toxicology 44, no. 3 (2003), 324-331. 19. Currie, “Recovery and Reconnaissance”; Simon, Biological Response Signatures. 20. Ohio Environmental Protection Agency, (1988). Biological Criteria for the Protection of Aquatic Life: Volume II: Users Manual for Biological Field Assessment of Ohio Surface Waters, (Columbus, OH: Ohio EPA, 1988) http://wwwapp.epa.state.oh.us/dsw/bioassess/Volume2.pdf. 21. Simon, Biological Response Signatures. 22. Kennedy, “Field and Laboratory Assessment of a Coal Processing Effluent.” 23. Simon, Biological response signatures.


Part 2 PASSION There is a palpable passion in Appalachia. You can see this passion in the food, art, music, writings, activism, and kindness toward and concern for our neighbors. The essays in this section highlight projects that exemplify the passion of people who work and live here. The section begins with food. Chapter 6 offers context for food insecurity in Appalachia in general and Athens County, Ohio specifically. The authors define food insecurity, food justice, and food sovereignty. Activism is prominent throughout the history of Appalachia, and modern-day activism is emerging in the realm of food justice and ensuring the right of all people to enough healthy food. Because of the interconnectedness of food with so many other issues, food justice movements address climate change, land use, rural development, and working conditions. As a result of a series of interviews about one Appalachian food initiative, the authors document the passion of those working to improve food security in a way that will allow communities to thrive. Passion around food carries into Chapter 7 that further explains the role of a local food initiatives in building resilience in Appalachia. Whether these initiatives focus on health by prescribing produce to purchase at farmers markets or establishing donation areas for people in need, we are again reminded that food is a prominent force in a thriving region. The authors focus on how food ensures the economic, social, and environmental components of sustainability. When communities are food secure and involved in producing and selling local foods, they have a foundation on which to build a sustainable future.


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Moving from food to art, Chapter 8 paints a vivid picture of how passion around photography can address mental health in Appalachia. The Athens Photographic Project (APP) is an art installation of photographs taken by community members experiencing mental illness. In this chapter, three of the organizers of APP’s installation reflect on their roles in the project and its impact on the community. In their narratives, you can feel their pride and passion about this work and the difference it can make in community health. The final chapter in this section is also a reflection on how a partnership between Ohio University and local community organizations can improve health, in this case focusing on mothers and children. Chapter 9 explains that university-community partnerships are often fraught, but when there is open communication and shared goals, they are worth it. The author gives us the inside scoop on Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health) that involved numerous activities in 4 Appalachian counties in Ohio. Community health workers are becoming important sources of both care and comfort in Appalachia because of their passion for improving health and their commitment to their neighbors. There are so many more stories to tell about the passion of those who work to improve health in Appalachia. These stories document that, in many communities, people are thriving because of local initiatives that engage them throughout the entire endeavor.


Chapter 6 Food, Justice, and the Appalachian Way: Tackling Hunger with Community Food Initiatives Stephen J. Scanlan Kerrigan Boyd Introduction In this chapter we examine the significance and impact of Community Food Initiatives (CFI) as a case study of a non-profit organization and allied individuals working to achieve food justice and empowerment in Appalachia. CFI operates out of Athens County, one of the consistently poorest counties in Ohio with associated high levels of food insecurity, health issues, and related challenges.1 The mission of CFI is “to ensure that everyone has access to healthy, local food� and it works to achieve this through programming in multiple forms that have evolved over its more than 25-year history. Using a combination of media stories, secondary analysis of data and documents from the organization, and survey data from organizational leadership, community members, activists, and volunteers, we analyze its efforts and contributions through a food justice lens. Emphasizing its role in the local food movement in the region, we connect its efforts and impacts with national conversations on the food activism front.


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Findings point to the notion that despite challenges that come with the persistence of poverty and food insecurity in the Appalachian region, CFI serves as a beacon of resilience and a force of positive social change. Its programs include community and school gardens, seed and plant giveaways, public education, a “Veggie Van,” and reinvestment through food purchases in its “Donation Station.” The Donation Station simultaneously assists those in need and supports local agriculture with food purchases. The organization is an important example of grassroots efforts to achieve food justice and food sovereignty by empowering local communities to address food insecurity and related concerns. Grassroots movements to address food security are emerging in Appalachia and as well as other rural and urban settings throughout the country. This food activism includes “efforts by people to change the food system across the globe by modifying the way they produce, distribute, and/or consume food.”2 Generally, the term food activism provides a foundation for examining the work that CFI pursues with its anti-hunger vision. Challenging notions of powerlessness and acquiescence in the region, the story of CFI is one of hope and opportunity. Food Movements, Food Insecurity, and Food Justice The activities and analysis of CFI are particularly important because of the seriousness of poverty and food insecurity in its home of Athens County and the region the organization serves. According to the 2020 Map the Meal Gap Study from Feeding America, at 18.2 percent, Athens County has the fifth highest rate of food insecurity in Ohio. In addition, 64.9 percent of county residents have incomes below the Supplemental Nutrition Assistance Program (SNAP) threshold of 130% of the poverty level.3 According to the same study, the rate of child food insecurity is 24 percent and 76 percent of children live in SNAP-eligible households. CFI works in a rural region with a small population and this challenges transportation and distribution efforts. CFI is critical to those in outlying areas where the need is particularly acute with numerous food deserts.4 The U.S. Department of Agriculture (USDA) and its Economic Research Service uses four designations to account for food security and insecurity in its surveys and research.5 Food security occurs in two forms: 1) high food security in which there are “no reported indications of food-access problems or limitations;” and 2) marginal food security where “one or two reported indications—typically of anxiety over food sufficiency or shortage of


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food in the house; little or no indication of changes in diets or food intake”—exist.6 Similarly, food insecurity also occurs in two categories: low food security and very low food security. The former of these refer to households with “reports of reduced quality, variety, or desirability of diet; little or no indication of reduced food intake” while the latter means there are “reports of multiple indications of disrupted eating patterns and reduced food intake.”7 A food justice perspective considers multiple factors of food insecurity to understand how people experience it. In this regard we incorporate the framework of DeRose, Messer, and Millman who note food insecurity can be defined as addressing three questions: 1) Food shortage: How much food is available?; 2) Food poverty: Do I have economic, physical, or social access to existing food?; and 3) Food deprivation: Does the food serve my nutritional needs?8 True food security exists only when people can answer each of these questions satisfactorily. Furthermore, each question is essential to food justice and food sovereignty, which cannot exist without food security. Gottlieb and Joshi define food justice “as ensuring that the benefits and risks of where, what, and how food is grown and produced, transported and distributed, and accessed and eaten are shared fairly.”9 Food justice calls for revolutionary transformation of the food system to address the multiple factors that contribute to food insecurity and hunger. Closely connected to this is food sovereignty which McMichael defines as "the social right of a community or country to determine its own policies regarding food security (adequate supply and appropriate cuisine) and the cultural, social, and ecological conditions under which it is sustained.”10 With food sovereignty, citizens are empowered to make choices about all aspects of their food, including where it comes from, and local places can prioritize access and poverty in their decisions. As McMichael further notes, we need a discussion of rights that shifts away from the right to purchase food to guaranteeing the right to food for the world’s citizens—this latter idea emphasizing basic human needs and the imposition of powerlessness, poverty, and inequalities on food security.11 We examine the fundamentals of food security, food justice, and food sovereignty as the basis of activism within the broader and growing food movement of which CFI is a part. As Broad notes, food justice connects closely with “other systemic social, economic, and racial injustices”12 and


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thus overlaps with larger problems in the food system and its connections to poverty, health, and nutrition. If a place has a history of inequality or injustice in any form, you are likely to find food injustice there as well. Appalachia is a critical place for considering the connections between larger concerns of social justice, and with food justice more specifically, and examining approaches to address both. Both activists and academics highlight the significance of food movements, most notably works by Alkon and Guthman,13 Holt-Gimenéz,14 Reynolds and Cohen,15 Robinson and Farmer,16 and Ventura and Bailkey.17 Such calls for food justice emphasize the need for creating alternatives to an industrial food system dominated by corporate agribusiness, large food retailers and processors, and their distributors. Hunger and the idea of food as the most essential of basic needs is a powerful mobilizing force. Using a food justice framework, activism takes on several dimensions and forms including but not limited to: Collective purchasing and co-ops; community gardens; community supported agriculture; education campaigns; farmers’ markets; guerilla gardening and squatting; and regulatory campaigns and policy initiatives. Ultimately, food movements address important and interrelated issues including: • • • • • • • • • • • • •

Climate change and environmental well-being Food deserts Food safety Health and nutrition Hunger and food insecurity Inequality in multiple forms, including class and gender, indigenous, and racial justice Industrial food systems Land reform Organic and chemical free food Rural development Sustainability in its multiple forms Urban agriculture Wages and working conditions of food and farm workers

Our goal in this chapter is to connect the ideas behind food justice and activism with a story of resilience and positive social change in Appalachia by highlighting the important contributions of CFI as a critical


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example of what helps the region thrive. In more than 25 years of service to the Athens community and surrounding region, CFI’s story reflects the challenges faced by Appalachia and the power to move forward using food justice as its focus. Appalachian Foodways and Food Insecurity Appalachia is a diverse region incorporating elements of culture, demography, geography, history, and topography formed around the Appalachian Mountain Range. As those who work in and study the region know, the most used political definition of Appalachia came with the creation of the Appalachian Regional Commission (ARC) in 1965. Currently, this definition includes 13 states, 422 counties, and 205,000 square miles of land that is home to around 25 million people. Forty-two percent of the region’s population live in rural places, compared to 20 percent for the national population.18 The ARC further classifies five specific subregions within Appalachia, each distinguished by topographical, demographic, and economic characteristics. Due to the resource richness of the mountains, the region’s economy has historically been highly dependent on extractive industries, particularly lumber, coal, and now natural gas. The extraction-based industry model has had important ecological, social, and economic impacts on the region. Some scholars refer to this well-documented association between regional resource abundance and lower economic prosperity as the “resource curse.”19 The region still identifies coal as an important resource, but as Latimer and Mencken note, after decades of mechanization and changes in extraction techniques, it is not a major provider of jobs, despite political and popular perceptions as such.20 Though it is one of most biodiverse regions of the world, 21 Appalachia poses difficulty for farming with around 57 percent of land not suitable for intensive crop production.22 In a study of changes in Appalachian Agriculture from 1965 to 2000, Dale Colyer found that, compared to the national average, Appalachian agriculture endeavors remain smaller than the national average, and animal agriculture accounts for about 75 percent of agricultural sales.23 Despite this, Appalachia has a strong legacy of home gardening, seed saving, farmers’ markets, hunting, canning, and other food customs associated with the burgeoning local food movement today. In fact,


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small farms, farmers’ markets, regional restaurants and breweries, and community supported agriculture are all on the rise in the region.24 Historically, scholars have recorded cultural attributes such as self-reliance, homogeneity, family loyalty, and traditionalism having a strong presence among Appalachians.25 Modern scholars are more reserved about characterizing uniform cultural attributes throughout the region, citing that there is no singular Appalachian culture.26 Instead, many encourage a conceptualization of Appalachia that includes a multitude of intersecting spatial, generational, and cultural identities. There are in fact, “many Appalachias” each unique, though many sharing overlapping qualities. Socioeconomic indicators that vary from place to place reflect this uniqueness within Appalachia. For example, the ARC noted that the poverty rate in Central Appalachia is nearly 10 percent higher than that of Northern Appalachia, or that Southern Appalachia consists of 31.3 percent minorities, compared to 11 percent in Northern Appalachia.27 Appalachian food is a great example of this diversity, in that there is not a specific food associated with the area nor is there significant deviation from the national palette. There are connections to so-called southern food culture (fried chicken, ham, and apple pie) and well- known recipes utilizing regional flora and fauna (venison, blackberry cobbler, hickory nuts, paw paws, ramps, apple, and peach pies.)28 There is no question that there are high rates of poverty in Appalachia.29 There are many possible intersecting causes including a lack of stable employment opportunities, low levels of investment and economic diversification, below average education, low household mobility, and geographic isolation.30 Food insecurity persists in Appalachia and is synchronous with poverty and the health risks associated with it—particularly for children and issues such as obesity, malnutrition, and access to health providers.31 It is encouraging however, that regional poverty has steadily declined in the past five decades.32 In addition, the number of high-poverty counties as determined by ARC has declined by more than 50 percent. There are many grassroots campaigns and community organizations contributing to positive shifts in the region, particularly around food. These organizations support food related entrepreneurial endeavors (i.e., value-added food products, community-supported agriculture, and local restaurants), create community infrastructure that includes farmers’ markets and community kitchens, and meet immediate community need by stocking pantries with local food resources.33


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The ARC commissioned a review of health status in the region and ten counties were identified as “bright spots” because they had better than expected health outcomes.34 The subsequent report noted that community capacity building was an essential part of their successes. Although the report does not specifically address food insecurity, the researchers noted that bright spots had leaders engaged in health initiatives, cross-sector collaboration, resource sharing, and local providers committed to public health. Issues faced by Appalachian communities are contextualized by multiple historical, cultural, and geographic factors important to consider when building resiliency efforts. Community Food Initiatives has many characteristics of an Appalachian bright spot. It addresses food insecurity at multiple levels such as supporting community spaces for creating food (community gardens, seed saving exchanges), education (community led workshops, kids gardening programs), and addressing immediate need (investing in the local economy through its “Donation Station” and distributing to local pantries), as well as increasing food access with its Veggie Van program. Data and Methods We discuss a mixed-methods approach involving multiple research perspectives to analyze the impact of CFI on food justice in Appalachia. We used a combination of grounded theory and a community based participatory research approach (CBPR). Grounded theory allows us to understand CFI’s role in pursuing food justice as seen through the eyes of individuals closely involved in the organization.35 In short, “grounded theory has relied on flexible strategies for progressively analyzing and conceptualizing data for the purpose of theory construction. Grounded theory involves subjecting inductive data to rigorous analysis while engaging in constant comparisons throughout the research process.”36 Since we have a foundation in the study of Appalachia, alternative food movements, and food justice, grounded theory methods allowed us to establish theoretical perspectives that might not have emerged otherwise. In this regard, the discovery of concepts gleaned from interviews along the way inform both the research methods we incorporate and the ideas we use to explain them in our analysis and discussion. CBPR complements grounded theory well, further framing our ef37 forts. The authors have been involved with CFI, one currently as a


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member of the organization’s board of directors and the other as a past, yearlong COMCorps worker dedicated to its community garden programs. In keeping with the CBPR approach, we involve past and present CFI staff and leadership in our study, along with community collaborators and volunteers to allow stakeholders an important voice in our research. This empowers these individuals not only to contribute their ideas and direction to the analysis but also shape the potential impacts the research findings have on the organization and its mission. Data come primarily from open-ended surveys. We used purposive sampling methods to construct our subject pool. Purposive sampling is not a random approach; rather it relies on the judgement of the researchers, so most of the individuals we surveyed were familiar to us because of our involvement with CFI. We use pseudonyms in discussing the findings to protect the identity of our respondents. Qualitative analysis of the survey responses and thematic coding of the data enabled the central ideas to emerge from the questions and the perspective of the respondents to our inquiries. We received survey responses from 19 individuals that reflected a range of backgrounds in connection with CFI and its role in pursuing food justice in Appalachia. To supplement the data from the open-ended survey questions, we reviewed secondary sources that include media accounts of CFI activities primarily appearing in The Athens News, annual reports and other documents produced by CFI. Secondary analysis of these materials provides important context and perspectives on CFI from the greater community, including data pertaining to its programming and impacts. By including this secondary analysis, we believe this work reveals the contributions CFI makes towards moving the Appalachian region from surviving to thriving. Findings and Discussion Findings from both open-ended questionnaires and secondary analysis of CFI documents and media accounts reveal an important place for the organization in both the local community and beyond. Key themes we uncovered include contributions made by CFI toward economic development, education and empowerment, community resilience, and sustainability all of which contribute to food justice, food sovereignty, and food security in the region. Furthermore, as part of a national alternative food movement, CFI is an important example of positive social change on this front


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reflecting its mission “to foster communities where everyone has access to fresh, local food”.38 This is especially important in rural Appalachia. The Work of Community Food Initiatives. Building on its mission and vision for “a resilient region in which everyone in the community has access to an equitable, inclusive, and thriving local food system,” CFI frames its work in core values of 1) culture and community; 2) education and empowerment; 3) justice; and 4) collaboration.39 These ideals are present across multiple programs carried out by CFI’s small professional staff and legions of volunteers, community members, and activists. As for specific programming, CFI activities resemble many organizations, municipalities, religious groups, and others working in poor and underserved communities as part of the larger alternative food and food justice movements. For example, CFI manages school and community gardens and orchards, conducts “discovery kitchens,” puts on garden and culinary workshops, and carries out seed and plant giveaways. Table 1 provides highlights of the organization’s multiple contributions through these programs. Overall, the organization reaches both young and old in its programming as it pursues food justice. Carrying out these programs in rural communities means direct contact and communication with the region’s residents and those in need. Two programs are particularly unique to the organization: Donation Station and the YEAH! Kids Program. CFI is perhaps most closely associated with its “Donation Station” program in which monetary donations are used to purchase food from producers selling at the Athens Farmers’ Market and the Chesterhill Produce Auction in neighboring Morgan County. The benefits to the community come on multiple fronts. First, the purchases from CFI support the local and regional food economy and the livelihoods of small local farmers and producers at the center of what is a thriving regional food hub. Using data calculated from CFI annual reports in constant (2019) dollars since 2012, Donation Station has invested $112,578 in the local food economy, an average of more than $14,072 per year.40 As this money circulates through the local economy, it will likely make an even greater impact towards achieving regional development and a more just food system. In other words, money spent supporting local farmers is reinvested in the community by them and their workers at other local businesses, which spend that money to support


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others in the community and so on. The local food economy can thus be the catalyst for this.

Table 1: CFI by the Numbers: A Snapshot of Select Programs, 2019 (Sources: Community Food Initiatives Annual Report Snapshot 2019, supplemented by the 2017 and 2018 Annual Reports)

Program

Description and Highlights

Community Gardens

Managed 5 community garden sites with over 20,000 square feet under production. The requirement that a portion of each gardener’s efforts be donated to assist with food insecurity in the region resulted in 288.5 pounds of food grown for CFI.

Discovery Kitchens

Hosted 66 classes, tasting tables, and events that reached out to 2,497 individuals seeking to increase their knowledge on healthy food consumption, access recipes, and increase confidence in the kitchen.

Garden and Culinary Workshops

Conducted 22 community workshops in 2018 to foster empowerment and provide educational opportunities, skill development, and wellness centered on gardening and food.

School Gardens

Managed 13 gardens at schools across the region to provide a unique learning opportunity in conducting over 180 educational events reaching 813 students. Educating children on “where their food comes from” and mobilizing an interest in and taste for fresh vegetables is a critical endeavor.

Seed and Plant Giveaways

Provided 29,994 pounds of seed potatoes, 1,515 seed packets, and 3,340 plant starts to 2,333 families across in 10 counties in Appalachian Ohio.


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Southeast Ohio Foodlink

The Veggie Van

Collaborated with West Virginia University to manage an online database of food pantries, grocers, and census and food insecurity measures to increase access to food resources and raise awareness of poverty and hunger issues.

CFI launched this pilot project in 2020 in collaboration with the University of Buffalo. It operates as a mobile marketplace that seeks to offer fresh, locally-grown produce on a "pay what you can" basis to communities with limited access to healthy, fresh, food.

Second, food pantries and other agencies that aid those experiencing food insecurity in the region receive the food purchased through Donation Station. From 2012 to 2019 CFI distributed over 37 tons of much needed fresh produce to 50 community partners collaborating across 7 counties in Appalachian Ohio. Between 2012 and 2019 CFI has donated an average of 36 tons of food per year, a total of nearly 289 tons over this period.41 These donations serve as a critical source of fresh, healthy food for those in need— different from what food banks and local pantries are typically able to provide. In addition, they support canning and preserving seasonal foods in other ways, connecting with other programming CFI efforts that empower and educate local people. Another unique and signature CFI program is Youth Entrepreneurs at Hope, or the YEAH! Kids Program. This endeavor is a collaborative effort with the Athens Metropolitan Housing Authority. Low-income children ages 11-18 manage a garden in their apartment complex, growing food they then sell at the Athens Farmers’ Market alongside baked goods and other food products they create in a community kitchen. The children also attend workshops and learn about valuable culinary skills and healthy living. 42 The participants earn money at the market for their products. Although the money received may seem modest, it means a great deal to the participants who may come from families where every bit helps. In addition, this program contributes to a sense of pride and autonomy because the kids see the return on the investment of the hours of work they put into the garden. In


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this way YEAH! Kids is more than just a food program; it is a means of empowering youth that can extend to other life and job skills that can serve them well in the future. As with the school garden programming the experience is fleeting but the impact can be lifelong, developing a new generation of hopeful contributors to food security, food sovereignty, and the alternative food movement. Voices from the people. In addition to CFI’s programming, the true value and impacts of the organization come through in the voices of those working closely with it. Ideas emerging from our research emphasize impacts regarding economic development, education and empowerment, environmental sustainability, and resilience that helps the community thrive around food as a catalyst and ultimately the importance of food justice. As a foundation to the discussion, there was consensus among respondents on the importance of CFI’s mission to ensuring equitable access to healthy local food and efforts to achieve food security and food justice. Many point to commonly seen statistics such as those noted above in emphasizing concerns with poverty and how this underlies needs in the community. For example, Maggie notes that “generational poverty and continuing social/economic inequity are complex situations that have contributed to the lack of food security, health and wellbeing in the area.” This is reinforced by Lance who said “food insecurity goes hand in hand with the high poverty rates and low incomes typical in (southeastern) Ohio.” Respondents pointed to the needs of and impacts on children, hence the importance of CFI programming such as school gardens and YEAH! Kids that seek to uplift this most vulnerable segment of the population. Connecting the mission and vision of CFI closely to the goals and actions of the alternative food movement, respondents spoke of the organization’s multiple impacts and intersectional dynamics of the benefits that the organization has. Kristin notes that CFI is an organization where food access can be thought of from a perspective of economic justice, local economy and environmental health . . . CFI strives to take a more holistic or intersectional approach than many other organizations working on food security . . . This is important because of the complexity of hunger and poverty and the fact that in addressing these challenges, there are no easy solutions.


