I’ve covered a fairly wide array of topics at the front of most West Virginians’ minds during this election: education, the War in Iraq, the price of gasoline, the economy – however, there’s a huge topic affecting our state that I have yet to get to. To many, particularly those who have lost a friend or family member due to a lifestyle-related disease, it’s the most important factor to take into consideration when casting a ballot – I’m speaking, of course, of the health crisis currently plaguing West Virginia.

The term “health crisis” encompasses a large number of topics, like our state’s poor general health, and how many of our state’s common occupations pose major health risks. It includes the fact that many in the state live without health insurance, especially the elderly. It means that many of our state’s hospitals are losing money at a frightening pace.

We’ll start with that first point – our state, some would argue, is the unhealthiest state in the nation. According to StateMaster.com, a United States statistical comparison database, we’re the most obese state in the nation (contributing to our high rankings regarding heart disease), we’re first in the nation in disability prevalence, and last in the nation in rankings of general oral health. We’re the second-most tobacco consuming state, first in the nation for rankings of psychological distress, and second for prevalence of asthma and other respiratory illnesses. We’re also fifth in the country for cancer deaths, and first for diabetes.

Like I said, we’ve got problems.

A vast majority of the maladies listed above are lifestyle related – but what causes the lifestyle? We’re an agricultural community, which unfortunately lends itself to the use of tobacco and tobacco-related diseases. Perhaps, as I said earlier, it’s the fact that many in our state spend most of their adult life deep underground, mining for the coal that provides nearly half the energy for our nation. The affliction rate for Black Lung Disease for miners is still incredibly high – although breathing masks have become mandatory in most mining stations, these men spend many years in a hazardous breathing environment, increasing their exposure and risk.

Like most problems affecting our state, though, most of our health problems can be associated with our economic turmoil. Regarding food, for instance – many cannot afford an apple a day to keep physicians at bay. As eluded to in West Virginia native Morgan Spurlock’s documentary Super Size Me, many families live on McDonalds and other fast food restaurants, which largely contributes to our dominance of the obesity ranking. Those who live in West Virginia’s more rural areas simply reap the side-effects of a cholesterol-rich homecooked diet.

Poverty also has a way of keeping people out of gyms, and out of the office of dieticians. It has a way of keeping our underfunded schools from providing the necessary healthy meals, exercise programs and health instruction needed to keep our children healthy – evidenced by our top marks in childhood obesity. It contributes to a sedentary lifestyle lived by the unemployed, which also contributes to our state’s wide physique. Can we really be condemned for our state’s high rates of lifestyle-related diseases, if the factors that lend themselves to this crisis are largely out of our hands?

These diseases would not be as big a problem if they could be easily treated – unfortunately, nearly 200,000 West Virginians between the ages of 25 and 64 don’t possess any form of health insurance, according to a recent survey from Families USA, a national health care consumer group. This contributes to our state’s high level of untreated chronic disease, but unfortunately, the repercussions of an insurance-free life can be measured in mortality. It’s estimated that more than 200 West Virginians die every year because they can’t afford the treatment they need.

With so much on the line, it’s no wonder that healthcare reform is such an important topic for West Virginians to research and discuss before Election Day. Unfortunately, it will take more than reform to help our state recover from its poor levels of general health – it will take pre-emptive, government funded health education programs to inform our citizens how to take better care of themselves. It will take the efforts of local health organizations to convince our state to replace smoking with healthier habits.

We can be a stubborn state, at times – but reversing our generally unhealthy ways is a change we can no longer afford to resist.