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CFI is seemingly having a great impact, with participants revealing strong belief in the value of its programming on the region and its citizenry. Respondents cite each of CFI’s programs and their meaning and significance. Regarding the Donation Station specifically, for example, Ryan notes, “What the donation station does blows my mind every time I think about it. There should be a donation station in every community. CFI provides an example that other communities could replicate.” The multi-faceted approach of gardening, educational/workshop programming along with the distribution efforts of Donation Station empowers people and involves multiple collaborating agencies and institutions in the effort— “templates for actions necessary to create food justice” as Zach describes it. From an alternative food movements perspective, mobilization comes easily when participants can seize on the opportunities for meaningful social change facilitated through CFI and its collaboration with others towards a common interest “to grow and share the harvest”—the motto of CFI that appears in its logo. Courtney summarizes this well: “CFI helps facilitate citizens of the region taking care of other citizens in the region, empowering us to (be) more independent and resilient.” At the center of this are education, community support, and altering opportunity structures that move Appalachia forward from a “context of disadvantage” that many may typically associate with the region.43 With CFI, food is the pathway to address these disadvantages. Regina summarizes all of this quite well CFI builds community resilience through working holistically for food access—emergency food access/assistance and also future food access through promoting self-sufficiency and providing education—while supporting the local food system so that food security remains possible for future generations. She continues adding that many who struggle to make ends meet feel disempowered and “helping them to provide healthy food for their families is a boost.” Providing healthy, fresh local food is central to CFI’s work but so is providing the skills or space for growing it oneself. A common theme emerged related to CFI programming focused on food preparation and preservation. Consider Marilynn, for example, who notes “Teaching people


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to grow their own food and then cook and preserve that food enables individuals to be independent and empowered. Providing a place to grow food when one may not have the space or resources to do that empowers them.” This reinforces ideas such as, “gardening as a critical skill” as Tara cites or CFI fostering “the knowledge . . . necessary . . . so that folks may become more self-sufficient in the long run” as Kristin adds. These ideas thus importantly reinforce the contributions CFI makes to food sovereignty in the region. Finally, the role of CFI in supporting an eco-friendly, sustainable, local food system, is woven throughout responses to the questionnaire. Consider Regina, for example, and her claim “that community resilience is only possible with a food system that is both just and sustainable—and . . . CFI works to achieve both of these things.” “Sustainability,” from the perspective of the respondents in this study, integrates environmental well-being with economic development opportunities and social justice concerns that make resilience possible. Dorothy provides an extension of this in proclaiming “to have a healthy future we need to learn to live locally and support our local community—all the members of the community.” This includes advocating for and supporting local farmers; maintaining an important safety net in the form of high quality, fresh food for those in need; addressing poverty and inequality; and developing what Maggie argues for in the form of “a new, more democratic approach to facilitating food security and food justice in Athens and Appalachian Ohio.” Ultimately, the work of CFI and others in the alternative food movement reflects a model “food democracy”44 that reinvents food systems with the vision that bolstering the food economy goes hand in hand with addressing poverty and food insecurity—an idea that Colleen sees playing out particularly well in Donation Station. Pulling these ideas together, Dorothy adds, “with a thriving local food system we have opportunities for people to have meaningful work as well as a better environment.” These are fundamental to resilience in the region; carrying out these pursuits, as CFI and supporters will continue to help make this vision a reality for the region. Conclusion Taken as a whole, our work reveals that CFI has contributed to positive social change in the region. This change comes in many forms with food security and food justice being the core of these actions. CFI fosters


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hope and resilience in a way that empowers and enlightens the community. Those close to the organization note that there is much work yet to come, but progress is being achieved, one dinner plate at a time. Consider the following quote from nine-year old YEAH! Kid “Caleb” communicated to us by a former CFI executive director: “At the first day of the Athens Farmers’ Market, when asked what YEAH! Kids is, I was nervous and did not answer at all. Now I talk about all the stuff we do to everybody!”45 Thinking about just this one individual, the positive experience of being a gardener in the YEAH! Kids Program expanded his confidence through the medium of food, creating opportunities that without CFI would not be possible. His story is one of many impacts of CFI —not just with this program but across the range of opportunities the organization offers. CFI is affecting the community in multiple ways including: •

Food security assistance through direct access to donations of fresh food, seed starts, and school and community gardening programs; Food sovereignty and empowerment in the form of educational programming around health and nutrition, food preparation, and gardening skills among other areas of interest; Sustainability and environmental well-being with emphases on gardening, local food consumption, and caring for the planet; Advocacy and empowerment by serving as a voice for food justice in Athens County and across the southeastern Ohio region; and A key player in the local, alternative food movement scene in the region, serving as a model for what occurs at the larger level on this front.

In the end, CFI is an important example of positive social change in Appalachia that reflects the big picture regarding food justice. As Maggie states, “CFI creates a sense of participating in the actions that can affect


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change” and this is important in a region that has experienced more than its fair share of downturns and disempowerment. CFI is but one component of a larger Appalachian, national, and global movement for food justice. Regarding a thriving Appalachian region centered on food, its actions and those of other organizations such as the Appalachian Sustainable Agriculture Project and the work of the Appalachian Foodshed Project, capacity-building networks such as ACEnet, and events such as the Appalachian Food Summit among others, are important examples of individuals and organization “doing food justice.” In a region where all too often the focus is on the negative and downtrodden, food in Appalachia can provide a spark for hope and change that can continue to contribute to resilience and prosperity. This resiliency effort assists in the transition towards creating a more sustainable future with increasing numbers of bright spots for the Appalachian Regional Commission to highlight and share. Notes 1. Kayla Beard, “Athens County Leads the State in Food Insecurity,” The Athens News, accessed February 22, 2020, https://www.athensnews.com/news/local/athens-county-leads-the-state-in-food-insecurity/article_4b7f1d92-74e4-11e9-9f39-ab9fe1fcbcea.html. 2. Carole Counihan and Valeria Siniscalchi, Food Activism: Agency, Democracy and Economy, (London: Bloomsbury Academic, 2014). 3. “Map the Meal Gap,” Feeding America, accessed September 22, 2020, https://map.feedingamerica.org/. 4. “Food Access Research Atlas,” United States Department of Agriculture (USDA), accessed May 14, 2019 https://www.ers.usda.gov/data-products/food-access-research-atlas/go-to-the-atlas.aspx 5. “Definitions of Food Security,” USDA, accessed May 14, 2019, https://www.ers.usda.gov/topics/food-nutrition-assistance/food-security-inthe-us/definitions-of-food-security.aspx. 6. “Definitions of Food Security,” USDA. 7. “Definitions of Food Security,” USDA. 8. Laurie Fields DeRose, Ellen Messer, and Sara Millman, Who’s Hungry? And How Do We Know?: Food Shortage, Poverty, and Deprivation, (Tokyo, Japan: United Nations University Press, 1998). 9. Robert Gottlieb and Anupama Joshi, Food Justice, (Cambridge, MA: Massachusetts Institute of Technology Press, 2010)


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10. Philip McMichael, Development and Social Change: A Global Perspective, (Thousand Oaks, CA: SAGE Publications, 2004, 347). 11. Philip McMichael, Development and Social Change. 12. Garrett, Broad, More Than Just Food: Food Justice and Community Change, (Berkeley, CA: University of California Press, 2016). 13. Alison Hope Alkon and Julie Guthman, The New Food Activism: Opposition, Cooperation, and Collective Action, (Berkeley, CA: The University of California Press, 2017). 14. Eric Holt-Gimenéz (ed.), Food Movements Unite! (Oakland, CA: Food First Books, 2011). 15. Kristin Reynolds and Nevin Cohen, Beyond the Kale: Urban Agriculture and Social Justice Activism in New York City, (Athens, GA: The University of Georgia Press, 2016). 16. Jennifer Meta Robinson and James Robert Farmer, Selling Local: Why Local Food Movements Matter, (Bloomington, IN: University of Indiana Press, 2017). 17. Steve Ventura and Martin Bailkey (eds.), Good Food, Strong Communities: Promoting Social Justice through Local and Regional Food Systems, (Iowa City: University of Iowa Press, 2017). 18. “Health Disparities in Appalachia,” Health Disparities in Appalachia - Appalachian Regional Commission, accessed May 13, 2019, www.arc.gov/research/researchreportdetails.asp?REPORT_ID=138. 19. Mark D. Partridge, Mike R. Betz, and L. Lobao, "Natural Resource Curse and Poverty in Appalachian America," American Journal of Agricultural Economics 95, no. 2 (2013): 449-56. 20. Melissa Latimer and F. Carson Menchken, Socioeconomic Trends in Mining Dependent Counties in Appalachia, Research paper, Sociology and Anthropology, West Virginia University. 21. Darrin Nordahl, Eating Appalachia: Rediscovering Regional American Flavors, (Chicago: Chicago Review Press, 2015). 22. Dale Colyer, Agriculture in the Appalachian Region: 1965-2000, Report, Agricultural and Resource Economics, West Virginia University, 2001. 23. Dale Colyer, Agriculture in the Appalachian Region: 1965-2000. 24. Jean Haskell, “Assessing the Landscape of Local Food in Appalachia.” Report, accessed May 15, 2019, http://www.arc.gov/images/programs/entrep/AssessingLandscapeofLocalFoodinAppalachia.pdf


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25. Ronald L. Lewis and Dwight B. Billings, Appalachian Culture and Economic Development, Report, accessed May 15, 2019, http://kylechafin83.pbworks.com/f/appalachian+culture+and+economic+development.pdf 26. Lewis and Billings, Appalachian Culture and Economic Development. 27. “Exploring Bright Spots in Appalachian Health: Case Studies,” Creating a Culture of Health in Appalachia -Appalachian Regional Commission, accessed May 13, 2019 https://www.arc.gov/research/researchreportdetails.asp?REPORT_ID=145. 28. Barbara G. Shortridge, "Apple Stack Cake for Dessert: Appalachian Regional Foods," Journal of Geography 104, no. 2(2005): 65-73; Nordahl, Eating Appalachia: Rediscovering Regional American Flavors. 29. See Dwight B. Billings and Kathleen M. Blee, The Road to Poverty, (Cambridge University Press, 2000); Cynthia M. Duncan, Worlds Apart: Poverty and Politics in Rural America, 2nd ed., (New Haven, CT: Yale University Press, 2000) ; Ronald Eller, Uneven Ground: Appalachia Since 1945, (Lexington: University of Kentucky Press, 2013). 30. Ann Tickamyer and Cynthia Duncan, "Poverty and Opportunity Structure in Rural America," Annual Review of Sociology 16, no. 1 (1990): 6786. 31. Children’s Defense Fund-Ohio, “Ohio’s Appalachian Children at a Crossroads: A Roadmap for Action.” Accessed February 24, 2020, https://www.childrensdefense.org/cdfoh/wp-content/uploads/sites/6/2018/07/OH-appalachian-children-crossroads.pdf. 32. “Appalachia Then and Now: Examining Changes to the Appalachian Region Since 1965,” Appalachian Regional Commission, accessed May 13, 2019, https://www.arc.gov/assets/research_reports/AppalachiaThenAndNowCompiledReports.pdf. 33. Haskell, “Assessing the Landscape of Local Food in Appalachia.” 34. “Exploring Bright Spots in Appalachian Health: Case Studies.” Creating a Culture of Health in Appalachia -Appalachian Regional Commission. 35. Kathy Charmaz, “Grounded Theory Methods in Social Justice Research,” in The Sage Handbook of Qualitative Research, ed. Norman K. Denzin and Yvonna S. Lincoln (Thousand Oaks, CA: SAGE, 2011), 509-535; Barney G. Glaser and Anselm L. Strauss, The Discovery of Grounded Theory (Chicago: Aldine Press, 1967). 36. Kathy Charmaz. “Foreword,” Sociological Focus 52, no. 2 (AprilJune 2019): 87.


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37. Karen Hacker, Community-Based Participatory Research (Thousand Oaks, CA: SAGE, 2013). 38. “About CFI: Mission & History,” Community Food Initiatives, accessed August 28, 2020, https://communityfoodinitiatives.org/about/mission-history.html. 39. “About CFI: Mission & History.” 40. Annual Report(s), Community Food Initiatives, accessed August 28, 2020, https://communityfoodinitiatives.org/news-events/publications.html. 41. Community Food Initiatives, Annual Report(s) 42. Community Food Initiatives, Annual Report(s) 43. Ann R. Tickamyer, “Space matters! Spatial Inequality in Future Sociology,” Contemporary Sociology 29, no. 6 (November 2000): 805-813. 44. “Vandana Shiva: Create Food Democracy, Occupy our Food Supply,” Rainforest Action Network, accessed May 13, 2019, https://www.ran.org/the-understory/vandana_shiva_create_food_democracy_occupy_our_food_supply/. 45. Scott Winemiller, Email message to authors, October 31, 2018.


Chapter 7 Food as a Strategy for Resilience and Unification Alexandria Polanosky Joy Kostansek Rachel McDonald

The Seed We often view the Appalachian region through negative stereotypes and histories of destructive, extractive industries. However, we cannot let these narratives define the region. Appalachia is in a new phase of transformation, rooted in uplifting creativity and networks found across its communities. Food is a major part of every community and an important aspect of this transformation. Many individuals, organizations, and nonprofits throughout the region are working toward building networks and increasing access to nutritious food while having positive economic impacts on small farms and local food industries. The foundation of the Appalachian economy and lifestyle is deeply rooted in its land and people. Many Appalachians are still subsistence farmers, growing food on small plots of land to feed their families. Farming and working the land in this way has been a tradition passed from generation to generation. However, as John Gaventa wrote in Power and Powerlessness, the influx of extractive industries such as coal mining and natural gas


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exploration changed the relationship between the people and their land profoundly.1 The shift in this relationship was defined by the emerging presence of big business in Appalachia. In the late 1800s, the American Association, Ltd. identified an abundance of coal and mineral rich land in this region of the eastern United States. This discovery began the turnover of land from sovereign, subsistence farmers to acquisitive conglomerates. Those who own the land hold the power. In some places, Appalachian people lost autonomy over the land and lifestyle that was intertwined with their personal identity. Over the next 100 years, an increase in automation, depletion of the resources themselves, and a shift in economic interest caused corporations to abandon their interests in Appalachian coal and, in turn, the people who mined it for them. In the wake of this, single-industry towns were left behind in a state of dependence and vulnerability to outside forces. This state persists today in many Appalachian communities. Regional food system investment is one alternative single-industry communities can use to transform their economies into resilient, placebased societies.2 Regional food system investment is characterized by an emphasis on local, diversified farms and sustainable practices. This approach can provide new economic opportunities while reconnecting Appalachian people to their land.3 This place-based approach to development calls for an understanding of what resources in the region can be fostered and integrated into in a sustainable development strategy.4 However, in order to create change in the food system, we must understand how complex and dynamic these entities are. Eakin et al. conceptualized these pathways into six domains: individual food security, community food sovereignty, human economic welfare, agro-ecosystem integrity, land change, and global food democracy.5 The foundation of a strong, regional food system is grounded in something as small, yet impactful as a seed. Place-based seed saving is a concept that applies to all six of Eakin’s domains. Seed is the core of agriculture and is essential to the practices of everyone from backyard gardeners to industrial farmers. This critical nature has driven large corporations to seek control of seed supplies, making everyone in the system dependent on them.6 Beginning with the Green Revolution, multinational corporations have been working very hard to have complete control over this resource,


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with initiatives such as genetic modification and monocropping practices.7 The focus of the Green Revolution was to direct agricultural research, both governmental and private, toward the creation of high yield, chemical resistant staple crops.8 These corporate methods have begun to wipe out the biodiversity and cultural diversity that is crucial to small-scale agriculture systems in the United States and overseas where these practices have been exported.9 This growing method leaves communities in a cycle of dependence on the large corporations by requiring farmers to sign contracts mandating yearly seed purchases, rather than using saving methods.10 People are becoming increasingly vulnerable to the control of large corporations who are operating in this business for profit alone, having no concern for the preservation and respect of cultural and environmental diversity. Traditional seed saving practices are the precedent and alternative to the industrial agricultural system. Before this practice was monetized and co-opted by big business, seed saving was a place-based practice. Farmers grow a crop year after year while allowing a portion of the plants to go to seed. From there, the seed is harvested and saved so that it can be used for the next growing season. By using seed in this way, farmers know their crops are adapted to the climate and natural threats of the region, such as pests and disease.11 Seed saving encourages interconnected community organization. In line with seed sovereignty, when people save their own seed, they often distribute it through community-based gifting and trading. It calls on the human and social capital of a community that is the driving force behind traditional agriculture systems.12 In the face of industrial agriculture, these community-based resources are becoming increasingly scarce. We can preserve it by recognizing seed saving as an asset in developing regional food systems. Involving community members in development planning is an effective way to ensure it is focused on sustainable and real solutions. With asset-based development, community members recognize their strengths and resources and uses that to drive their developmental plans rather than their weaknesses and needs. The asset-based perspective fosters independence and reduced reliance on outsiders to create short-term solutions.13 In the example of seed saving systems, development plans require knowledge and documentation of what seeds are being grown where and by whom. Understanding the breadth of details surrounding each variety is multi-faceted. Each seed tells a story about how to best grow, manage, and preserve it. This offers us a history of regional farming skills, as well as


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culturally relevant methods of cooking and preparing dishes with the crops. Often this information is passed on from generation to generation, in a way that is deeply rooted in the community’s history. All these elements make seed saving systems a way to viably connect regional identity and sustainable development through food systems. Seed saving can help communities connect to the land, foster resilience, and create an autonomy that does not depend on outside support. It is important to consider how this concept fits into the Appalachian identity, and how it can be used to positively approach uplifting the economic, cultural, and creative opportunities of Appalachian communities. An example of work fostering community seed systems can be found in the southeast corner of Appalachian Ohio in Athens County through Ridge & Hollow Seed Alliance (R&H). This Alliance is a program within the non-profit organization Community Food Initiatives (CFI) whose overall mission is to “foster communities where everyone has equal access to healthy, local food.”14 R&H operates as a social enterprise, where the profits generated from the business go back into the supporting non-profit and its programming. Seeds have always been an important part of CFI, with seed saving and sovereignty programs in place for over a decade. This programming began with peer education and evolved into seed swaps, plant start giveaways, and other community events surrounding gardening and seeds. This work also included the creation of an annual inventory book that documents regional varieties being saved. The book includes the grower’s contact information and operates as a public resource. The growers for this inventory were identified informally, relying on the pre-existing community networks. CFI identified a local seed company as a missing link in the regional food system of southeast Ohio. In 2014 CFI piloted a seed company under the name of Southeast Ohio Savers, which eventually evolved into R&H in 2016. The company was created to provide regionally adapted, open-pollinated seeds to the southeast Ohio Appalachian region through local retail operations. Growers were initially identified through the seed inventory, and the numbers grew as the project progressed. These contracted growers sell a portion of their seeds to R&H, that clears, performs germination tests, and packages it. The seed packs are sold throughout the region, including in retail locations and occasionally at the Athens Farmers Market. Without the


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work of this organization, open-pollinated, regionally adapted seeds would not be a resource accessible by the public. This has opened the doors of seed saving to a larger market, allowing growers to participate in the regional food system in a deeper and more culturally relevant way. Seed saving can bridge the connection between economic development, cultural identity, and food systems. It connects people to the roots of their communities by shedding light on place-based tradition. It fosters a dependence on the community rather than outside industry and has the potential to spark wide engagement in a strong, decentralized, regional food system. The People Beyond those conserving the culture and roots of the Appalachian food system are those who do not have access to the system at all. Food is not only necessary for individual survival, but also for strengthening communities and overcoming social barriers. Access to food, starting from the seed and continuing through the entire food system, means more than just improving health; it means empowerment and resiliency for those who are often left in the dust of progress. Food sovereignty has become a rallying call in Appalachia as people work to overcome circumstances from past extractive patterns by regaining empowerment through food. When speaking at a recent gathering of various non-profit leaders across Appalachia, Rural Support Partners’ Andrew Crosson said: Food access is a really important area to focus on across the region. It affects public health; it affects community development, and it affects economic development. It is really how we weave in this question of equity into the food system and how we make sure that the food systems development work that we’re doing is benefiting the most vulnerable people in the communities we’re working in.15 Initiatives working toward increasing this access include programs such as Farmacy in Letcher County, Kentucky, which prescribes produce to those with diet-related illnesses as well as pregnant mothers in the form of vouchers to use at the local farmers’ market. According to local foods organizer Valerie Horn, “the Farmacy program began as an attempt to make better choices accessible to vulnerable populations.”16 The program brings a


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health care provider into the process, allows community members to purchase food they likely could not afford or are not comfortable shopping for, and opens a new market for small farmers in the area. In 2017, 300 families participated in the Farmacy program bringing an investment of over $100,000 to the market.17 Beyond increasing food access, Farmacy takes a giant leap forward in providing preventive health care by addressing illnesses with healthy food choices before more serious medication and treatments become necessary. Through Farmacy’s programming, participants are given the opportunity to discuss recipes and techniques with farmers and other market visitors as they shop. The whole concept humanizes health care as participants are empowered to heal themselves, feed their families and experience their food in a whole new way. If a Farmacy participant lives with other family members, everyone in the household receives vouchers for use at the market as the program “is about changing the look of the whole table – not just one person’s meal, but to change a whole pattern,” according to Horn. An initiative like Farmacy can be found in Athens County, Ohio through Community Food Initiatives’ Donation Station which is discussed in more detail in Chapter 6. This program delivers fresh, local food to pantries in the area, including the pantry available to Ohio University students on campus, while providing an economic incentive for farmers and community members. Anyone growing produce can donate excess fruits and vegetables to volunteers stationed at the farmers market, produce auction, and other events. This initiative eliminates food waste through distributing produce that might otherwise be disposed of and provides fresh food to those using food pantries across the region. As much of the food donated to pantries often includes canned and other shelf stable products, Donation Station also helps to inform community members of the wider range of resources available while eliminating the stigma that those using these resources do not deserve the freshest, healthiest food. To have a truly nutritious diet and escape the cycle of poverty, the community must come together through food-related programs to close the gaps that federal assistance programs leave. For example, the Supplemental Nutrition Assistance Program, or SNAP, is the largest federal food assistance program in the country, yet it fails to cover the cost of a low-income meal in 99 percent of the country.18 Farmacy and Donation Station are just


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two local examples of how Appalachian people are furthering access to fresh, healthy food beyond what federal assistance programs are doing, and increased food access often coincides with increased community and resiliency. If one can produce and prepare food on an extremely local level, he or she is no longer reliant on a federal system that does not always provide the healthiest foods in an accessible way. This independence through food grows into resiliency, and “it is really important that we feel resilient as people and as households. As Candace Mullins from Grow Appalachia put it, “There is something so powerful about food. It’s a connector, it pulls a lot of people together that are very different.”19 Much of this programming across Appalachia is led by a younger generation that either grew up in the region or moved here and wants to create change and be a part of the tight-knit communities often at the heart of small-town Appalachia. The commitment, ingenuity, and compassion of these young leaders is incredibly inspiring, and their efforts are driving positive economic development while allowing people to experience one of the most vital human rights: food. According to Crosson, many of these young leaders just want to “keep spreading and lifting up these models, showing what’s possible, showing that Appalachia is a place where innovation and creativity and commitment are what’s driving the work.”20 The Land Environmental degradation in the Appalachian region persists as one of, if not the most, pressing concerns for the current and future health and well-being of the people, land, and economy in Appalachia. When considering strategies for development in Appalachia, it is crucial to understand the intrinsic interconnection between improving the economy, restoring the ecosystem, and strengthening communities. This understanding requires acknowledging that the economy cannot exist independently from nature, and that people cannot prosper with depleted land and natural resources. Knowledge of these concepts was evident in human societies historically, yet this knowledge was considerably lost, or overlooked as our society modernized and industrialized because of capitalism. To reintroduce and apply these concepts to contemporary times, the term sustainability is used. Sustainability has emerged as the spearhead of international development, urban planning, business models, grassroots movements, nonprofit organizations, and so on.21 And though the term’s overuse has somewhat turned


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sustainability into a trendy buzzword, at its core, the concept remains imperative to the future of human society and the planet. So what does sustainability look like in the Appalachian region? Wendell Berry, a writer, farmer, and environmental advocate from Kentucky, wrote I can think of no better form of personal involvement in the cure of the environment than that of gardening. A person who is growing a garden, if he is growing it organically, is improving a piece of the world. He is producing something to eat, which makes him somewhat independent of the grocery business, but he is also enlarging, for himself, the meaning of food and the pleasure of eating.22 Berry writes from personal experience. As an adult, Berry bought a farm in the Kentucky county where he was born, and after acquiring the land, he dedicated his life to restoring it through sustainable farming methods. His writing touches on various central ideas; the critique of commercial agriculture, and more generally the corporate and industrial harm caused to land and resources in Appalachia, the opportunity to regenerate land through agriculture, and the personal, cultural, and community empowerment gained through farming. Berry is often referenced in contemporary sustainable agriculture discussion and his advocacy serves not as an example of how every resident of Appalachia, or rural America in general, should live to strive for environmental sustainability. Instead, Berry’s work illustrates larger conceptual ideas regarding the relationship of economy, environment, and citizen.23 The theories surrounding sustainable agriculture delineated in Berry’s writing, and reiterated around the nation and globe today, have set the groundwork for various farming and food initiatives. There is an evident national and international movement to create an alternative to our current food and agriculture system. And while the global strive towards sustainable agriculture is important for the strength of the movement, place-based and regional approaches are necessary to carry out the initiatives effectively; an essential element of more sustainable agriculture is its regional focus.24 Looking at place-based approaches, sustainable farming and food strategies have seen success in areas with wealthy urban and suburban


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populations to economically fuel such pursuits. We see this trend manifest through increasing numbers of farmers markets, CSAs, and “local” labels on produce in chain grocery stores such as Whole Foods.25 The challenge for Appalachia involves utilizing these sustainable agriculture practices to promote economic and community development, as well as environmental regeneration, in rural, economically and resource poor, and often, food insecure areas of the region. Currently, this challenge is being tackled throughout Appalachia by many organizations, and these efforts are creating visible change and improvements.26 In the southeast region of Appalachian Ohio, this challenge of combating environmental and economic problems through agricultural strategies is being addressed by farmers, entrepreneurs, and non-profit organizations. Southeast Ohio suffers from environmental, public health, and economic disparities common throughout the Appalachian region, but also shares the historic and cultural ties to subsistence agriculture prevalent across Appalachia. Nonprofits such as Rural Action work to train more farmers in sustainable farming techniques, increase the market size for farmers to sell more of their products, and expand access to the fresh food from the region, focusing on distribution in rural, food-insecure communities.27 Farmers in southeast Ohio realize the value of sustainable agriculture. Some of these sustainable practices include raising grazing animals to regenerate land, using organic growing methods to protect and conserve soil, embracing energy efficient processes to reduce fossil fuel use, and using solar energy, high-tunnel systems, and water conservation methods. Several restaurants and food producers, mostly located in the region’s largest town, Athens, seek out the products from these farms, and are willing to pay a higher price to support better practices and their regional economy. Additional support to these farmers comes from the local residents who can access their food, the majority of whom live in Athens. There is a “locavore” culture in Athens in people frequenting the restaurants mentioned above and purchasing the regionally and sustainably grown products directly at places such as the Athens Farmers’ Market. Food as a Worthy Solution Appalachia Ohio has made forward progress using food and agriculture as a vehicle for sustainability efforts; yet there is much more progress to make. Small-scale farmers in the region still struggle to compete against big agriculture, and food insecurity and unemployment rates in Athens County


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are some of the highest in the state.28 How do rural Appalachian regions striving for sustainable development gain the momentum and backing to turn progress into transformation? We hear phrases like sustainable planning, green infrastructure, eco-innovation, and think of large urban cities with intricate bike routes, public transit, and high-rises with roof-top greenhouses or solar panels. These incredibly important urban initiatives deserve recognition, but we cannot ignore the people in rural places throughout Appalachia. Sustainable agriculture has proven itself worthy as a solution to a diversity of issues Appalachia faces, and the grassroots, place-based, and citizen led efforts are carrying the movement toward a more sustainable food system. To truly advance and transform Appalachia’s rural regions, investment, policy-change, and support must come from institutional levels; sustainable agriculture and other sound sustainability strategies must be prioritized by the region’s largest institutions such as government, universities, and hospitals. For institutional change, thinking must no longer be shortsighted, and social, environmental, and economic impacts must be considered interdependent of one another. Notes 1. John Gaventa, Power and Powerlessness: Quiescence and Rebellion in an Appalachian Valley, (Chicago: University of Illinois Press, 1982). 2. Joseph Holland, "Examining Capacity Within the Local Food Economy: Lessons Learned from the Appalachian Region in Mississippi," Journal of Appalachian Studies 22, no. 1 (2016): 31-44. 3. Gaventa, Power and Powerlessness. 4. Gary Paul Green and Anna Haines, Asset Building & Community Development, 4th ed., (Thousand Okas, CA: Sage publications, 2016). 5. Hallie Eakin, John Patrick Connors, Christopher Wharton, Farryl Bertmann, Angela Xiong, and Jared Stoltzfus, "Identifying Attributes of Food System Sustainability: Emerging Themes and Consensus," Agriculture and Human Values 34, no. 3 (2017): 757-773. 6. Jack Kloppenburg, "Impeding Dispossession, Enabling Repossession: Biological Open Source and The Recovery of Seed Sovereignty," Journal of Agrarian Change 10, no. 3 (2010): 367-388.


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7. Peter Jacques and Jessica Jacques, "Monocropping Cultures into Ruin: The Loss of Food Varieties and Cultural Diversity," Sustainability 4, no. 11 (2012): 2970-2997. 8. Prabhu L. Pingali, "Green Revolution: Impacts, Limits, and the Path Ahead," Proceedings of the National Academy of Sciences 109, no. 31 (2012): 12302-12308. 9. Jacques, “Monocropping Cultures into Ruin,” 2970-2997. 10. Abigail Wincott, "Heritage in Danger or Mission Accomplished? Diverging Accounts of Endangerment, Conservation and “Heritage” Vegetables in Print and Online," Food, Culture & Society 18, no. 4 (2015): 569-588. 11. Kloppenburg, Impeding Dispossession, Enabling Repossession, 67-388. 12. Jacques, “Monocropping Cultures into Ruin,” 2970-2997. 13. Green and Haines, Asset Building & Community Development. 14. Community Food Initiatives, Community Food Initiatives: About CFI, Accessed May 4, 2019, https://communityfoodinitiatives.org/about/mission-history.html. 15. “Central Appalachian Healthy Food Access Case Studies- Project Summary,” produced by Alexandria Polanosky, Central Appalachian Network, interview with Andrew Crosson, March 15, 2019, video, 3:20, https://www.cannetwork.org/healthy-food-access-in-appalachia-summaryvideo/ . 16. “Central Appalachian Healthy Food Access Case Studies- Project Summary.” 17. “Central Appalachian Healthy Food Access Case Studies- Project Summary.” 18. Elaine Waxman, Craig Gundersen, and Megan Thompson, How Far Do SNAP Benefits Fall Short of Covering the Cost of a Meal?, February 23, 2018, https://www.urban.org/research/publication/how-far-do-snap-benefitsfall-short-covering-cost-meal. 19. “Central Appalachian Healthy Food Access Case Studies- Project Summary.” 20. “Central Appalachian Healthy Food Access Case Studies- Project Summary.” 21. Leslie P. Thiele, Sustainability, 2nd ed, (Boston: Polity Books, 2016). 22. Wendell Berry, The Art of the Commonplace: The Agrarian Essays, (Berkeley, CA: Counterpoint Berkeley, 2003).


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23. Jeffrey Ilipiak, “The Work of Local Culture: Wendell Berry and Communities as the Source of Farming Knowledge,” Agricultural History 85, no. 2 (2011): 174-94. 24. Giaime Berti and Catherine Mulligan, “Competitiveness of Small Farms and Innovative Food Supply Chains: The Role of Food Hubs in Creating Sustainable Regional and Local Food Systems,” Sustainability 8, no. 7 (2016): 616. 25. Debra Tropp, Why Local Food Matters: The Rising Importance of Locally-Grown Food in the US Food System, 4th Annual Virginia Women’s Conference, October 26, 2013. 26. Kathryn Webb Farley and Carrie Blanchard Bush, "Using Relationships as Resources in Social Impact Investing: Examining a Local Food Movement in Appalachia," Journal of Appalachian Studies 22, no. 2 (2016): 224-244. 27. Rural Action, “Sustainable Agriculture,” ruralaction.org. 28. Office of Research, The Ohio Poverty Report, (Columbus, OH: Ohio Development Services Agency, 2019).


Chapter 8 A Thousand Words: Art Impacting Community Mental Health Josh Birnbaum Nate Thomson Paul Logue Introduction In 2018, the Athens Photographic Project (APP) in collaboration with the City of Athens installed a major public art exhibition, A Thousand Words, on the front of the Athens City Parking Garage. APP is a nonprofit art program that promotes mental health recovery by providing opportunities for community members living with mental illness to express themselves creatively through photography. The work celebrates the community and landscape of southeast Ohio as seen through the lens of regional photographers, all of whom are members of the APP. The project took four years from conception to completion and is an example of how university, city, and community collaborators can work together in advancing community art and mental health awareness. Faculty and graduate students from Ohio University served as instructors and volunteers to the project; the City of Athens provided planning, logistics, and funding; and the APP supported photographers in bringing unique and otherwise invisible perspectives to light. The APP led two artist cohorts through a 30-week curriculum focused on learning about public art. During this period, the artists provided feedback on designing the installation while they actively created photographs for it. In working together, all


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collaborators created an experience that encourages us to engage in self-reflection and see our world with new eyes. It reminds us that our experiences matter, no matter how big or small they may seem. Here, three of the main collaborators will explain the collaborative process, detail the planning of the public art project, and explore the impacts on artists and community. This project can serve as a positive model for how unique collaborations can restore communities by leveraging resources in new ways, sharing ideas, and recognizing the input and value of all community citizens.

Figure 1. A Thousand Words officially opened to the public on October 27, 2018. (Photo by Joel Prince / Athens County Convention and Visitors Bureau) Background on the Athens Photographic Project and Genesis of A Thousand Words Nate Thomson Back in 2001, I was studying photojournalism at Ohio University. At the time, photographers were still using film and some, like myself, still spent time in the darkroom processing and printing black and white


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images. One day as I was heading into the darkroom, I noticed a very modest flyer pinned to a bulletin board surrounded by full-color glossy advertisements for international study abroad opportunities in the arts. The flyer read, something to the effect of, “Athens Photographic Project is seeking volunteers to serve as Teaching Assistants in its upcoming Black and White Photography class. Athens Photographic Project offers photography classes to adults living with mental illness. Contact Elise Sanford . . .” Reading this flyer caused my heart to race. I knew in an instant that I needed to get involved with this group. For several years prior, I had been interested in the idea that the process of taking photographs can very quickly transform how you see yourself and how you relate to the world. I personally had this experience and felt that if the tools for photography and supportive arts communities were more accessible, then photography might have an important role within the health and social service sectors. I had been scanning articles and publications on the subject of photography and health care and found very little that spoke to how the process of photographing affected personal well-being. And now, here was what I had been looking for, on an unassuming flyer with the invitation to get involved. It can be very intimidating to stumble across something that you’ve been daydreaming about and realizing that it is real and that you are not alone in your thinking. I questioned whether I was qualified to be of assistance within the Athens Photographic Project. I was a young photography student with no training in psychology or social work. What did I have to offer? I finally got up the nerve to call Elise Sanford to ask if I could volunteer. Elise started the APP as a photographer and mental health advocate who witnessed first-hand the struggles of mental illness within her own family. I was struck by the amount of time Elise spent on the phone getting to know me. In reflecting back on her life, I now see that she had a way of holding someone in her presence until some deeper truth arose out of the conversation that neither party might have been able to anticipate. During this first conversation with Elise, I found myself sharing details about how mental illness had impacted my own family and how I’ve never really had an outlet for sharing those stories and emotions.


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Figure 2. Elise Sanford, pictured here in 2014.

As I began volunteering with the Athens Photographic Project as a teaching assistant, I quickly realized that the group of artists in fact knew much more than I did about photography and life. I also learned that they were not looking for psychologists and social workers to help them through photography, but they were truly interested in becoming skilled photographers and contributing community artists. Elise modeled her photography classes after the studio art class model that included art history, class critiques, camera instruction, and weekly photography assignments. The classes culminated in juried, group exhibitions. While the class structure was familiar to what I had been accustomed to in my own photographic studies, there were other elements to the group that were new to me and offered what I had been looking for and needing in my own life. The group used its love of photography to connect with each other on very deep levels and to explore their own feelings and environs. It was a safe space for everyone. We talked very little about mental illness within the classes. Photographic subjects ranged from street photography, to portraiture of family, to still life images of constructed antique


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and doll assemblages. The group was honest, intimate, and unobstructed by grades or graduation deadlines. I felt like the group was touching the heart of what I yearned for in the photographic process. It reminded me of photography groups that I idealized, such as Group f/64 in San Francisco. There was nowhere else I wanted to be, and it seemed nowhere else that this talented group of photographers wanted to be either. Alas, my own graduation and life travels pulled me away, but I always yearned to return to such a photographic community and pondered how I could create something like Elise’s vision outside of southeast Ohio. In 2007, Elise contacted me to let me know that she was retiring from her role at Athens Photographic Project and encouraged me to apply to serve as Executive Director. Accepting the position, my wife and I returned to Athens in May 2007, and I quickly found myself immersed in this very unique arts community crafted by Elise, the APP artists, and so many other Athens community members who contributed to and supported Elise’s vision over a seven-year period. Like Elise once did, I began posting modest volunteer flyers around the halls of Ohio University, and recruiting potential photographers by making short presentations to staff at Tri-County Mental Health Services (now called Hopewell Health Centers). Participant interest in our classes increased from year-to-year, and we developed an ongoing waiting list for community members to join our introductory class. I knew it would be important to shorten our waiting list time and provide opportunities for new artists. I also knew it was important to provide ongoing opportunities for currently enrolled artists who were growing in their artistic skills, self-expression, and capacity to contribute to the vibrancy of our community through the arts. These artists had made a commitment to using photography as a vehicle for mental health recovery and I felt it was necessary to support them as far as they wanted to go with this very uncommon recovery support process. It was clear that this approach was facilitating a level of growth outside the realm of clinical mental health treatment on its own. Athens Photographic Project artists are truly defining how photography is beneficial in mental health recovery. They are overcoming isolation, low self-worth, stigma, and other barriers to recovery as they use photography and peer-support to rebuild meaningful lives in the community. They are the artist-researchers, public advocates for this innovative methodology, and feel blessed to live in Athens, Ohio where community partners such as the Athens-Hocking-Vinton 317 Alcohol, Drug Addiction, and


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Mental Services Board; Hopewell Health Centers; Ohio Arts Council; and many other organizations and individuals trust and support their artistic journey. Creating ongoing classes for continuing, advanced level artists is always a challenge and one that requires support from the community at large. Such classes require new arts learning objectives, and new opportunities for artistic skill building and creative expression, all while maintaining the same safe, peer-centered space of our original classes. We developed one particular advanced level class with a cohort of senior level artists who had a history of contributing to our gallery exhibitions but were unsure about sharing their work with a broader audience. I realized that if the group was able to learn about public art and collaborate on the creation of a new installation, then this perceptual gap would lessen, and the community would benefit from having new public art in the process. During summer 2015, I began pulling together a team to help steer this process. The two primary partners are co-authors of this article, Paul Logue and Josh Birnbaum. Paul is the Athens City Planner and was the first person that I reached out to with the idea of collaborating on a public art project. To my surprise, when I first met with Paul he handed me a copy of the city’s recently published, Essence of Athens1 community design plan, which basically served as an open invitation for such artistically-driven partnerships with the city. Paul enthusiastically championed the project to Athens City Council who approved it moving forward. During the early stages of this project, newly elected Mayor Steve Patterson also recognized the value in the partnership and pledged city planning time and financial resources to see the project through to completion. Josh is a faculty member in the School of Visual Communication at Ohio University and a former volunteer and instructor with the Athens Photographic Project. I reached out to Josh to be the lead class instructor because of his interest in blurring the lines between public, private, academic, and civic activities. More importantly, Josh was always successful in maintaining an artist-centered learning environment within our classes, which I knew would be vitally important during a highly collaborative project such as this.


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Paul, Josh, and I began scouting locations for the installation and planning the project during summer and fall of 2015. At this time, we identified other community voices to invite to work on the project. Some of these partners were involved in early planning stages. Others, such as Hilferty Museum Planning, joined the project in 2017 to help bring all our ideas together into a cohesive work of art. E3 Custom Fabrications and Robin Imaging then produced and installed the final installation. Additionally, Athens Photographic Project instructor Kim Crum led a group of artists in the established public art curriculum during 2016-2017, all of whom contributed work to the installation.

Figure 3. Athens Photographic Project artist Janet Boring shows off her picture at the ribbon cutting ceremony for A Thousand Words on October 27, 2018. (Photo by Joel Prince / Athens County Convention and Visitors Bureau) Looking back on this project, I feel gratitude for all those involved, most notably, the Athens Photographic Project artists. As evidenced through the final installation, these artists held true to their personal artistic visions while working on a complex public art project bringing greater visibility to their work and their association with mental health recovery, than they had previously ever experienced. While this new challenge created


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some discussion and worry during the class, it never once stopped them from creating authentic, heartfelt work. Details of A Thousand Words Public Art Installation Josh Birnbaum Photography is about more than just the final product. Glenna Parry, a long-time APP artist, once exclaimed to me in class, “A camera will change you. It does!” It is with such sentiments that APP’s advanced artists still regard photography. These artists have been in the APP for many years — some since the inception of our organization in 2000. They are constantly searching for new ways of seeing the world, new techniques, new art to devour and think about, as well as new ways to approach their mental health recovery through exploring art. Many of them see photography as an essential part of their lives: even after having been involved with the project for a while, it still gives them a sense of excitement, pride, and value to learn about, make, and share artwork in a supportive community. With this attitude, we approached the task of learning about public art and making a shared public work. To prepare for this project, I drafted a curriculum that incorporated history, theory, and practice. We studied the historical development of public art, from graffiti to political sculpture to large-scale public works, and discovered how complex and layered projects can be. We delved into reasons why an artist might create a public work, and why collaboration can be an integral part of that process. When asked to describe why an artist would create a publicly viewed art installation, one artist, Jamey Taylor, said that she wanted “to be active in the community [and] to find a way to share my art in my community.” Another, Leah Reasoner, acknowledged the healing component of the project in that she hoped “to create awareness of mental health and erase stigma.” Chris Leonard desired “to create an oasis of wonder in a normally mundane environment.” And Stephanie Schmidt admitted that vulnerability was required “to take a risk in self-revelation to community.” All these reasons and more were discussed to build understanding and investment in the complex project. Students in the class learned wheatpasting and emulsion transfer processes that adhered photographs to various materials, like wood, stone,


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fabric, and glass. The class studied environmental art (projects that use nature in art or had ecological interactions) and pop-up exhibits, which are temporary shows in informal spaces that are visible to passersby. The artists hosted their own outdoor exhibit featuring this work in the space near our local mental health center, Appalachian Behavioral Healthcare. Legendary zine (small magazine) artist Cindy Crabb came to share her expertise with artists, who then created their own zines to be shared collectively. Local graffiti artist Matt Glass shared his insights on process and materials for outdoor works. Getting the artists to study a variety of works, hear from artists who practice, and then make art themselves helped them connect to the idea of making a large-scale public work. Field trips became an essential way of experiencing various forms of public art because they allowed students to see context, scale, and impact in person. We visited downtown Lancaster, Ohio, which has a plethora of historical and modern sculpture and architecture along its main street. We participated in a local collaborative art endeavor, Honey for the Heart, where artists were able to help create costumes for a Halloween parade. The most impressive to artists was the trip to Portsmouth, Ohio, to see the flood wall murals made by Robert Dafford. The work spans more than 2,200 feet and is comprised of 60 individual murals that are 20 feet tall. It was no small feat for us to travel as a group to Portsmouth in the dead of winter and walk the entire span in sub-freezing temperatures! Artists were given weekly assignments that challenged them to think about what they wanted to express to the outer world. What do you want to say about yourself, about your art, about your community, about your vision, on this wall? Throughout the project period, artists were constantly making images and practicing photography as a way of connecting to their community. Artists were creating their own expressive and meaningful images, but they are also working in conjunction with graphic designers, builders, and city employees to make this project all-inclusive and accessible to the community at large. Mark Franz, Graphic Design chair at Ohio University, came to class multiple times to share his project design with the artists and hear their feedback. Athens Mayor Steve Patterson met the artists during a site visit to the parking garage wall one day and spent time with the group explaining his interest in the installation and hearing about the artists experiences in working on the project. City Planner Paul Logue and City Council member Kent Butler visited our classes to share their thoughts on the collaboration


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and view the photographic work created in class. After artists chose their favorite images from the project, a committee of those planning the project helped to jury images for the exhibit. Artists who were accustomed to making their art in isolation were now getting to work as a true team. During class, I saw a wealth of excitement and enthusiasm towards this project. Participants felt as if they were a part of something greater than themselves — yet this project was something that could still nourish the individual with pride in participation. This wall has beautified uptown Athens and can be cherished by residents and visitors alike for years to come. As a member of the faculty at Ohio University, I was able to connect student volunteers and graduate assistants to our collaboration and build relationships with other partners at the University. Students who otherwise might be siloed off from the community were able to engage with artists and contribute to the project. I see it as my duty as an educator to facilitate understanding of what it means to be connected to the larger world. I was an instructor with the APP for four years and I can attest to the fact that it positively impacts the lives of all artists, staff, and volunteers involved, as well as the greater community of southeastern Ohio. Even though I concurrently taught full-time at Ohio University, it was always a pleasure to get to help some very experienced photographers continue to reinvent themselves, deepen their relationship with the community and their art, and continue onward in their recovery. It is important to me to support my local community by bringing diverse experiences together. Additionally, to work as a teacher in our unique Appalachian town requires an understanding of this region, its history and its culture. However, I think the most important skill one can bring to any collaborating group is being a good listener. By listening intently and hearing what people are saying, one can actively incorporate individual opinions and thoughts into the group mission. In this way, we were able to build an understanding of the journey we embarked upon, and the destination we wanted to reach.


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Figure 4. Although it was a rainy day, a crowd attended A Thousand Words opening on October 27, 2018. (Photo by Joel Prince / Athens County Convention and Visitors Bureau)

The photographs shown on the wall are from the APP’s 2015-2017 advanced level artists and were created specifically for A Thousand Words gallery. The gallery gives APP’s advanced artists the chance to continue making the art they love, work toward a common goal with city employees and collaborators, learn about public art, and share their art unflinchingly with the world in a new venue. They are not only continuing their discovery of art and deepening their recovery; they are also changing perceptions of mental health by boldly sharing their artwork publicly to break down stigma. This gallery exhibit, for which these artists and collaborators have been working so hard, will surely testify to Athens’ continual reinvention of what art and community can be. On Arts and Community Development Paul Logue In 2013, the City of Athens launched The Essence of Athens project, a strategic community design plan that focuses on reinforcing the unique aspects of Athens in our built environment. The plan originated out of


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conversations between myself as the Athens City Planner and Kyle Ezell, an Ohio State University City and Regional Planning faculty member and then-principal at Designing Local, a Columbus based planning consulting firm. Ezell was interested in taking a deeper approach to creative place-making that focused on creating community design elements that were reflective of a given community. As the city planner, I was approached to see if Athens would be interested in testing this new planning initiative. I was committed to using the city’s public spaces to better tell the story of Athens by incorporating public art and local design elements in the built environment. Although many of us held a notion that Athens is an arts-based community, I argued that this is not reflected around us. I wanted our city to celebrate our arts culture in public spaces so that anyone who comes to Athens knows that art matters here. Kyle and I had regular meetings at a diner in Logan, Ohio (roughly halfway between Athens and Columbus), to brainstorm an outline for this innovative planning approach. We talked about strategies to protect Athens from outside threats, and how cities are in competition with each other for businesses, residents, tourist dollars, and prospective college students and their parents. We both agreed that cities that do not focus on their unique qualities begin to look the same (i.e., cookie cutter franchise restaurants, chain retail, suburban commercial corridors) and that this sameness creates a competitive disadvantage. To combat development inertia towards cut-andpaste projects, we both believed that cities must take a fresh approach to community design that builds on the uniqueness of their community. In short, Athens must reinforce its identity to successfully compete with other cities. Ask anyone who knows anything about Athens, and they will likely tell you that we have a distinct culture and a quirky vibe that makes it unique. We aimed to better define those characteristics and then reinforce it throughout the city. After several such meetings Kyle and I agreed to launch the Essence of Athens plan. Project partners for the planning included The City of Athens, community members, and consultants from Designing Local and MKSK. Our consultants worked on a pro-bono basis since this planning approach was new and untested. We conducted a public visioning process where community members were challenged to define Athens by considering the key characteristics that when layered together makes Athens “Athens.�


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Participants were encouraged to provide images of these characteristics by taking pictures on their phones and sharing on social media, submitting ideas via email, or through public meetings. In total more than 300 people provided photographs, brief email thoughts, essays, and even a poem to help our efforts. We then worked with an ad-hoc committee of community members who helped integrate this visioning information into the plan. Committee members included local artists, planners, historians, and the city engineer. Because Athens is a small town, we all begin to know each other after a few years of living here, so it was relatively easy to form the committee with local people. There is a level of familiarity and trust where we can approach people we do not know and ask them to help us with a city effort. In my official capacity, I am often featured on the city’s cable government channel that is popular with interested citizens and local insomniacs alike. Due to this very low-level local celebrity status people frequently stopped me at the grocery store or in local restaurants to tell me they saw me on TV discussing a city issue. This almost always includes sharing an idea they have for the city to act upon. Many times, these ideas are excellent and exciting, but my work responsibilities do not allow me to drop everything and take on a new initiative. For the Essence of Athens project, I reached out to some of the local “idea” people I have talked with in the past. I asked them to participate in a city plan where we try to incorporate their great ideas into a framework that is vetted by city staff, consultants, and then city council to get ideas implemented. Once we had our team in place, we started to work on how to incorporate ideas into the plan’s structure. I wanted this plan to focus on concepts that could be realistically implemented. While discussing this, we came to the conclusion that rather than creating a plan that tells people what they have to do; we wanted to draft a plan that said “this is what the city is going to do for the community.” To that end, we concluded that the plan should center on the strategies and policies that can be incorporated into the city’s public rights-of-way and properties. In committee meetings we challenged members to think about how our built environment could be modified to celebrate the uniqueness of Athens. We discussed questions like “how would you design a bike rack so that it could only be authentic to Athens?” or “how can we use our sidewalks to tell our story?” And then we went to work fleshing out those ideas to see how we could apply them. The final plan included concepts such as Athens-


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based street furniture designs, methods for incorporating public art, and ideas to better tell our community story through public design. The plan encouraged readers to embrace the concepts outlined in The Essence of Athens and use it in their own projects. The significance of The Essence of Athens in how we approach public projects and public art in Athens cannot be overstated. The plan was validated through community and professional scrutiny and was the recipient of the 2015 American Planning Association award for Outstanding SmallTown Special Project. Most importantly, the plan has been embraced by the city leaders and continues to be implemented. We are several years in on this plan being adopted by Athens City Council and the plan remains on the tip of our tongues. Stakeholders are still excited about the ideas in the plan and we continue to look for new ways to use its concepts.

Figure 5. Athens Mayor Steve Patterson reads a proclamation during the A Thousand Words ribbon cutting ceremony on October 27, 2018. (Photo by Joel Prince / Athens County Convention and Visitors Bureau) We have newer community members that even used the Essence of Athens plan to build a new community park in uptown Athens in April 2019. The success of the overall plan is evidenced throughout Athens, including in pedestrian crosswalk patterns that reflect design elements from a prominent


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historic building, local art on traffic boxes, bike path mile markers that use patterns based on our historic local bricks, and splash pads at our city pool that burst with colors from the Essence of Athens palette. And most prominently, the plan has been used to help inspire the Athens Photographic Project’s A Thousand Words public art installation on the city’s uptown parking garage. Among the many reasons I love the Athens Photographic Project installation is that it takes some inspiration from the Essence of Athens and adds value to what the APP already does so well. The installation helps to tell the story of Athens and the lives of those who live here. From a public policy perspective, the installation contributes towards several city goals — it is public art in a very public location, it reflects the story of Athens and Athenians, and it is deeply embedded in public health. Every day I have the opportunity to watch people interact with A Thousand Words as they walk past it. I see the passing glance from people who walk past it frequently, people who noticed something they missed the last time. And I see the slow walk to look at every photograph from someone discovering it for the first time. Conclusion A Thousand Words is a model for how public art, community health, and civic engagement can merge to form a greater whole. As a contemporary illustration of mental health, the project enables artists to take ownership of their work and feel immense satisfaction as contributing members of the community at-large. The collaboration created an outlet for these artists to be a part of the development of the project, thereby expanding their agency and investment. Being a small community allowed this permanent outdoor exhibition to happen organically, but it could not have come to fruition without strong support from the Athens City Council, City Planner and Mayor, who all saw this as an important endeavor for our region. Elise Sanford, founder of the APP, unfortunately passed away in March of 2018 — seven months before A Thousand Words opened — but her impact as an advocate for arts and mental health will be felt by generations of viewers who see this landmark public work of Athens.


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Figure 6. Artists, city employees, and community members cut the ribbon for A Thousand Words on October 27, 2018. (Photo by Joel Prince / Athens County Convention and Visitors Bureau) Notes 1. The Essence of Athens: A Strategic Design Plan for Economic Enhancement and Community Competitiveness, http://www.designinglocal.com/wp-content/uploads/2014/07/Essence-Plan.pdf.


Chapter 9 Expanding Maternal and Child Health in Appalachia Dawn Graham I cannot fully understand what it means to be born in Appalachia and I was not raised in this region. I offer a point of view as someone with a deep love of this area who has called this my home for more than a decade. The southeastern portion of Ohio contains vibrant and resilient communities. The lush hillsides, abundant farmers’ markets, and sense of place among residents is palpable. Maybe it is because of its history of poverty and mining, but it seems to me that people here are close to the land, maintain strong connections with family and friends, and are unafraid of hard work. Sometimes I see portrayals of this unique culture as being mostly negative, but what many do not recognize is the vast array of community assets and the resilience of the Appalachian people. I have witnessed how this resilience can make a sustainable impact on family and community health even in the face of barriers to accessing care. University and community partnerships are expanding and enhancing health programming throughout the Appalachian region. Specifically, funding from federal, state, and local sources has contributed to collaborations between Ohio University and various agencies to improve health outcomes


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for mothers, infants, and children. Examples of strategic partnerships include Project LAUNCH (Linking Actions for Unmet Needs in Children’s Health), a formalized community health worker curriculum, and trauma informed education. Although there are multiple healthcare service agencies in the region, in this chapter I highlight the sustainable impact when collaborating agencies set goals, assess strategies for collaboration, and directly care for the women and children of our community. Short and long-term health outcomes are improved when they are guided by ongoing quality improvement. When health centers and universities unite for a common goal, they can make a strong positive impact and improve community health. Several factors contribute to the need to provide comprehensive healthcare service in Appalachia, specifically in rural places. Barriers to care in rural places include lack of transportation, long wait times to see primary care providers, and limited access to specialty care. These barriers, and others, mean that coordination is a critical component of access to care. Coordinating care is most effective when providers, agencies, and community members collaborate and communicate. When this coordination results in improved access to care, the focus could shift from treatment to prevention. Preventive care is the foundation for maternal and child health, and rural places often face challenges in recruiting and maintaining providers in this practice. The shortage of providers means that patients may have to travel great distances to seek health care. As a result, many children and families delay seeking care, this includes important prenatal preventive services. When feasible, ongoing collaborations between local health agencies and organizations and university infrastructure can create a system in which preventive health care is prioritized. The intersection between major universities and the community can be complicated and this is the case with the city of Athens and Ohio University. The university brings some economic vitality into the community, but it also might be perceived as an ‘elite’ section of town that keeps resources to itself while taking advantage of community members as research subjects. However, maternal and child health services coordination through programs such as Integrating Professionals for Appalachian Children (IPAC), Project LAUNCH, and the Community Health Worker program challenges these assumptions. After several decades of long and difficult conversations,


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grant writing, leveraging institutional resources, and following through on commitments, it appears that local community perception about the value of partnering with the university is slowly changing. Building a comprehensive community-based health program relies on engaging a range of professionals and community members to meet a common goal. In southeast Ohio, collaborating agencies have partnered with the university to create a longstanding and effective mechanism for sharing resources, ideas, and services in order to improve and enhance maternal and child health services. These longstanding partnerships continue to develop and change over time but share a common goal of providing the best possible health care for children and families in this region. Maternal and Child Health Partnerships Integrating Professionals for Appalachian Children (IPAC) was the brainchild of several local healthcare professionals and spearheaded by Dr. Jane Hamel-Lambert at Ohio University. IPAC’s mission is to enhance programming and reduce redundancy in health care. In 2003, professionals began collaborating to improve the health and wellbeing of children in this area. By 2006, the organization became a non-profit agency 501(c) (3) and over the next decade, IPAC served as a community hub to help improve efficiencies and resources to the children and families of this area. Under the umbrella of IPAC, Project LAUNCH (Linking Actions for the Unmet Needs in Children’s Health) became a successful grant mechanism in which maternal and child health needs were the primary focus. Project LAUNCH was a five-year initiative sponsored by the Substance Abuse Mental Health Services Administration between 2009-2014. The grant funds were funneled through the Ohio Department of Health and subcontracted through Ohio University Heritage College of Osteopathic Medicine. Several additional subcontracts were issued in four Appalachian counties: Athens, Hocking, Meigs and Vinton. The purpose of this project was to initiate and sustain services and enhance already existing structures to keep children and families healthy. There were five specific activities within Project LAUNCH: 1) Enhancing developmental screening and assessment in primary care clinics; 2) Developing family strengthening projects; 3) Enhancing early childhood mental health services within school settings; 4) Integrating behavioral health services in primary care settings; and 5) Improving home visiting services.


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During Project LAUNCH we determined that home-based services was a critical component of healthcare delivery to children. One of the primary goals of these services is to provide developmentally and culturally appropriate parenting education in the comfort of the home or preferred community setting. In general, local families in rural areas have relied on home visiting as a resource to fill gaps in services for many years. “Help Me Grow,� which is a state-funded parent support program that encourages prenatal and well-baby care, has offices in every county in Ohio. Help Me Grow Home Visiting is funded at the county level based on numbers of children and families and the size of each county. This means that rural counties are usually served by one home visiting provider, so local agencies must balance the high demand for services with the resources provided by the state to each county. Project LAUNCH partially supported staff and provided supplemental materials and equipment to home visiting agencies in the four counties. There are many success stories unfolding as a result of the university-community partnerships. For example, the Gallia-Meigs Community Action Agency combined support funds and in-kind labor and services to develop a playground area for preschool aged children in a local park that did not previously have any play equipment. The ability for this dedicated community agency to provide a safe place for physical activity in a place without easy transportation to other playgrounds could not be understated. Children and families continue to use the playground to this day. In addition to home visiting services, Project LAUNCH included screening and assessing young children for developmental and cognitive delays. The idea of enhancing and expanding developmental screening and assessments rose out of the need for increased programming and education for pre-kindergarten children. School personnel often found gaps in learning for children, leading to costly interventions when these children enter public school settings. Enhancing programming for developmental assessments and screenings helps to ensure that children are adequately prepared to begin school. Simple solutions such as providing billing information for the appropriate screenings to primary care providers allowed parents to learn about normal child development. With Project LAUNCH’s support, local and regional behavioral health and primary care agencies provided many of the


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developmental screenings and assessments. This resulted in children being assessed earlier so they were able to access additional services to provide the foundation for their success upon entering preschool and kindergarten. Through assessments, agencies continued to recognize the need for services that cross over between behavioral health and primary care, leading to greater service integration. Behavioral and Mental Health Care One of the main successes of the integration of behavioral health and primary care began at the OhioHealth OB/GYN clinic. OhioHealth is a notfor-profit, charitable, health system and is one of the five largest health systems in the country. In our area, physicians and nurse practitioners were seeing a high volume of mothers suffering from undiagnosed depression and anxiety. Multiple barriers including stigma, transportation, and time, meant that some new mothers were not receiving mental health treatment, and this was affecting their families and their ability to care for their infants. Through collaboration with the Ohio University Department of Psychology, Project LAUNCH leadership coordinated a training/practice program and created clinic run by supervised, advanced psychology doctoral students to provide immediate mental health care to women accessing services at the OB/GYN clinic. In addition, systematic screenings of maternal depression were integrated into the practice. This gave women the opportunity to have immediate and efficient mental health interventions if needed. There is still a stigma attached to seeking mental health treatment, particularly in small towns, where it is hard to be anonymous. As the mental health clinic was now centered in the obstetrician’s office, the ability to seek mental health services during well-child checkups for their babies, made it easier for mothers to seek services. The use of doctoral students benefited both the student and the community. This approach was cost-effective, led to well-trained professionals, and provided a wider net for mental health services in the community. Because of this project, the practice has led to mental health professionals on site after the grant period ended. Overall, this systematic way of caring for families strengthened relationships and helped build trust between families, healthcare organizations, and the university. These relationships were enhanced further by building an infrastructure with local nursing navigators in order to reach mothers and children in remote places throughout Appalachia. By combining nurse


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navigator services with local early childhood programming, providers were able to deliver care to previously unreachable families. Early Childhood Mental Health Programs involved extensive collaborations between mental health service providers in the region and local school systems. Changes in public school policies has led to integrating special needs students into classroom settings. As a result, teachers may face challenges caused by varying needs of students within the general classroom. They may feel unprepared for the demands of such a diverse student population. Teachers often do not have mental health training and find themselves challenged with educating children with dual diagnoses and other developmental concerns. Combine these challenges with a focus on mandatory testing as a measure of teaching effectiveness and stress levels can climb, leading teacher burnout. Community Health Workers We collaborated with local mental health service providers, such as community mental health organizations, to develop mental health education and training for public school teachers so that they could feel more prepared to meet the needs of all their students. Early childhood mental health consultants provided education and assistance to teachers at no cost to the school. As the school mental health training program was implemented, we noted a parallel challenge with adult community members. Specifically, we identified the need to enhance access to care across the lifespan and we were determined to engage community leaders in addressing this need. Community health workers (CHW) are lay community members who serve as a conduit between individuals and health resources. Evidence is emerging that CHWs are effective and important in providing education and outreach to mothers and families in rural areas especially. People who live in rural areas may delay wellbeing and preventive care visits due to many factors. In these cases, community health workers serve as a pipeline by health linking patients with dedicated providers. Ohio Medicaid funding led to creating community and university partnerships between Ohio University and Athens City/County Health Department. Faculty from both the College of Health Sciences and Professions and the Heritage College of Osteopathic Medicine combined efforts to develop curriculum and conduct a master training for local community health workers.


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We soon found that developing a community health worker program from scratch was a challenging process. We started by collecting information from agencies and organizations that had already established curricula. The most effective training program for the CHW workforce will contribute to improvements in maternal and child health. CHWs are trusted community members and neighbors, so mothers and families feel as if the CHW understands the challenges they may face rather than a healthcare professional who is not from the community or region. Over time, CHWs can empower women and their families to access and sustain health care because they come from a place of trustworthiness and relatability. Though still growing, practitioners have welcomed CHWs as part of their practices. Rather than serving as competition, a CHW is often viewed as a support structure to services for families who may be reluctant to see a primary care or mental health service provider. For example, one current physician who focuses on lifestyle medicine, has enlisted the help of a local community health worker to help his patients who are managing Type II diabetes. By having a consistent ‘helper’ encouraging his patients to keep current on measuring their blood sugar levels as well as encouraging healthy eating and exercise behaviors, ongoing care is provided. This type of care eases the burden on the healthcare system and provides a support system for patients facing a lifelong and overwhelming chronic health condition. There are several existing collaborations with CHWs in southeastern Ohio that focus on the effects of psychological trauma and its broader impacts on health. Research has shown that chronic stress and exacerbation of symptoms related to Adverse Childhood Experiences (ACE) escalate longterm health problems in children and adults. The programs we developed have enabled CHWs to attend educational programs on defining trauma, understanding trauma’s effects on the mind and body, and methods for mitigating the effects of trauma to promote health. Healthcare providers who specialize in maternal and child health told us that the main barriers to accessing programs is transportation and cost. Building off nationally and internationally known evidence-based treatment training programming offered in the major metropolitan areas, we were able to use existing grant funds and in-kind funding to offer, at no cost to participants, several trauma informed care educational sessions to anyone interested. Examples of trauma informed care trainings offered include Trauma Focused Cognitive Behavioral Therapy taught by Cincinnati Children’s Hospital as well as Neurosequential Model of Therapeutics training by Dr. Bruce Perry.


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Reflections on Success The community/university collaboration was able to help determine the needs of healthcare professionals through formal and informal meetings conducted throughout the region and state. Using the state/community collaborations facilitated through the Ohio Department of Health combined with local IPAC meetings, a clear need emerged for localized training that did not involve undue expense, travel, and family care logistics. Combined with resource constraints in local agencies, it was difficult for many professionals to seek educational development services to keep up with licensure expectations that were necessary to keep their jobs. The ability of collaborating organizations to identify needs and offer support and training was a great resource to healthcare providers seeking professional development without placing unnecessary burden to scheduling and travel. In sum, despite barriers to access to health care in Appalachia, there are possibilities to improve this access through strong partnerships that are dedicated to the mission of helping women and children not only survive but thrive. The programs described here are just some examples of success when communities and universities leverage resources with a common goal. There is still work to be done to build and maintain trust, but long-term collaborations might be the key to serve and enhance health care to build a healthier Appalachia. These same attributes are the ones that exist in the very people who call this region home.

Special Acknowledgements: Drs. Sherry Shamblin, Joe Bianco, Tracy Shaub, Jane Hamel-Lambert, and Lesli Johnson. In addition, thank you to Kerri Shaw, The Athens City County Health Department, and The Ohio Department of Health.


Part 3 POSSIBILITIES For Appalachia to go from a place that is just surviving to one that is thriving, passion combines with possibilities. This final section highlights some work that exemplifies how it is possible to make a difference in communities. The projects highlighted here include helping children with disabilities and their families, cleaning up environmental contamination, and improving access to health care. In chapter 10, the authors detail partnerships between the university and the community in assisting families who have children with Autism Spectrum Disorder (ASD). They describe the success of several collaborative approaches that engaged professionals, families, and university students in enriching the lives of children with ASD. One approach included students in designing and tailoring educational materials to meet the needs of individual children and their families. The authors also talk about engaging professional speech-language pathologists with university students to the benefit of both the students and families. Music is another innovative way to support children with ASD and their families. Camp ROCK (Reaching Out and Connecting Kids) uses music therapy to engage children in developing social skills and has been successful in serving many families in the region. Environmental contamination from historical coal mining is abundant throughout Appalachia, but Chapter 11 details possibilities for cleaning up watersheds. The example of one watershed in southeast Ohio demonstrates the success and persistence of local groups and researchers in recovering streams that were just about dead. The recovery involved many projects and some significant investment, but the results have led to numerous


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benefits to the region including enhanced outdoor recreation and an overall pride in their accomplishments. Access to health care is challenging in rural areas in general, but when these rural areas are also in Appalachia, these challenges are magnified. A lack of providers, low insurance rates, poverty, and many other factors contribute to conditions that can lead to health disparities. Chapter 12 lays out the possibility of engaging the community in prioritizing solutions to improve access to care. These possibilities are enhanced with local buy-in and can lead to long-term improvements in health outcomes. There is a wealth of possibilities in Appalachia. These possibilities can improve the environment and health of people who live here. What the stories in this section, and most of the other chapters in the collection show, is that partnerships and collaboration are the keys to success.


Chapter 10 Community Focused Programs Designed to Support Children with Autism Spectrum Disorder in Appalachia Joann P. Benigno Laura Brown John W. McCarthy Sarah Taylor

Introduction The goal of this chapter is to showcase innovative programs that engage families and health professionals in our rural, underserved region to support children with autism spectrum disorder (ASD). These efforts include a project supported by the Ohio University 1804 Fund to create visual communication materials for children with ASD to use at home with caregivers and other family members. A second project funded by Autism Speaks involved creating similar types of materials for regional speech-language pathologists working with children with ASD in the schools. The final project is an ongoing inclusive summer social skills music camp experience for children with and without ASD known as Camp ROCK (Reaching Out and Connecting Kids). Training undergraduate and graduate students is an integral part of each program as we seek to inspire our students to support children with ASD. We present positive outcomes of our programming


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efforts along with future directions and implications of conducting community focused programming for children with ASD and other disabilities in our region. One of the primary reasons faculty from around the globe choose to work at Ohio University (OHIO) is the motivation to enact change in the lives of the community members. The Appalachian region surrounding the university is rich in history and culture and the university itself houses a vibrant community of learners and educators.1 Armed with goals of addressing the needs of underserved populations and enhancing connections with the community, we sought to make a difference in the lives of a subpopulation of children with developmental disabilities—children with Autism Spectrum Disorder (ASD). ASD is a developmental disorder characterized by ongoing challenges in the realm of social interaction, such as forming and sustaining relationships and appropriate use of nonverbal communication. ASD also manifests as displays of “restricted” and “repetitive” behaviors which may include intense interests and repetitive verbal and motor movements.2 The Centers for Disease Control and Prevention (CDC) estimates that 1 out of 54 children in the U.S. have ASD.3 The overwhelming majority of schoolbased speech-language pathologists (SLPs; 90%) provide services to children with ASD on a regular basis.4 Within the state of Ohio, 10% of children age 3-21 who receive special education and other school services have been diagnosed with ASD.5 The community engagement pursuits discussed in this chapter were developed to benefit children with ASD, their families, and their SLPs in our underserved region. We were also motivated by a desire to provide training opportunities for undergraduate and graduate students in communication sciences and disorders, music therapy, and related fields. These endeavors included rich opportunities for our students to develop important professional and interprofessional skills and apply what they learn in the classroom through experiential learning activities. Partnering with Families The journey to provide direct support to children with ASD and relevant stakeholders began in 2014. Ohio University researchers Joann Benigno, John McCarthy, Sarah Taylor, and Chao-Yang Lee received funding


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through a competitive internal grant mechanism known as the 1804 Fund. Though not anticipated at the time, this funding mechanism was pivotal in launching a programmatic journey of serving children with ASD within Athens and the surrounding area. We had three major goals for the project. First, we hoped to identify a group of undergraduates from multiple disciplines who could create materials and effectively interact when working with families and children with ASD. The second goal was to enhance graduate student skills through training in mentorship and project management. The third goal was to develop community partnerships with local schools and organizations to assist in identifying families in need. Over the course of two academic years, eight master’s students in speech-language pathology (MA-SLP; all female) and 19 undergraduate students (18 female; 16 majors in Communication Sciences and Disorders, two from Music Therapy and one from Psychology) participated in the training experience.6 All university students selected for the program completed two semester-long courses on ASD. During the first semester, we focus on evidence-based practice in the course with a core theme of connecting current theories and research on children with ASD to the best treatment practices. Students learned to become better consumers and evaluators of ASD research. The class format also fostered skill development in creating developmentally appropriate, creative, and engaging materials for participating children and families. During the first semester, practitioners in our community from social work and occupational therapy, as well as parents of children with ASD delivered guest workshops to promote students’ cultural awareness and understanding of the needs and challenges families face in our region. Some of this chapter’s authors also lectured on music therapy and augmentative and alternative communication. During the second semester, faculty members divided students into teams. The smaller groups of students participated in weekly team meetings and with a faculty mentor (first author), the graduate students in speech-language pathology, and a certified speech-language pathologist and clinical supervisor (fourth author). The goal of these meetings was to assess progress on creating materials and family outreach practices. Throughout the program, graduate student mentors engaged in guided readings, completed online instructional modules, and discussed mentoring interaction scenarios with faculty. Graduate students learned key skills in managing projects and developing and implementing an effective


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workflow model. Students designed this workflow model to ensure that the materials created for families were both high in quality and completed within the promised timeframe. Finally, graduate students also participated in several discussions on mentorship, developed a mentoring philosophy, and evaluated the implementation of their philosophy at the end of the experience. The most unique element of this program was the direct outreach to families in our community. In total, 10 families with a preschool or schoolage child with ASD (average age was 7 years; 9 male) enrolled in the outreach program. All families resided within a 30-minute radius of the university. At the initial intake session, which lasted approximately one-hour, graduate students conducted assessment the child’s communication strengths and challenges. During the same session, the primary investigator interviewed the caregiver(s) regarding the child’s strengths, challenges, and current communication supports used at home and school. Caregivers were provided with sample materials created by the team. They offered input on the materials most suitable to their child’s preferred activities, their favorite colors, and characters from movies and cartoons. Within two to three weeks of the first session, the caregiver(s) and child returned to receive the materials created specifically for their family. Graduate students described and demonstrated how the families could use the materials at home. Families also received electronic copies of all materials along with instructions and guidance for home use. The number of tailored materials and material sets ranged from three to 26, depending on the needs of the child and the nature of the caregivers’ requests. Across all the families, we created a total of 120 material sets. Most of the material sets included visual schedules, picture cards, stories about social situations, and emotion self-regulation scales to manage stress and feelings in a variety of situations. Visual schedules for younger children incorporated pictures and words to outline specific tasks or activities in a family’s daily life. For instance, several visual schedules focused on the family’s morning and evening routines, highlighting tasks such as brushing teeth, eating a meal or a snack, getting dressed for school (or bed), and feeding pets. Schedules for older children focused on completing homework, chores, and other activities of daily living. Social stories use affirmative statements to teach and reinforce social skills or prepare a child for an


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upcoming event. Topics of social stories written for the children included situations such as asking a peer to play and playing a game, meeting someone new, going to the doctor or dentist, and getting a haircut. We conducted a satisfaction survey and followed up with each caregiver within two weeks of their receipt of the materials. The questionnaire included 12 statements regarding caregivers’ satisfaction with features of the program such as the extent to which their needs and the needs of their child were met and whether the materials met their expectations. They also rated the team’s timeliness in creating the materials, availability to communicate, and the responsiveness of the team to their needs. Caregivers provided additional comments on the program and had the opportunity to ask questions about the materials created for their family. Caregivers’ satisfaction ratings based on eight participants were positive with an average rating of 4.89 out of five. Their comments focused on the importance and necessity of this type of outreach program, particularly given the lack of tailored programs like this in our region. One parent stated that such tailored programs are “few and far between.” Parents also discussed the quality of the materials and the professionalism displayed by the students who worked with their child. Caregivers characterized the team as “excited” and “resourceful.” They indicated that the students “really listened” to their needs and they recognized the team’s “effort to build rapport” with their family. In addition to serving families in need of guidance, this project was also successful from the perspectives of the university students. These students learned more about ASD and the necessity to create personalized materials to support children’s communication and interactions with their family members at home. Both graduate and undergraduate students wrote a reflection paper each semester and most of these detailed how they appreciated the opportunity to collaborate and gain hands-on experience creating evidence-based communication supports. Additionally, students expressed that they gained valuable experience in reading and discussing relevant research in the field.7 Partnering with Speech-Language Pathologists A funding opportunity through the Autism Speaks Local Grants mechanism allowed us to extend our presence in the community to schoolbased speech-language pathologists (SLPs) working within an hour radius of our campus. Participating SLPs represented the poorest counties in the state


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where the poverty rate is between 16.4% to 33%. The primary goal of this program was to provide support to SLPs who work with children with ASD in the schools in southeastern Ohio.8 One of our objectives was to expand outreach services to SLPs directly working with children with ASD. Another objective was to train future SLPs in creating communication supports for children with ASD. Fifteen SLPs benefitted from the efforts of our team. The SLPs averaged 17 children with ASD on their caseload, ranging from five to 65 children. Six MA-SLP students and four undergraduate students in Communication Sciences and Disorders participated in the training experience. One of the SLP students served as the project manager and assisted with creating materials, controlling quality, and communicating with SLPs. The workflow model used for this project was like the family outreach program. Depending on the SLP’s preference, their material needs were assessed in an individual in-person or phone session. They could make requests for any materials that would benefit the children they worked with. On average, SLPs received over 50 materials and nearly 800 materials were created by the university students. Most materials created were like those generated for the families in the previously described outreach program. Though SLPs requested some materials for specific children on their caseload, most of the materials had to be more flexible to adapt to a wide range of children with ASD. These materials included laminated picture cards (to be used with visual schedules and for children to make activity choices), visual schedules, stories about social situations, and choice boards (i.e., children choose a preferred activity from a selection of picture cards). The SLPs were pleased with the materials created and rated them highly. All SLPs who completed the follow-up satisfaction questionnaire rated most of the aspects of the program as a five out of five. These items included meeting their needs and expectations as well as the team’s timeliness, communication, and responsiveness in listening to their needs. The frequency of their use of the materials and their students’ use was more variable because the much of the study was completed during the summer months when SLPs may not be providing direct services. SLPs commented on time as a barrier to creating materials themselves. Two SLPs referenced the time-saving aspect of the program deeming it “very beneficial for working SLPs who don’t have much time to make materials.” Another SLP


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stated, “the program helped provide needed materials for students with autism that the SLP would have trouble finding time to provide.” Another SLP recognized the hard work of the team, “those involved with the program went above and beyond to provide materials and ideas that can be adapted for a variety of students.” Each student had the opportunity to create materials for three to nine SLPs. At the end of the experience, students rated their knowledge of and confidence in implementing material types between four and five out of five. Students’ responses about what they liked most included creating evidence-based materials, understanding, and meeting the needs of SLPs in the area, using software to create materials, and collaborating with others. One student stated, “collaboration with the other members of the team was a great aspect of this project. Being able to discuss ideas and materials with another person is beneficial in creating high quality materials for SLPs. I think our work was better for it.” For another student, “it was so rewarding to know that I made a big impact on the workload for local SLPs.” The active role in creating the materials was also noted, “I liked the hands-on experience the most. It is one thing to learn about materials/supports in class, but it is much more meaningful to actually create the materials.” We deemed this project a major success. Not only were we able to meet the needs of 15 SLPs, but these SLPs were serving an estimated total of 260 children with ASD in our region! In addition, we reestablished and solidified contacts with SLPs in our region and community including alumni from our SLP master’s program and our undergraduate program. Success stories for both the university student trainees as well as the SLPs reflect the benefits of this outreach program. One of the participating SLPs sums it up best, “This is an awesome program that benefits all involved- the students with autism, the SLPs, and the undergraduate and graduate students making and organizing the materials.” Partnerships Between Speech-Language Pathologists and Music Therapists: Camp ROCK At the time this chapter was written, Camp ROCK (Reaching Out and Connecting Kids) was about to begin its third camp since 2016. The camp is co-organized by the first and second authors of this chapter. The primary aim of the camp is to target social skills in a music-rich environment. Each year we aim to host an equal number of children with and without ASD, as our focus is on inclusivity. We developed Camp ROCK to


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support children with ASD and their peers residing in this area because few programs exist to support school-age children with ASD without intellectual disabilities and whose primary difficulties lie in the realm of social interaction. This program fills a significant need in the community, as this type of programming is scarce locally and throughout Appalachia. The camp was initially held in July 2016 for 10 children (five with and five without ASD). During June of 2018, we received internal funding through OHIO’s Baker Fund to support the expansion of the camp staff and participants to 16 children (eight with and eight without ASD). Recent funding from the Ohio Arts Council led to a third iteration of the camp during June 2019 that included 16 children and an expanded staff in a way similar to 2018. The camp is structured in two parts: an early morning group focused on the social skill of the day (e.g., meeting new friends, working together, etc.) and a smaller group time where children work together in a “band� format. Children plan and prepare a performance for their families on the final day of camp. SLP and music therapy (MT) students co-facilitate the camp together. In the morning group sessions, the camp leaders use music therapy experiences and social stories to review the social skills concepts. MT students focus on facilitating music experiences while SLP students lead social story readings, discussions, and help any campers who need accommodations or modifications. MT and SLP students let campers lead the smaller group experiences and guide the children in making decisions and working together. Campers complete arts and crafts projects and participate in structured games during breaks and snack time. The camp concludes with a performance of songs learned by the whole group as well as the performances of the two small group bands. Camp ROCK is free to all participants. From the first iteration of Camp ROCK, inclusion was one of the central tenets of the project. There are summer music opportunities for children with varying types of disabilities in the central Ohio area as well as around the country, but few opportunities for children with ASD to practice social skills with their peers in a safe music environment. Both children with and without ASD grow in their social abilities as they work together at Camp ROCK to learn music and plan the performance at the end of the


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week. Throughout the camp, there is no specific mention of ASD, and all the children seem to discuss their social challenges and successes openly. Camp ROCK is a community service project that also includes a research component. In the first version, the camp directors video recorded all components of camp and reviewed for important social interactions. Student leaders were also surveyed and interviewed, and findings were published.9 Overall, university students appreciated the opportunity to practice interprofessional collaboration prior to entering their respective professions and felt the collaborative nature of the camp resulted in higher quality programing for the children. For the second and third offerings of Camp ROCK, we used the same student interview and questionnaire and added indicators assessing the children including social skills measures, parent questionnaires, and interviews with each child before and after camp. In preparation for the third offering of Camp ROCK, we developed an interprofessional course so university students could learn about ASD, the SLP and MT professions, and interprofessional collaboration. The course was offered in a hybrid format with three in-person meetings and weekly online assignments and discussion boards. Students were placed in small interdisciplinary groups and asked to prepare programming for an experience like Camp ROCK. Student leaders for Camp ROCK 2019 were selected among the students in the course. The course allowed many students to gain collaborative skills, even if they were unable to participate as camp leaders. All offerings of Camp ROCK have resulted in meaningful social connections between the campers, improved collaboration skills for the university students, and high parent satisfaction ratings. Through careful preparation and planning, the camp directors and university students have determined a successful format that helps the children have fun while developing social skills through music. Continuing the Partnerships The partnerships formed through these three programs represent the types of relationships we want to build and sustain with our community. The important part from our perspective is the “win-win� side of the projects for everyone involved. Families and their children had high- quality, unique experiences, health professionals had an opportunity to enhance their services, and students had an opportunity to learn by doing and helping.


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The challenge in creating new programs is that financial support may be available for new ideas and directions. However, finding a means to provide long term programmatic assistance is difficult. Our programs were designed to be low cost, but scalable depending on funding. One of the lessons learned in working with families in the region had to do with long term relationships. Providing assistance was meaningful but being available to help in the long term is just as important. We offered suggestions to some parents about follow-up, just to find out how things went or to obtain new materials as the needs of their children and their family changed. Camp ROCK allows connections to be developed across colleges at Ohio University, with public schools and parent groups in the Athens community, with students with and without disabilities from various schools in the area, and with university students who may work together in the professional world. Although Camp ROCK was an innovative experience, in other ways, the idea of a child going to a summer camp is not. Providing programs at the university allows parents of children with disabilities to give their children a chance to participate just like those without disabilities. Every camp activity was designed to be inclusive. We believe the interprofessional course developed for Camp ROCK can serve as a model for students in various service and health professions and can be adapted to focus on many specific populations. Students groups are another avenue for building relationships and for extending programs. For example, an earlier collaboration with MT and SLP led to the formation of a student organization called “Creative Expressions.” The group started with visits in Child Development Center on the Ohio University campus and subsequently expanded efforts to serve multiple preschools and schools in the surrounding area. More recent elementary school projects have focused on developing and illustrating narratives through a book club as well as an inter-grade pen pal project. Each fall since 2015, the organization has sponsored a Saturday afternoon “Kid’s Fest.” This is a three- to four-hour program for children with and without disabilities to participate in arts-based activities to promote language development and inclusion. Students demonstrate a willingness to engage in service beyond the curriculum. The activities demonstrate that partnerships can indeed extend outside of the classroom.


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Conclusions Our programs focused on children with ASD and their caregivers, but these models can certainly be extended to other groups. In rural Appalachian areas, the services needed by children with complex needs can require multiple appointments in multiple locations involving extensive travel. University-based programs allow for a single point of service delivery or for the assembling of teams to travel to other locations. Partnership models can blend the boundaries where services are enhanced in multiple locations through distance or live interactions. Through our partnerships, understanding the needs and perspectives of health providers and families in the region means better and more inclusive preparation for our students. Notes 1. Betty Hollow, Ohio University: The Spirit of a Singular Place (Athens, OH: Ohio University Press, 2003). 2. American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (Arlington, VA: APA, 2013). 3. Centers for Disease Control and Prevention, “Data & Statistics on Autism Spectrum Disorder,” last reviewed November 5, 2020, https://www.cdc.gov/ncbddd/autism/data.html. 4. American Speech-Language-Hearing Association, “Schools Survey: SLP Caseload and Workload Characteristics,” (Rockville, MD: ASHA, 2018), https://www.asha.org/uploadedFiles/Schools-2018-SLP-Caseload-andWorkload-Characteristics.pdf. 5. Ohio Department of Education, “Implementation of Special Education and Related Services for Children with Disabilities,” (Columbus, OH: ODE, Jan 22, 2019), https://files.eric.ed.gov/fulltext/ED600420.pdf. 6. Joann P. Benigno, John W. McCarthy, Sarah O. Taylor, and Bridget Gornichec Wright, “Training Students Through a Community Outreach Program to Support Families of Children with Autism Spectrum Disorder,” Teaching and Learning in Communication Sciences and Disorders 3, no.1, (2020), https://doi.org/10.30707/TLCSD3.1Benigno. 7. Bridget Wright et al., “Graduate Student Reflections on Mentorship in a Training and Outreach Program for Families of Children with Autism Spectrum Disorder,” Teaching and Learning in Communication Sciences and Disorders 3, no.1, https://doi.org/10.30707/TLCSD3.1Wright .


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8. Joann P. Benigno, John W. McCarthy, Sarah O. Taylor, Heather Hamm, and Bridget Gornichec Wright, “Training University Students About Autism Spectrum Disorder Through Outreach to School-Based Speech-Language Pathologists,” Teaching and Learning in Communication Sciences and Disorders 4, no.1, (2020), https://ir.library.illinoisstate.edu/tlcsd/vol4/iss1/4. 9. Laura S. Brown, Joann P. Benigno, and Kamile Geist, “Come Together: Music Therapy and Speech-Language Pathology Students’ Perspectives on Collaboration During an Inclusive Camp for Children with Autism Spectrum Disorders,” Music Therapy Perspectives 36, no. 1, 17-25 https://doi.org/10.1093/mtp/mix017.


Chapter 11 Recovering Appalachian Streams Natalie Kruse Jen Bowman Kelly Johnson Dina Lopez Amy Mackey Nora Sullivan Danny Twilley

Coal mining in Appalachia is deeply rooted in the culture and communities of the region. Villages with names like Mineral and Carbondale are scattered throughout Appalachia. Rows of small, tidy, identical company houses harken back to the heyday of mining. Demand for coal was born out of the industrial revolution, driven by railway expansion and steel production. Remnants of the iron furnaces and coal mines that fueled the industrial revolution in the United States are still seen in parks and on roadsides. So too are the environmental impacts of a century of mining. Records of coal in Appalachian Ohio date back to the mid-1700s when a coal seam in Lamanshikola Creek, now Sandy Creek, in Eastern Ohio was reported to be on fire.1 In Ohio, the first coal mining was reported in Jefferson County, in 1800. Coal production climbed as railroads expanded and peaked in the 1910s to fuel World War I, aided by mechanization of extraction. After decreasing significantly during the Great Depression, extraction rose again during World War II into the 1970s. After WWII advances in mechanized processes drove surface mining as the predominant


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method. Iconic large equipment like the “Big Muskie” dragline, the largest ever bucket digging machine used in eastern Ohio, extracted more coal with less manpower, increasing profits in the industry. Production decreased steadily from the 1970s as environmental legislation was enacted.2 Comprehensive mining regulations in Ohio were implemented in 1972, and nationally in 1977 with the passage of the Surface Mine Control and Reclamation Act (SMCRA).3 SMCRA created the Office of Surface Mining Reclamation and Enforcement (OSMRE), which required mining and reclamation or cleanup plans to be submitted prior to mining and began collection of reclamation bonds. Mining companies were now responsible for preventing damage and cleaning up any damage they caused. In case the company went out of business before it could restore the mine lands, the bonds assured that the company would remain liable for potential longterm pollution discharges. Many mines were exploited prior to regulations (pre-law) and simply abandoned. These mines have no responsible clean-up party either at the mine site or any residual environmental damage areas. SMCRA sets aside monies for states to address abandoned mines issues in the Abandoned Mine Land (AML) fund. In Ohio, the Ohio Department of Natural Resources (ODNR) is responsible for regulating post-law mines and reclamation of abandoned mines.4 The Environmental Legacy of Mining Acid mine drainage (AMD), one environmental consequence of coal mining, is formed when sulfide minerals, like pyrite or fool’s gold (iron sulfide), contained in Ohio’s coal, are exposed to oxygen and water through the mining process. This weathering of sulfide minerals produces highly acidic waters. Acidic conditions make metals more likely to dissolve from the surrounding rocks thereby elevating the amount of metals in the water. AMD can form from both underground and surface mining operations. As abandoned underground mines fill with water, sulfide laden coal reacts with oxygen, condensation, and water vapor in the mine to create AMD. Reaction products may remain in the mine until water levels rise, and they are flushed into surface waters as AMD. With no consequences for environmental degradation, pre-law surface mines left both ‘gob piles’, or poor-quality coal spoil with no value, and overburden, the layers of rock and soil above the coal seam, exposed as seen in Figure 1. Spoil is often


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gravel size, allowing a large surface area to be exposed to weathering by atmospheric oxygen and moisture. Again, the weathering reactions may take place on the surface of the rock and remain there until carried away in the next rain event causing episodic acidification of water.

Figure 1. Mine waste in a stream valley at Buckeye Furnace site, the location of the first treatment and reclamation project in Raccoon Creek Watershed.

Decades of surface and underground mining dramatically alters the habitat for organisms (fish and macroinvertebrate ‘bugs’) that live in streams. Appalachian streams affected or impaired by AMD typically have pH of 2-5, elevated iron, aluminum, and manganese, elevated sulfate, and elevated conductivity. These conditions are highly detrimental to biological communities and may result in streams not supporting aquatic life at all. Aquatic organisms are particularly susceptible to pollution associated with mining. Acidity, sulfur, and elevated metals such as iron and aluminum disrupt the oxygen transport and ion exchange, including acid/base balance, performed by gills. Few aquatic organisms can tolerate waters more acidic than pH 5.5 and are killed within days. Widespread strip-mining deposited silt and sediment in stream channels, where it collected in low flow areas and covered the coarse gravel and cobble in the stream bottom preferred by macroinvertebrates to live and fish for spawning.


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Throughout Appalachia there are waterways devoid of life and others with varying degrees of damage. Some tolerant macroinvertebrate and fish can endure moderate or occasional acid stress. For example, small chironomid midge larvae survive in their burrows within the sediments. Beetles and hemipterans rely on structures other than gills to breathe so they can continue to inhabit the streams unlike animals with gills. Other organisms, with thicker integument skin and generalist feeding habits, eating whatever is available, are common in streams with moderate AMD inputs. Tolerant fish species, such as creek chub and green sunfish, can also survive poor water quality and are widespread and common in Appalachian Ohio streams. While pollution tolerant species sometimes flourish in the absence of competitors and natural predators, AMD impacted streams simplify food webs with fewer links among species because they support only a fraction of aquatic life found in healthy streams and rivers. Sensitive taxa like mayflies that graze algae underwater, caddisflies that make elaborate nets or pebble cases to live in, and stoneflies are missing from affected streams. Without the rich biodiversity and abundant insect life emerging from the waters, the streams no longer support fish and salamanders. Even terrestrial birds that feed on aquatic organisms and spiders that build their webs on the edges of the streams are affected. With fewer species, the simplified food webs in AMD impaired streams lack what ecologists call ‘resiliency.’ Resiliency is the ability of a system, in this case, the food web, to have many connections. If one connection is severed, there is another to take its place so the whole system does not break down. Years of mining can degrade the key processes of energy and nutrient flow throughout the food web. Without an abundance of algae and microbial life in the biofilms that normally coat the stream bottom, grazing macroinvertebrates have nothing to feed on, and nutrient cycling slows. The biomass of mayflies, caddisflies, and stoneflies needed to support fish populations drops to a fraction of that found in a healthy stream. Without the invertebrates, predator fish have no food source. Even after remediation has improved the water chemistry, the biology of some streams is slow to recover. Recent studies suggest that iron and sulfur in sediments can permanently bind to key nutrients such as phosphorous, making them unavailable for the growth of plants and algae.


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Widespread impairment at the watershed level can eliminate nearby populations of fish and macroinvertebrates needed to recolonize streams. Alterations of physical habitat in stream channels (e.g., accumulation of silt and sediment after decades of strip mining) degrade the habitat needed to support thriving biological communities and is not easily reversed. Streams without alternating sequences of fast flowing water over riffles, deeper pools, woody debris, and areas with coarse gravel or cobble substrate may never be able to support pre-mining levels of aquatic diversity. Partnerships and Possibilities Raccoon Creek watershed, (Figure 2) in southeastern Appalachia Ohio drains 684 square miles of Hocking, Athens, Jackson, Vinton, Meigs, and Gallia Counties and is a direct tributary to the Ohio River, discharging near Gallipolis, Ohio. The mainstem of Raccoon Creek is 112 miles long and has been heavily impacted by AMD. The watershed is home to about 50,000 acres of abandoned mines, approximately half underground and half surface mines. The abandoned underground mines are clustered in the headwaters of the watershed, primarily in the sub-watersheds of Hewett Fork and East Branch in Athens and Hocking Counties. The abandoned surface mines are primarily in the sub-watersheds of Little Raccoon Creek, West Branch, and East Branch in Vinton, Jackson, and Hocking Counties. There was very little mining in the watershed in Gallia County near the mouth of the creek. Mining in Raccoon Creek Watershed was primarily preregulation with small amounts of modern, post-SMCRA regulation mining in Vinton, Jackson, and Meigs Counties. Raccoon Creek is a prime example of a watershed damaged by AMD but also is an example of the benefits of recovery from coordinated reclamation efforts. In the 1980s, concerned citizens in Gallia County, reacting to the Ohio Environmental Protection Agency (OEPA) designating the parts of the creek unrecoverable,5 formed the Raccoon Creek Improvement Committee (RCIC) to address the environmental issues in the creek. Acid mine drainage and sedimentation from abandoned mines had decimated the biological communities (fish and macroinvertebrates) of Raccoon Creek from the headwaters in Hocking and Vinton Counties, to the confluence with the Ohio River in Gallia County. The citizen group organized countless tree plantings and trash clean-ups, but with very limited funding the group could not repair the streams damaged from the larger more costly AMD water quality issues.


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Figure 2. Raccoon Creek Watershed The most important contribution of the RCIC was the community and governmental agency support that resulted from their efforts. The effort of RCIC led to investment in AMD treatment and reclamation systems and the formation of Raccoon Creek Partnership in 2007. The recovery in Raccoon Creek Watershed is a product of partners across the region, including ODNR, OEPA, Ohio University, Raccoon Creek Partnership, OSMRE, Zaleski State Forest, Wayne National Forest, and private landowners. This


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multi-stakeholder effort has allowed Raccoon Creek Watershed to transition from “dead as a bag of hammers,” a colloquialism used to describe the lifelessness in AMD impacted streams, to Exceptional Warmwater Habitat, the rating given to the healthiest warm water streams. The recovery in Raccoon Creek has been an incredible journey. In Raccoon Creek, the worst legacy impacts of mining were found in the upper watershed: Hewett Fork, East Branch, West Branch, and Little Raccoon Creek, the largest tributary.6 The lower watershed had few direct inputs of AMD, but the water quality was poor and fish communities decimated due to AMD further upstream. The first AMD reclamation project began in 1999 located at the Buckeye Furnace site in Buffer Run a tributary to Little Raccoon Creek. The treatment consisted of installing a passive successive alkaline producing system (SAPS), regrading and capping several surface coal refuse areas (gob piles), and draining and capping slurry ponds (ponds that held fine grained, reactive mine waste) draining to Buffer Run.7 From this first project in 1999 to the current day, we have conducted a total of 22 reclamation projects in the Raccoon Creek Watershed; many with multiple types of treatment systems installed. The projects include active treatment with a doser, which raises pH by continuously dispensing calcium oxide into the creek, and surface reclamation that re-contours the land, reestablishing natural water flow pathways. Other projects include passive treatment systems such as limestone channels/beds/trenches or steel slag leach beds that introduce alkalinity through percolation, and treatment wetlands that utilize plant life to reduce pollutants. There are limitations and various ongoing costs to all types of AMD treatments. Passive treatment, the cheapest of the three options and used most heavily in Raccoon Creek Watershed, requires semi-annual monitoring for effectiveness, leakage, and signs of clogging. Surface reclamation has the highest upfront costs but requires less on-going monitoring. Surface reclamation is considered ‘source control’ and once finished, after an initial 5year window of monitoring, the project is considered complete. Then only downstream sites need to be monitored periodically for continued effectiveness. Active treatment, the doser in Raccoon Creek, requires continual upkeep on a weekly basis to moderate chemical dosing levels in the system, perform basic mechanical maintenance, and monitor performance. Active treatment systems such as dosers have the largest annual costs. Over time, as more remediation projects were implemented, many of the anticipated improvements in water chemistry emerged. As of 2016, 110


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of the 116 monitored stream miles have a pH greater than 6.5, creating conditions favorable for aquatic life.8 Positive trends in pH and a decrease in the frequency of low (pH <4.5) readings suggest that treatment is working and water quality is improving.9 Increased pH has been accompanied by decreases in dissolved metal concentrations. Treatment in Raccoon Creek Watershed has led to a daily reduction of over 4,000 pounds of acidity and nearly 1,000 pounds of metals.10 Biological recovery follows treatment, albeit at a slower pace than water chemistry and sometimes with mixed outcomes. While improvements in water chemistry after remediation are frequently used as easy-to-measure targets, measures of biological attributes are most valuable for determining the relative success or failure of remediation efforts. The most reliable measures of ecological recovery are from the number of species that return, the amount of energy flowing through the food web, and biomass (productivity) of the aquatic ecosystem. In Ohio, ecologists use several indices of biotic integrity that combine 8-12 measures (metrics) of species richness, diversity, and additional metrics related to feeding style, habitat needs, or tolerance to chemical stressors, to produce an overall score that can be compared to high quality ‘reference’ streams in the ecoregion. Biological indices used in Ohio to monitor recovery in mined watersheds include the Index of Biotic Integrity for fish (IBI), the Invertebrate Community Index (ICI) and the Macroinvertebrate Aggregate Index for Streams (MAIS). Finding the proper treatment method is often a matter of trial and error. In Hewett Fork, the primary impacts are caused by four AMD sources. Carbondale East and West discharge from the long-abandoned Rice Hocking Mine, and the Carbondale Creek and Trace Run acidic tributaries flow into Hewett Fork near town of Carbondale. The installation of a wetland complex with passive successive alkaline producing systems (SAPS) at Carbondale in 1990 did not accomplish the desired reduction of pollution. Within a few years after construction, it reached capacity and was unable to buffer the acid loads. By 2000, most of the 11-mile length of Hewett Fork remained impaired, especially the upper portion. Installation of a doser in 2004 to replace the ineffective wetland and SAPS at Carbondale caused steady improvement in biological quality downstream. Heavy metal precipitates and acidity resulting from the chemical reactions inhibited biological recovery in a well-defined 2.5-mile-long ‘mixing


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zone’ downstream of the doser; however, six miles further downstream showed rapid recovery of fish and macroinvertebrates. In general, sites along the stream length recovered at different rates. The furthest downstream sites showing the most rapid improvement, for example, sites located 7 and 10 miles downstream of the doser were meeting targets within 2 years. Sites in closer proximity to the doser did not reach the target score until 2011, seven years later. This spatial and temporal pattern of biological recovery in Hewett Fork is strongly influenced by initial reactions in the mixing zone and seasonal patterns of stream discharge, gradient and deposition of metals.11 The good news is that much of the stream has obtained significant biological recovery. In Little Raccoon Creek, widespread surface mining and coal processing operations left large swaths of impacts to the land surface, resulting in extensive AMD. Key acid producing tributaries, Flint Run, Middleton Run, Mulga Run, and Buffer Run contributed over 7,000 pounds of acid per day into Little Raccoon Creek. Before treatment, Little Raccoon Creek supported 13 species of fish, 12 of which were tolerant species. In 1999 treatment started with a SAPS and a gob pile reclamation in Buffer Run. Reclamation projects continued for the next decade in Little Raccoon Creek with multiple projects on sites in Mulga Run in 2004, Middleton Run in 2005 and 2014, and Flint Run in 2006, 2014, and 2015.12 Long term monitoring at a United States Geologic Survey gauge station at river mile 12.7 recorded significant pH increase over time, and by 2013, 99% of measurements at that site met the pH target of 6.5. By 2016, the mouth of Little Raccoon Creek was meeting the goal of Warmwater Habitat use designation. East Branch and West Branch of Raccoon Creek join to form the mainstem of Raccoon Creek. Both have been heavily impacted primarily by surface mines, with limited underground extraction in East Branch. In 2000, prior to widespread treatment and reclamation in East and West Branch, the uppermost sampling location on the mainstem of Raccoon Creek, just downstream of the confluence of East and West Branch, had a pH of about 5.5. The six fish species found there earned the site an IBI score of 22/60, deemed ‘poor.’ An extensive treatment project in East Branch was installed in 2007 with two additional phases in 2010 and 2011. These projects included reclamation of waste rock piles and installation of 12 steel slag leach beds in total. Steel slag leach beds percolate water through an alkaline waste product from steel production to increase the alkalinity water sources, thereby


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buffering acidity. While several of the steel slag leach beds have now been abandoned, they were effective at improving the water quality and biological quality at the mouth of East Branch.13 and served as test sites for steel slag leach bed technology. A recent maintenance project on the East Branch steel slag leach beds has incorporated lessons learned from those studies to improve design and function. As of this writing, the mouth of East Branch meets the targets for macroinvertebrates and is slightly below the target score of 44 for fish community. West Branch was primarily impaired by surface mines and waste rock heaps. Several large-scale reclamation projects at Harble Griffith, Orland Gob Pile, and Ilesboro Road capped the acid generating material with clay and soil, regraded and revegetated the sites. Since treatment, the mouth of West Branch now meets targets for Warmwater Habitat use designation for both fish and aquatic macroinvertebrates. The Raccoon Creek Recovery In the 1980s and 1990s, when the first AMD remediation projects were being planned and implemented, sections of Raccoon Creek mainstem and Little Raccoon Creek were nearly devoid of life. Many Little Raccoon Creek sites sampled in the 1980s had zero fish. After decades of telling the sad story of a watershed riddled with orange water, exposed gob piles, and dead streams, we are very excited to share the news of recovery in Raccoon Creek. As of 2018, data collected by Ohio University, ODNR, and Ohio Environmental Protection Agency show tremendous improvement in chemical and biological water quality in Raccoon Creek. Completed remediation projects in the watershed have resulted in an acid load reduction of over 4,000 pounds per day. Raccoon Creek at its confluence with the Ohio River is consistently alkaline and 110 of the 116 stream miles monitored are meeting the pH target of 6.5. More than 100 stream miles in the Raccoon Creek watershed are now meeting or exceeding criteria for Warmwater Habitat; with 40 of those miles meeting criteria for Exceptional Warmwater Habitat, the highest Aquatic Life Use (reserved for aquatic systems with unique and unusual assemblages of aquatic life) category by the OEPA. More than 70 species of fish currently call Raccoon Creek home; from the prehistoric state threatened paddlefish inhabiting the deep and wide waters near the Ohio


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River, to the striking redside dace found only in small, high gradient, rocky headwater streams. Recovery efforts in Raccoon Creek have also increased recreation and tourism in the area. Raccoon Creek Watershed and the surrounding communities have access to large swaths of public lands that are undeveloped, therefore ideal for outdoor recreation. The proximity to public land presents an opportunity for rural communities to capitalize on the robust powerful outdoor recreation economy, a robust and growing industry. The initial federal analysis found outdoor recreation contributed 2.2% of the GDP in 2016;14 according to the Outdoor Industry Association, outdoor recreation is an $887 billion-dollar industry in the US.15 Many rural communities such as Duluth, MN,16 Oakridge, OR,17 and Calhoun County, AL18 have relied on outdoor recreation to bolster their economies as they transition from extractive industries. In addition to economic benefits, access to trails in rural communities increase frequency of exercise and enhances community pride.19 Raccoon Creek Watershed’s recovery is allowing a similar transition to begin in the area. Paddlers and anglers now frequent the watershed to enjoy the clean and productive waters. Recently, two liveries opened on Raccoon Creek. Long-time watershed residents often comment on the changes they have seen in the creek; from a dead stream to a productive ecosystem with plants, insects, fish, and stream-side birds and mammals. While the recovery of Raccoon Creek Watershed has been striking, it is the result of a significant investment from Abandoned Mine Land funding enabled by SMCRA. As current coal mining declines, the tax revenue that funds abandoned mine land reclamation and remediation also declines. The projects highlighted here require perpetual maintenance to ensure that all the water quality gains are not lost. Since funding is likely to decline, we may be faced with difficult choices about what systems to maintain and which to abandon. Past failures have shown that even small lapses in treatment can have long-term effects on biological communities. In 2010, a two-week lapse in treatment in Hewett Fork in Raccoon Creek led to a decrease to pre-treatment levels of macroinvertebrates for one year and fish for two.20 This emphasizes the critical importance of continued maintenance and monitoring in mining-impaired watersheds; what we have gained can also be easily lost. In the Appalachian hills, as fewer tons of coal are mined, the environmental legacy of a century of extraction remains. Raccoon Creek Watershed shows


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the hope for recovery of streams, but also the critical importance of maintaining the thriving ecosystem we have recovered. Notes 1. Douglas Lawrence Crowell, History of Coal Mining in Ohio: GeoFacts 14 (Columbus, OH: Ohio Division of Geological Survey, 2005), http://geosurvey.ohiodnr.gov/portals/geosurvey/PDFs/GeoFacts/geof14.pdf. 2. Crowell, History of Coal Mining. 3. "History of Coal Mining and Regulation in Ohio," Ohio Department of Natural Resources, http://minerals.ohiodnr.gov/citizen-resources/history-of-ohio-coal-mining#. 4. “History of Coal Mining and Regulation in Ohio.” 5. Chip Rice, et al, Acid Mine Drainage Abatement and Treatment (AMDAT) Plan for the Headwaters of the Raccoon Creek Watershed (Athens, OH: Institute for Local Government Administration and Rural Development (ILGARD), 2002), http://www.watersheddata.com/AMDATView_Report.aspx. 6. Rice, et al., Acid Mine Drainage. 7. Jennifer Bowman, “Racoon Creek Watershed Individual Projects”(Athens, OH: Voinovich School of Leadership and Public Affairs, 2017) http://www.watersheddata.com/userview_file.aspx?UserFileLo=1&UserFileID=213. 8. Jennifer Bowman, Nora Sullivan, and Kelly Johnson, 2016 Stream Health Report (Athens, OH: Voinovich School of Leadership and Public Affairs, 2017) http://www.watersheddata.com/userview_file.aspx? UserFileLo=1&UserFileID=207. 9. Bruce E. Underwood, Natalie A. Kruse, and Jennifer R. Bowman, “Long-erm Chemical and Biological Improvement in an Acid Mine Drainage-Impacted Watershed,” Environmental Monitoring and Assessment 186, no. 11 (2014):7539-7553, https://doi.org/10.1007/s10661-014-3946-8. 10. Bowman, et al., 2016 Stream Health Report; Henry Bedu-Mensah, “Influence of Water Quality and Sediment Transport on Biological Recovery Downstream of Lime Doser Systems” (Master’s thesis, Ohio University, 2015), http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1430922920. 11. Natalie A. Kruse et al., “The Role of Remediation, Natural Alkalinity Sources and Physical Stream Parameters in Stream Recovery,” Journal


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of Environmental Management, 128 (2013):1000-1011, https://doi.org/10.1016/j.jenvman.2013.06.040. 12. Bowman, et al., 2016 Stream Health Report 13. Caleb M. Hawkins, “The Recovery of an AMD-impacted Stream Treated by Steel Slag Leach Beds: A Case Study in the East Branch of Raccoon Creek, Ohio” (Master’s thesis, Ohio University, 2015) http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1429784673. 14. Tina Highfill, Connor Franks, and Patrick S. Georgi, “Outdoor Recreation Satellite Account: Updated Statistics,” Survey of Current Business 98, no. 9 (2018), https://apps.bea.gov/scb/2018/09-september/pdf/0918-outdoor-recreation.pdf. 15. Outdoor Industry Association, “The Outdoor Recreation Economy,” accessed June 19, 2020 from https://outdoorindustry.org/advocacy/. 16. Abby Savolt, Economic Impact of Off Road cycling in Duluth: An Expenditures Approach, (Duluth, MN: University of Minnesota, 2017) https://conservancy.umn.edu/handle/11299/195214. 17. Nicholas S. Meltzer, Adapting to the New Economy: The Impacts of Mountain Bike Tourism in Oakridge, Oregon, (Eugene, OR: University of Oregon, 2014) https://headwaterseconomics.org/trail/104-or-mtn-bike-tourismoakridge/. 18. Benjamin B. Boozer and Mike Self, An Economic and Impact Analysis of the Coldwater Mountain Bike Trail (Jacksonville, AL: Jacksonville State University, 2014) https://headwaterseconomics.org/wp-content/uploads/Trail_Study_13-coldwater-mountain-bike-trail.pdf. 19. Paul M. Gordon, Samuel J. Zizzi, and Jeff Pauline, “Use of a Community Trail Among New and Habitual Exercisers: A Preliminary Assessment,” Preventing Chronic Diseases 1, no. 4 (2004): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1277951/.; Donald L. Greer, Nebraska Rural Trails: Three Studies of Trail Impact, (Omaha, NE: University of Nebraska at Omaha, 2001) https://www.americantrails.org/images/documents/nebtrailimpacts.pdf . 20. Natalie A. Kruse, et al., “The Lasting Impacts of Offline Periods in Lime Dosed Streams: A Case Study in Raccoon Creek, Ohio,” Mine Water and the Environment 3, no. 4 (2012):266-272.


Chapter 12 Rural Appalachia: Gaps and Progress in Health Cory E. Cronin Kristin A. Schuller Shannon E. Nicks

Introduction Over the past decade, the United States has been engaged in an ongoing discussion and debate surrounding health care issues such as cost and access. The 2010 Patient Protection and Affordable Care Act (ACA) took steps to make health insurance more accessible for many Americans while also reducing barriers to primary care services for specific populations. Specifically, states that have expanded Medicaid have seen a significant reduction in their uninsured populations. However, not all people or places benefitted in the same ways. As we consider how the ACA has improved health care for some and seek to recognize the gaps that still remain, we must acknowledge the persistent social and economic barriers that exist for certain populations and regions; Appalachia is prominent among these. Background: Appalachia and Health Disparities Appalachian people have endured a range of challenges that relate to health outcomes and access to health care. This is especially true in rural


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areas where several socioeconomic measures including income, poverty rates, unemployment rates, and postsecondary education levels are lower than the rest of the nation. Though the overall poverty rate for the region and the number of high-poverty counties have declined in recent decades, persistent inequities present challenges to the region.1 The health disparities present in Appalachia include higher rates of obesity and diabetes, risks associated with environmental contamination, and increasing problems with drug use.2 A recent report for the Appalachian Regional Commission describes a “widening gap in overall health between Appalachia and the nation as a whole.� People who live in the region are more likely than others to die from heart disease, cancer, chronic obstructive pulmonary disease (COPD), injury, stroke, diabetes, and suicide.3 Child health is also an area of concern, with rates of infant mortality, low birth weight, and teen births all outpacing national averages. The rate of fatal drug overdoses is higher for the region than the nation. Between 2016-2017, most Appalachian states experienced increases in drug overdose deaths. In fact, West Virginia, Ohio, Pennsylvania, and Kentucky had the highest rates of drug overdose deaths in the country in 2017.4 Finally, mental health is also a persistent and even increasing concern; a study by the Ohio Alliance for Innovation in Population Health reported the rate of suicide deaths in Appalachian Ohio counties to be higher than those of nonAppalachian counties in the state.5 From these disparities, we recognize the importance of addressing structural inequities that include improving access to health care within the Appalachian region. The supply of health care professionals in primary care, mental health, specialty care, and dentistry are well below the national average, particularly in the rural areas of the region. However, it is also important to note that not all the challenges affect the region consistently, and some areas are doing better than expected when it comes to health outcomes.6 For instance, poverty is higher within Central Appalachia than Northern Appalachia. Minorities represent a much larger percentage of the population in Southern Appalachia (31.3%) compared to Northern Appalachia (11%). Because access to resources also varies greatly, it follows that health challenges are localized and solutions to these challenges should be evaluated with local input. In order address health disparities related to health care access, we must understand the complexity of the meaning of access to care.


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A Model of Access to Health Care Research on predisposing characteristics and health behaviors provides several tools to assess the ways in which we might seek to address the issues of disparities in Appalachia. Key among these is Ronald Andersen’s Health Behavior Model.7 Even within one state, we can identify demographic differences between those counties designated by the federal government as Appalachian and those that are not. In Ohio, Appalachian residents are older and poorer than non-Appalachian residents, with lower educational attainment and lower rates of health insurance coverage. According to an assessment of health behaviors by Robert Wood Johnson Foundation County Health Rankings, nine of the ten poorest performing counties in the state are also Appalachian counties.8 Using the framework of Andersen’s Health Behavior Model, we can consider relationships between disparities in economic and social resources and disparities in health care access and health outcomes. Andersen explains health status (both as perceived by the individual and as evaluated by a professional) as informed by factors in three categories: environment, population characteristics, and health behaviors. Several factors fall within each of these categories (Figure 1). Health care systems, external environmental factors and costs are considered as part of the environment. The demographic category includes predisposing characteristics and enabling resources. Health behaviors encompass both personal health practices and use of health services. All these factors, in turn, inform each other and are further informed by health outcomes, creating what can be viewed as a cycle of behaviors and results. We can use these categories to identify if there are characteristics unique in Appalachia that influence the ability of residents to use health care services. For example, according to the “Rural Health Report Card,” approximately one-third of Ohio’s rural counties and a corresponding onethird of Ohio’s Appalachian counties are considered primary care shortage areas.9 This shortage is considerably higher for mental health services. These shortages are a type of environmental factor that inevitably affects health care use, as do demographic factors of higher age and lower educational attainment.


160 Rural Appalachia

ENVIRONMENT

Health Care System External Environment Cost

DEMOGRAPHIC

Predisposing Factors Enabling Factors

HEALTH BEHAVIOR

Personal Health Practices

OUTCOMES

Health Status Satisfaction

Use of Services

Figure 1. Components of Access to Care (adapted from Andersen)

More limited enabling resources, such as lower incomes, insurance rates, and access to computers and internet, may further influence how people in Appalachia use health services. Complicating all these factors is the documented presence of adverse health behaviors in the region, such as smoking and physical inactivity. As Andersen’s model suggests, people in Appalachia facing these disparities also faces poorer health outcomes. The question to be considered is the extent to which these disparities are being addressed by national and state initiatives and the extent to which new initiatives and efforts must be developed to meet the needs of the Appalachian population. In many cases, the disparities are caused by inequities that exist throughout the region. The Role of Policy in Access to Health Care Assessing access. Indicators of access to health care often include three main environmental components of the Andersen model: health insurance coverage, service availability (including having a usual or regular source of care), and the timeliness of services. These indicators can lead to


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unmet health needs, delays in seeking care, limited use of prevention, financial strain, preventable hospitalizations, avoidable mortality, and poor overall health status. However, we cannot ignore the social and demographic determinants that affect access to care such as employment status, income, housing, transportation, health literacy, education, access to healthy foods, stress, and discrimination.10 Within the health care system, limitations in coverage, availability and cultural competency of providers, and quality of care can influence patient’s access to care, health status, and health expenditures. In rural communities, inequities in access to care are exacerbated by hospital closures and changing reimbursement models. Stricter Medicare reimbursement models have simultaneously increased solvency and decreased fraud and abuse, but rural hospitals are faced with declining reimbursement from one of their main revenue sources. Changes in Medicaid reimbursement policies also negatively affected struggling rural hospitals. Some state Medicaid managed care plans financially disincentivized overuse of the emergency department by only reimbursing the hospital a small triage fee.11 Unfortunately, the emergency department may serve as the only care provider in some rural communities. Finally, with the culture change in the U.S. healthcare system shifting away from volume to value-based care, rural hospitals are struggling to meet the higher demands with limited human and financial resources. Medicaid expansion. Recent data shows that 639,000 Ohioans are covered by Medicaid expansion, totaling more than 2.7 million Medicaid beneficiaries in the state.16 Ohio Department of Medicaid examined the effects of Medicaid expansion on the newly insured Medicaid recipients in its Medicaid Group VIII Assessment. The findings indicate that the percentage of uninsured adults age 19-64 who were at or below 138% of the federal poverty level declined from 32.4% in 2012 to 14.1% in 2014. The newly insured were white (71.5%), male (55.8%), over age 44 (51.4%), single (83.8%), and experienced poorer health compared to traditional Medicaid enrollees.17 Overall, Ohio’s Appalachian counties saw greater gains of newly insured compared to non-Appalachian counties in the state. After enrolling in Medicaid, almost one-half (48%) of the newly insured reported improved health status and 44% reported improved access to services for mental health care needs. With this improved access, over one


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quarter of this population’s chronic conditions are being diagnosed and treated. Additionally, Medicaid expansion improves hospital financial performance and decreases the risk of hospital closure, especially in rural areas. This suggests that Medicaid expansion improves the ability of all people in vulnerable regions to access health care, even if they are not directly insured by Medicaid.18 The impact of increased Medicaid eligibility reaches beyond improving access to care and population health. Medicaid expansion enrollees reported improvements in their financial situation, including ease of buying food, paying rent or mortgage, and paying off debt. Three-quarters of the unemployed found it easier to seek employment because of having Medicaid. These are some of the factors in the Andersen model that contribute to access to care. However, as Ohio joins other Appalachian states in seeking legislation to enforce work requirements on Medicaid, this could reduce coverage by thousands of individuals. In these states, to avoid disenrollment, Medicaid beneficiaries need to start working, enroll in education or job training, or volunteer. With the current opioid epidemic, one disadvantage of the work requirement is that individuals will lose coverage and be less likely to seek substance use treatment. Population health efforts in the ACA. The Patient Protection and Affordable Care Act (ACA) aimed to enhance population health by expanding health insurance coverage, improving the quality of health care services, increasing use of and focus on prevention and health promotion, and promoting “community- and population-based activities.”12 To further enhance population health, the ACA now requires hospitals and public health departments to determine the needs of the communities they serve and devise solutions to better meet the needs of their constituents. Hospitals must conduct a Community Health Needs Assessment (CHNA) every three years. These CHNAs compile community data, identify available resources, and prioritize the community’s needs. Public health departments that undergo accreditation must create a similar report called the Community Health Assessment (CHA). Once the needs are determined through the comprehensive CHA, health departments develop a Community Health Improvement Plan (CHIP), which outlines priorities to improve public health with strategies to increase or enhance access to care. In 2012, Ohio became the first state in the country to pass legislation requiring local public health departments to attain accreditation. To accomplish this, local public health departments must have applied for


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accreditation by 2018 and successfully achieve accreditation by 2020. According to the rationale from the Ohio Department of Health, Accreditation by the national Public Health Accreditation Board (PHAB) demonstrates that health districts are meeting or exceeding a common set of national standards; have the capacity to provide core public health services; and are continually striving to improve service, value and accountability to stakeholders.13 To date, less than one-half of the 113 health departments in Ohio are nationally accredited. Most of those health departments serve urban communities, very few of the 32 counties designated as Appalachian have attained accreditation.14 Rural health departments are struggling to meet the rigorous documentation requirements associated with gathering and reporting data for accreditation. To minimize the struggle, the state has provided some financial and technical assistance to local health departments. In addition, we have developed a process to help local health departments prioritize strategies to improve access to care.15 Perception of Access to Care in Appalachia Despite statewide and national efforts to improve health care access and strengthen population health outcomes, there are still notable disparities and vulnerable populations in Appalachia. We conducted a survey to assess perceptual differences between the 32 Appalachian and the 56 non-Appalachian counties, and between the 72 rural or partially rural and 16 nonrural counties within the state of Ohio. These counties are all subject to the same state policies. We recruited participants from across the state through local health departments, social media posts, and county fairs to participate in the electronic survey. The resulting sample was 695 respondents representing 84 of 88 counties across the state, with nearly 60% of the sample coming from rural areas and 63% living in Appalachian counties. The results allowed us to compare perceptions of health care access based on where people live in the state. The data shows that Appalachian and rural residents perceived health care to be more difficult to obtain. Appalachian Ohio residents’ perception of their health care challenges are consistent with those that have been


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documented across Appalachia more generally. People who live in the rural Appalachian counties struggle the most to access health care. Specifically, 72% of those in rural counties felt there were not enough health services available, as compared to 45% of residents in non-rural counties; this was also true for 71% of the Appalachian subset of the sample (Figure 2). Appalachian residents also reported having to travel longer distances for care than their non-Appalachian counterparts. Approximately 30% of the Appalachian residents indicated that they have to travel more than 20 miles for primary care and 76% reported traveling more than 20 miles for specialist care, compared to only 14% and 46% respectively of the non-Appalachian population. Perhaps most notable is that 34% of those in Appalachian counties felt as though there was a time in the past 12 months that they needed care but were not able to access it. This is higher than the rural population generally (31%) and considerably higher than the non-Appalachian population. Other differences include higher rates of Appalachian residents with trouble paying medical bills (37% compared to 24%) and higher rates of uninsured (9% compared to 4%). Fewer (17%) Appalachian respondents reported being able to identify a substance use disorder treatment service than non-Appalachian respondents.

80

71.6

71

70 56

60

No

55.1

50 40

Yes

44.9 36.8 28.3

30

28.9

20 10 0 Ohio (645)

Rural (378)

Appalachian (404)

Nonrural (284)

Figure 2. Are There Enough Health Care Services in Your County? (% respondents)


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These differences exist despite all survey respondents living within the same state with the same laws, policies, and programs. In addition, all these differences continue to exist despite policy attempts at both the state and local levels to expand health care coverage. It is important to remember that increased health care coverage does not necessarily lead to a comparable increase in health care access. If we again consider Andersen’s model, we can recognize health care coverage as an enabling resource that can help facilitate access and utilization, but it does not unilaterally change other factors such as predisposing characteristics or external environment. Working Toward Solutions Appalachian communities are far from resigned to accepting health care issues as ongoing or irreversible. In 2018 and 2019, We facilitated 9 meetings in which residents participated alongside public health professionals and community leaders to identify solutions to improve access to care. These meetings demonstrated the willingness of people to engage regarding the issues affecting their families, as well as their dedication to seeking ways of improving such circumstances. The state accreditation requirement has burdened many rural health departments, but it is also the starting point for many of these conversations rather than the only reason for the stakeholders participating in them. While some communities are starting with preliminary discussions about the needs its residents are facing, others are going as far as developing collaborative efforts to establish new health care access points in their rural communities. Interestingly, while there are common needs being discussed across the many counties and communities that took part in these meetings, the solutions that are being proposed are highly localized. That many Appalachian communities are motivated to address health disparities is in line with efforts identified by the Robert Wood Johnson Foundation work, “Exploring Bright Spots in Appalachian Health: Case Studies.�19 Recognizing that socioeconomic and health outcomes are interdependent, the report presents ten counties within the Appalachian region that are exceeding expectations on a range of health indicators and found similarities in the ways these counties are addressing health issues. These similarities comprise six categories: community leaders engaged in health initiatives; cross-sector collaboration; resource sharing; local health care


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providers committed to public health; active faith communities; and initiatives to combat substance abuse. These types of efforts are precisely what we documented and witnessed across many Appalachian communities within Ohio. Though disparities persist, local stakeholders are seeking both to promote expanded access through policies coming from state and federal governments while also seeking out solutions that are most feasible in their own communities. These solutions may be as varied as the communities themselves. In some areas, it may be a matter of integrating new provider types into primary care services, such as the increasing role of advanced practice nurses in preventive and mental health screenings.20 For other communities, nontraditional sources of care such as freestanding emergency departments may be poised to make a difference. Though these facilities are more common in urban areas21 and cannot take the place of important primary care services, they have the potential to address an urgent need in rural communities that have experienced the closure of a local hospital.22 We must acknowledge and continue to document health and health care access disparities that exist in Appalachia while also recognizing the continuous effort of policymakers, health care providers, and community leaders to address these needs through the use of a wide range of practices and policies. Through ongoing and collaborative efforts between local and state agencies, educational institutions, health care organizations, and community partnerships, progress can continue to be made to reduce disparities and improve access for historically vulnerable populations and regions. Notes 1. PDA, Inc., Health Disparities in Appalachia, August 2017, https://www.arc.gov/assets/research_reports/Health_Disparities_in_Appalachia_August_2017.pdf. 2. PDA, Inc., Health Disparities in Appalachia; Kevin Pollard and Linda A. Jacobson, The Appalachian Region: A Data Overview from the 20122016 American Community Survey Chartbook, March 2018, https://www.arc.gov/assets/research_reports/DataOverviewfrom2012to2016ACS.pdf. 3. PDA, Inc., Health Disparities in Appalachia. 4. Lawrence Scholl, et al., “Drug and Opioid Involved Overdose Deaths – United States, 2013–2017,” Morbidity and Mortality Weekly Report 67, no. 5152 (2019): 1419-1427.


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5. Ohio Alliance for Innovation in Population Health, A Longitudinal Analysis of Ohio Suicide Deaths, 2008-2017, May 2019, https://docs.wixstatic.com/ugd/89e8f1_610152f376f34af09465c60c303c760e.pdf. 6. Appalachian Regional Commission (ARC), Exploring Bright Spots in Appalachian Health: Case Studies, July 2018, https://www.arc.gov/assets/research_reports/BrightSpotsCaseStudiesJuly2018.pdf. 7. Ronald M. Andersen, "Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?" Journal of Health and Social Behavior 36, no. 1 (1995): 1-10. 8.Robert Wood Johnson Foundation, County Health Rankings, accessed July 8, 2020, https://www.countyhealthrankings.org/. 9. Rural Health Quarterly, U.S. Rural Health Report Card 2017, Fall 2017, http://ruralhealthquarterly.com/home/2017/12/15/u-s-rural-health-report-card-2017/. 10. Samantha Artiga, Kendal Orgera, and Olivia Pham, Disparities in Health and Health Care: Five Key Questions and Answers, March 4, 2020, https://www.kff.org/disparities-policy/issue-brief/disparities-in-health-andhealth-care-five-key-questions-and-answers/. 11. Jane Wishner, et al., A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies, July 2016, http://files.kff.org/attachment/issue-brief-a-look-at-rural-hospital-closures-and-implications-foraccess-to-care. 12. Michael A. Stoto, Population Health in the Affordable Care Act Era, February, 21, 2013, https://academyhealth.org/sites/default/files/publications/files/AH2013pophealth.pdf. 13. Ohio Department of Health, National Public Health Accreditation, February 3, 2020, https://odh.ohio.gov/wps/portal/gov/odh/about-us/LocalHealth-Departments/Accreditation. 14. Public Health Accreditation Board, Complete List of Nationally Accredited Health Departments, accessed July 8, 2020, https://phaboard.org/whois-accredited/. 15. Kristin A. Schuller, et al., “Development and Application of a Rubric to Compare Strategies for Improving Access to Health Care in Rural Communities in the United States,� Evaluation and Program Planning 74 (2019): 61-68.


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16. Ohio Department of Medicaid, Ohio Medicaid Group VIII Assessment: A Report to the Ohio General Assembly, 2016 https://medicaid.ohio.gov/Portals/0/Resources/Reports/Annual/Group-VIII-Assessment.pdf. 17. Ohio Department of Medicaid, Group VIII Assessment. 18. Richard C. Lindrooth, et al., "Understanding the Relationship Between Medicaid Expansions and Hospital Closures," Health Affairs 37, no. 1 (2018): 111-120. 19. ARC, Exploring Bright Spots. 20. Sarah K. Hill, et al., "Factors Influencing Mental Health Screening and Treatment Among Women in a Rural South Central Appalachian Primary Care Clinic," The Journal of Rural Health 32, no. 1 (2016): 82-91. 21. Ashley F. Sullivan, et al., "A Profile of Freestanding Emergency Departments in the United States, 2007," The Journal of Emergency Medicine 43, no. 6 (2012): 1175-1180. 22. Jesse M. Pines and David Ernst, “Solving The Rural Health Care Access Crisis With The Freestanding Emergency Center Care Model,” Health Affairs, February 21, 2017, https://www.healthaffairs.org/do/10.1377/hblog20170221.058847/full/.


Contributors Ada Woodson Adams was born and raised in Nelsonville, Ohio. She earned a B.S. degree from Ohio University in education and was active in the U.S. Civil Rights Movement in 1963 and 1964. Her extensive professional career includes the roles of schoolteacher, management, and business owner. She also plays a major role in the community, preserving and amplifying the history of Black Americans in Appalachia whose voices that too often have gone unheard. Mrs. Adams is one of the Founders and Past President of the Multicultural Genealogical Center, Co-Founder and Vice-President of the Mount Zion Baptist Church Preservation Society, Trustee of the Southeast Ohio History Center, Trustee of the Athens County Libraries, Board Member of the Athens County Foundation, Underground Railroad Tour Conductor, and Co-founder of the Ohio University Community and Campus Days. She has received many awards for her professional and community service, including the Midwest Archives Conference Presidents’ Award, United Campus Ministry Social Justice Award, Martin Luther King, Jr Scholarship Fund Award, Father Lawrence Martin Jenco Award, Foster B. Cornwell Community and Philanthropy Service Award, The Friends of Freedom Society, Inc. Ohio Underground Railroad Conductor of the year Award, Nelson T. Gant Woman of Distinction Award, and Athens Middle School Andrew Jackson Davison Club, Lifetime Community Service Award. Tiffany G. Arnold, PhD is Associate Director of the Appalachian Rural Health Institute as well as Assistant Professor of Instruction with Ohio University's College of Health Sciences and Professions. She is from Morgan County Ohio in Appalachian Ohio and has a BA in Political Science, an MEd in Curriculum and Instruction, and a PhD in Curriculum and


170 Contributors

instruction with a focus on Appalachian Studies all from Ohio University. Her research interests include Appalachian cultural competency and humility as well as the role of Appalachian culture in the decision making of Appalachian youth. Joann P. Benigno, PhD, CCC-SLP is an Associate Professor and the Coordinator of Professional Programs in Communication Sciences and Disorders at Ohio University. She teaches courses and conducts research on child language development and language disorders, including autism spectrum disorder. Her scholarship of teaching and learning interests focus on interprofessional education and training for undergraduate and graduate students through community outreach programming targeting children with autism and their families residing in Appalachia. Josh Birnbaum is an associate lecturer in the School of Visual Communication at Ohio University, where he teaches photography, picture editing, digital imaging, and video storytelling courses. He has worked for a variety of American newspapers and interned with photographer James Nachtwey. His first book, Dream Shot, which documented the nation’s first wheelchair basketball team, was published by the University of Illinois Press in fall of 2017. Josh has a passion for social justice and has worked as a visiting artist with the Athens Photographic Project – a non-profit fine arts program that offers photography classes to community members living with persistent mental illness – where he has taught advanced classes and leads artists in pursuit of their creative and personal recovery goals. Josh holds a B.S. in Aerospace Engineering from the University of Illinois, and an M.A. in Photography from Ohio University’s School of Visual Communication. Jen Bowman, Director of Environmental Programs / Hydrogeologist. Jen Bowman has an MS in Environmental Geochemistry from Ohio University (2000). She has 18 years of experience in watershed and data management and water quality assessment while working at the Voinovich School of Leadership and Public Affairs (14yrs) and previously at Rural Action as a watershed coordinator (4yrs). She holds her OEPA Credible Data Program level 3 Quality Data Collector (QDC) Status for Chemical Water Quality Assessment and Level 2 QDC for macroinvertebrates. She currently is the Director of the Energy and Environment team at the Voinovich School. She meets with stakeholders to align environmental needs in the region to the


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expertise across the University; bringing ‘real-world’ projects to the School where students, faculty, and professional staff work cross collaboratively to solve complex environmental issues. She leads the Appalachian Watershed Research Group at the University. Laura Brown, PhD, MT-BC, Assistant Professor of Music Therapy, joined the faculty at Ohio University in the Fall of 2014. Dr. Brown holds a Bachelor of Music Therapy degree from Appalachian State University (2003), a Master of Music Therapy degree from Appalachian State University (2009), and a PhD in Music and Human Learning from The University of Texas at Austin (2012). Her clinical experience includes working in both private practice and public-school settings with children and adults with disabilities, as well as with older adults. Dr. Brown’s primary research interests include music with children with autism spectrum disorder, inclusion in music settings, and various special education topics. Her research has been published in the Journal of Music Therapy, Music Therapy Perspectives, General Music Today, and Music Educator’s Journal. Cory E. Cronin, PhD is an Assistant Professor of Social and Public Health at Ohio University, where he serves as the coordinator of the undergraduate health services administration program. He received his Ph.D. in medical sociology from Case Western Reserve University and a Master of Health Services Administration from Xavier University. His academic interests include access to care, community health issues, and vulnerable populations. His research largely focuses on the roles health care delivery and policy play in regard to population health issues, with particular attention to the ways in which policies influence interactions between health care organizations and their communities. His research has included the use of both national, secondary data and the collection of primary data through community-based surveys. Dr. Cronin is actively involved with the Appalachian Rural Health Institute at Ohio University, and he has been a part of local initiatives to increase health care access throughout Southeast Ohio. Dr. Frans H. Doppen is a Professor in The Patton College of Education and Chair of the Department of Teacher Education. He holds a Doctorandus degree in Modern History from Utrecht University, the


172 Contributors

Netherlands, as well as an Ed.S. in Educational Leadership and a Ph.D. in Social Studies Education from the University of Florida. Dr. Doppen has taught courses in Social Studies Education and currently teaches graduate courses in Curriculum and Instruction. His research focuses on place-based education, service learning, local and global education. He is the author of Richard L. Davis and the Color Line in Ohio Coal: A Hocking Valley Mine Labor Organizer, 1862-1900. B. Patrick Fahey is a graduate student at Arizona State University working towards a PhD in anthropology. During his undergraduate career at Ohio University, Patrick studied prehistoric food systems of populations in the southeastern Ohio with a focus on paleoethnobotany, as well as information graphic design. He received a bachelor’s degree in anthropology and visual communications. His current research interests are in the evolution of modern human behaviors during the Late Pleistocene. He studies animal remains in archaeological contexts to better understand how ancient humans interacted with other members of their ecosystems. Sarah B. Garlington, PhD, MPhil, MSSW is an Assistant Professor in social work at Ohio University. Her research examines shared social values and how communities meet social welfare needs. She has clinical social work experience in the Appalachian region. She earned her PhD in Interdisciplinary Social Work & Sociology from Boston University and holds master’s degrees in Ecumenics and Social Work. Dawn Graham, PhD, is a Lecturer in the Department of Social Medicine at Ohio University Heritage College of Osteopathic Medicine. She earned a Doctorate in Counseling Psychology from Purdue University in 2010 and Master of Arts in Applied Behavioral Science from Valparaiso University in 1999. She has experience running a multimillion-dollar federal grant to promote maternal/child health in southeastern Ohio with university and community partnerships in coordination with the Ohio Department of Health. She is a member of the American Psychological Association and acted as chair of the Ohio Psychological Association Public Sector Issues committee. Her areas of interest include creativity and mental health, community psychology, rural health and policy change.


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Dr. Kelly Johnson’s area of expertise is in aquatic ecology and environmental toxicology, with a focus on insects and other invertebrates found in streams and rivers. She is currently a tenured faculty member in Biological Sciences at Ohio University, member of the Appalachian Watershed Research Group and currently holds the American Electric Power Watershed Professorship at the Voinovich School of Leadership and Public Affairs. She has spent several decades investigating the ecology of streams and rivers impacted by acid mine drainage with state agencies, local watershed groups, and the at Ohio University. Her interests include insect ecology, biomonitoring of wadeable and headwater streams, supporting volunteer-based biomonitoring programs, and interpreting long-term patterns of stress and ecological recovery in insect communities. Dr. Michael Kopish is an Associate Professor in the Department of Teacher Education in The Patton College of Education. He holds a B.A. in History with a minor in Secondary Education and Psychology from Mt. Mercy College, a Master of Arts in Teaching from Coe College, and a Ph.D. in Curriculum and Instruction with a minor in Educational Psychology from the University of Wisconsin-Madison. Dr. Kopish teaches courses in social studies education and AYA courses in secondary education. His major research interests include teaching and learning in social studies classrooms; inclusive literacy practices; and youth participation and civic engagement. Joy Kostansek is a graduate student at Ohio University pursuing an M.A. in Sociology. She also received her B.A. in Sociology and Food Studies from Ohio University with a focus on agriculture and food policy. Kostansek’s current research interest is understanding the role large, public institutions play as drivers for positive regional development. She is studying this through the lens of regional food procurement, and how that can be used as a tool for Ohio University to align its stated priorities with its mission. Her career goals include earning a PhD in food studies or public policy and to work on reforming food and agriculture policy to better support small-scale, diversified farming practices.


174 Contributors

Dr. Natalie Kruse is an Associate Professor of Environmental Studies in the Voinovich School of Leadership and Public Affairs at Ohio University. She earned her doctoral degree at Newcastle University in Northeast England in Civil Engineering and Geosciences, completing research in coal, lead, and zinc mines in northern England. Dr Kruse specializes in water quality impairment and restoration after mining and oil and gas operations. She has worked in Appalachian watershed impaired by mining pollution for nearly two decades with a focus on watershed-wide processes that lead to stream recovery. Paul Logue is the planner for the City of Athens since 2008. He manages city planning efforts including such topics as public art, historic preservation, housing, sustainability, and active transportation. He has a bachelor’s degree in Public Administration from Ohio University and a master’s degree in City and Regional Planning from The Ohio State University. Paul is a member of the American Institute of Certified Planners and serves as a board member and treasurer to the Ohio Chapter of the American Planning Association. Paul managed the city arts plan Essence of Athens: A Strategic Plan for Economic Enhancement and Community Competitiveness which received the American Planning Association’s 2015 Vernon Deines Award for an outstanding small town or rural plan. He is currently completing the city’s new comprehensive plan. He lives in Athens with his wife Sarah, son Calvin, and their dog Dobby. Dina L. Lopez, PhD is Professor of Geochemistry and Hydrogeology of the Department of Geological Sciences, Ohio University. She graduated with a BS in Chemistry and Physics from the University of El Salvador (1975), a M.Sc. in Physics from Virginia Tech (1979), and Ph.D. in Geology from Louisiana State University (1992). She worked as a professor of Physics in the Universidad de El Salvador, and in Geothermal Energy projects in El Salvador. Her areas of interest are environmental geochemistry and geochemistry and hydrogeology of geothermal systems. Research topics include geochemistry of acid mine drainage, geothermal systems, arsenic in natural and contaminated waters, diffuse soil degassing and heat flow in hydrothermal areas, and the fate of acid mine drainage contaminants in streams. In Ohio, her research is focused in the impact and remediation of acid mine drainage in streams. She is particularly interested in hydrological and


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geochemical modeling. She belongs to the Appalachian Watersheds Research Group of Ohio University. Amy Mackey coordinates restoration work in the Raccoon Creek watershed and assists with other environmental projects as needed. She has experience with watershed project planning and maintenance, chemical, physical, and biological monitoring, and planning and facilitating outreach and education events. Amy supervises AmeriCorps members, interns and students, guides the activities of the local non-profit group the Raccoon Creek Partnership, and teaches fish and macroinvertebrate sampling and identification to Hocking College and Ohio University students (undergraduate and graduate). Amy has coordinated the Voinovich School STEM education station at the U.S. Department of Energy Science Alliance at the former uranium enrichment facility in Piketon, Ohio for the past 10 years. Amy has achieved and maintains Ohio EPA credible data collector status for chemical monitoring, benthic macroinvertebrate sampling, fish sampling, and habitat evaluation. She collaborates with landowners, citizens, universities, non-profits, businesses, local, county, state, and federal agencies and has worked with the Voinovich School since 2007. John McCarthy, Ph.D., CCC-SLP is an Associate Professor and is the Interim Associate Dean for Research and Graduate Studies at Ohio University. His research interests include developing better computer user interfaces and expanding the creative possibilities for children and young adults with complex communication needs. He teaches courses on Introduction to Communication Disorders, Research Methods, Language Development, Interprofessional Rural Health, and Augmentative and Alternative Communication. He is the Co-Editor of the electronic resource Augmentative and Alternative Communication: An Interactive Clinical Casebook. Rachel McDonald is currently an undergraduate student at Ohio University majoring in Global Studies and minoring in Geography and Political Science. She is also earning the French and Francophone Studies, Food Studies, and the Environmental Studies Certificates at Ohio University. During spring of 2017 she studied abroad in Luxembourg for a semester, and she strives to apply the different perspectives she encountered


176 Contributors

abroad to her coursework, and future career. Looking forward, she hopes to pursue work in economic and community development in Appalachia and combine her multidisciplinary academic background with her interests in sustainability, food, and culture. Theresa Moran, PhD, was the Director of Food Studies at Ohio University, establishing the interdisciplinary program in 2013 and an adjunct associate professor in the College of Arts and Sciences. She has been a university lecturer in the United States, Italy, and Japan. Formerly an analyst for the World Bank, Dr. Moran worked on human resource lending operations in the Republic of Korea, Venezuela, and Brazil. She has also worked for the United Nations Food and Agriculture Organization. Agricultural entrepreneurship with community organizations is the focus of much of her work in Appalachian Ohio. As the university’s Sustainable Living Hub Coordinator, her research interests focus on the sustainability implications of food choices. Michele Morrone, PhD is a Professor of Environmental Health at Ohio University and the Director of the Appalachian Rural Health Institute. She is the author of numerous papers on environmental topics including the community impacts of hydraulic fracturing, environmental health disparities in Appalachia, and environmental justice. She has published five books, most recent is Ailing in Place: Environmental Health in Appalachia. She is a Past President of the Appalachian Studies Association. She was the 2012 Fulbright Research Scholar in Science and the Environment at McMaster University in Hamilton, Ontario, Canada and was a member of a group to present Appalachian-related research in Ukraine in 2014. Her research focuses on Appalachian health issues, specifically the relationship between environmental conditions and health outcomes. Shannon Nicks, PhD MPH is an Assistant Professor in the Department of Social and Public Health housed in the College of Health Sciences and Professions at Ohio University in Athens, Ohio. She earned her PhD and MPH, concentrating in Behavioral Science and Health Education, from Saint Louis University College for Public Health and Social Justice in 2016 and 2011, respectively. Dr. Nicks' research focuses on using community-engaged approaches to examine health disparities and promote health equity. Currently, her work examines the influence of social support on health


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behaviors and health outcomes related to rural health, cancer, diabetes, women’s health and mental health. Additionally, Dr. Nicks teaches at both the undergraduate and graduate levels, serving as primary instructor for numerous public health courses. Alexandria Polanosky graduated from Ohio University with a Visual Communication degree in Photojournalism and certificates in Environmental Studies and Food and Society. Alexandria also attended Stellenbosch University in Stellenbosch, South Africa while studying Cities, Sustainability and Community. She is happy to be able to combine her skills and experiences to work toward a stronger community in Appalachia. Alexandria is currently a freelance photographer and videographer in Southeast Ohio focusing primarily on food access and sustainable agriculture. Stephen J. Scanlan, PhD is an Associate Professor of Sociology at Ohio University. His teaching and research interests include development and social change, environmental sociology, food insecurity, poverty, and social movements. More specifically his research has examined environmental justice in Appalachia; food deserts and hunger; gender and development; and greenwashing and corporate environmental communication. He has contributed to a number of edited volumes in addition to being published in International Journal of Comparative Sociology, International Journal of Agriculture and Food, Journal of Appalachian Studies, Journal of Conflict Resolution, Local Environment: The International Journal of Justice and Sustainability; and World Development among others. Dr. Kristin Schuller is an Associate Professor of Health Services Administration at Ohio University and the Program Coordinator for the online Master of Health Administration Program. She earned her Ph.D. and master’s in Health Services Policy & Management from the University of South Carolina. Dr. Schuller completed a post-doctoral research fellowship at Texas A&M’s Health Sciences Center. Her research focuses on initiatives and policies aimed at improving the quality of care delivered in healthcare organizations and access to care in rural areas.


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Dr. Bahman Shahri received his PhD in Curriculum & Instruction from Ohio University Patton College of Education and completed the Albert Schweitzer Fellowship at Ohio State University. As a Schweitzer Fellow for Life, he is dedicated to and skilled in addressing health disparities among underserved people. He holds a B.A. in English Language & Literature and M.A. in General Linguistics from Ferdowsi University of Mashhad in Iran. He has worked as a teacher, lecturer, teacher trainer, and educational leader. His short articles and interviews have appeared and been featured on some renowned international websites such as BBC and Medium. Innovative pedagogy and experiential learning are other areas of his current research interests. Charlene Suggs has been a community organizer and grassroots activist for 30 plus years, and devoted much of her life finding ways for people to share life, land, and vision. Charlene has extensive experience in both corporate and nonprofit management and has founded several businesses and organizations. Presently, she promotes regional efforts for renewable energy, creative and sustainable lifestyles, and regenerative agricultural practices. Charlene is also the founding president for Wisteria Community, a workerowned land-based venture in southern Ohio. Nora Sullivan is an Environmental Specialist with Ohio University Voinovich School's Energy and Environment Program, specializing in GIS, data analysis, and project management. She earned a Bachelors in Business Administration from Mount Vernon Nazarene University, Associates of Applied Science in Ecotourism and Adventure Travel from Hocking College, M.S. in Environmental Studies and M.A. in Communications and Development from Ohio University. Prior to environmental work, Sullivan managed care for persons with developmental disabilities, managed a veterinary clinic, processed mortgages for first-time and immigrant home buyers, and groomed pets. Along with calling Appalachia home, these experiences perfectly position her to understand the social, economic, and environmental influences in the region. Sarah Taylor is a Clinical Supervisor in the graduate level M.A. Speech-Language Pathology program at Ohio University. She oversees graduate level practica for M.A. SLP students and teaches courses on clinical


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methods and speech science. Areas of interest include autism, AAC, dysphagia, voice, and underserved populations. Nate Thomson leads the Athens Photo Project (APP) as Executive Director. Nate volunteered with the APP in 2002 and rejoined the APP as Executive Director in 2007. Since joining the APP, Nate has worked collaboratively to teach APP classes; expand program capacity for adults; develop a teen photo program; purchase and renovate a dedicated Art Studio in Athens, present at local, state, and national levels; and create multiple group art installations in public and private settings. Under Nate’s leadership, APP has been awarded the nationally competitive Lilly Reintegration Award, Ohio Department of Mental Health’s Quality Award, and The Rita Gillick Mental Health Advocacy Award. Nate was honored for his leadership in 2014-2015 by receiving the Ohio Art Education Association’s Art Educator of Year award for the Southeast Region and The Rita Gillick Mental Health Advocacy Award. Nate studied Fine Art Photography at Otterbein College and earned a B.S. in Photojournalism from the School of Visual Communication at Ohio University in 2002. Dr. Lisa Trocchia is an Associate Faculty member in the graduate program in Sustainable Food Systems at Prescott College. She holds an interdisciplinary PhD in the Social Ecology of food from Ohio University and an MS in Sustainable Food Systems from Green Mountain College. She is a sensory ethnographer exploring food-based ecosystems from multiple perspectives including the lenses of Communication Studies, Sociology, Political Theory and the study of networks and complex adaptive systems. Dr. Trocchia researches and writes about the performance of cultural foodways and identity, food and the transmission of affect, and community-based food systems as sites of mutual aid, equity, and transformative social change. Dr. Danny Twilley is the Assistant Dean of the Outdoor Economic Development Collaborative at West Virginia University. In this role he is working to utilize WVU’s intellectual and social capital to make WV a more desirable place to live, work, start a business, go to school, and visit by leveraging the state’s outdoor recreation assets to stimulate and improve


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economic opportunities throughout the state. Previously, Dr. Twilley spent 13 years as a faculty member in Ohio University’s Recreation and Sport Pedagogy Department where he served as a Professor of Instruction and Assistant Professor in the Recreation, Parks, and Leisure Studies Program, Director of the Ecotourism Certificate, Interim Program Coordinator, and Coordinator of the Outdoor Skill Development Program. Finally, his research interest includes the psychological outcomes of leisure engagement, recreation’s role is community development, and the socio-economic impact of recreation-based development. Elizabeth “Libby” Williams’ paternal and maternal family has resided in the Athens, Ohio area for five generations. Elizabeth was born in Athens but reared in Columbus, OH. She holds a Bachelor’s degree from Kent State University and a Master’s degree from Central Michigan University. Although now retired, most of her career was spent with Westinghouse Electric and Gannett Publishing Company. She served as the Vice President of Human Resources at Gannett-owned Cincinnati Enquirer. John Winnenberg is a community organizer, founding member and Lead Staff Associate of Sunday Creek Associates, a nonprofit organization located in Shawnee, Ohio, responsible for a community building experience named "Little Cities of Black Diamonds." It includes organizing local history bus tours, the Little Cities of the Forest, the Little Cities Archives, the Little Cities of Black Diamonds Day, and the Appalachian Spring Festival. Most recently Winnenberg served as Interim Director of the Center for Campus and Community Engagement at Ohio University.



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