20 ways that West Virginia is a public health, healthcare, and human rights disaster area

Above: The description for this photograph, taken in Milton, West Virginia, July 6, 1938, reads: "Morris Memorial Hospital for Crippled Children. Children are being shown given therapeutic treatment for infantile paralysis. This pool and hospital were built by WPA labor." The New Deal greatly improved public health and healthcare in West Virginia, with more facilities; more nurses; health clinics; immunizations; recreation projects for both physical fitness and mental well-being; better drinking water and better sewage treatment; etc. As you will see below, West Virginia desperately needs another New Deal. Photo from the National Archives.

West Virginia's Public Health and Healthcare Today: Welcome to Hell on Earth

West Virginia's public health is like something out of a nightmare. Here are 20 reasons why:

1. Worst Overall Health in the Nation

"West Virginia ranks dead last in national health study—here’s how Virginia compares," WVVA (Channel 6, Bluefield, West Virginia), January 20, 2026. 

2. Unaffordable Health Insurance

"West Virginia ranks among least affordable states for health insurance," WCHS-TV (ABC and Fox, Charleston, West Virginia), July 16, 2026.

3. Substandard Healthcare

"West Virginia ranked 47th in U.S. for worst healthcare," WTRF-TV (Channel 7 News, Wheeling, West Virginia), July 27, 2026.

4. Too Many Premature Deaths

"West Virginia ranks 49th in the nation for premature deaths, meaning more people die before the age of 75 than in almost every other state" (The Center of Rural Health Development, accessed August 8, 2026, emphasis added).

5. Poor Quality Nursing Homes

"The 2022 Nursing Home Report by Nice Rx has been released and says that less than 3% of West Virginia’s nursing homes are top-rated... West Virginia has 123 total nursing homes, and U.S. News reported that only three... had a five out of five rating. Each of these nursing homes have fewer than 35 beds... U.S. News also reported that 35 of West Virginia’s nursing homes are considered worse than average and seven are being monitored by Medicare due to a history of low quality care" (12 WBOY News (NBC and ABC), August 24, 2022, emphasis added). 

Nursing home violations in West Virginia include: "failure to provide proper medical treatment... untreated bedsores... failure to respond to medical emergencies... multiple instances of elder abuse... missing money and personal belongings from nursing home residents... severe medication mismanagement, understaffing, and unsanitary conditions... dismissive staff responses to safety concerns... residents suffering from severe malnutrition and dehydration... patients left in soiled bedding for extended periods... residents were left without proper mobility assistance, leading to falls and serious injuries... nursing home residents were found suffering from untreated bedsores and infections... lack of proper dementia care" (Nursing Home Law Center LLC, using state and federal reports, March 5, 2025).

6. Little or No Support for Family Caregivers

"... [family] caregivers spend an average of $7,200 out of pocket each year, creating significant financial, emotional and physical strain,” Tom Hunter, associate state director of the AARP-WV, said in an email" (Mountain State Spotlight, January 22, 2026). A bill to give family caregivers a tax credit has stalled in the West Virginia legislature; meanwhile, "In 2026, West Virginia’s richest five percent of households will receive $1.2 billion from tax cuts enacted over the last decade" (West Virginia Center on Budget & Policy, December 27, 2025). 

7. Filthy Drinking Water 

"West Virginia was the state with the highest levels of violations and contaminants in its drinking water systems, according to the Afina study, which reviewed data from various EPA sources." (Newsweek, January 27, 2026, emphasis added).

8. Obesity and Diabetes

"New Report: W.Va. Remains Most Overweight State" (West Virginia Public Broadcasting, October 16, 2025). And this, no doubt, contributes mightily to 223,000 West Virginians having diagnosed diabetes, another 45,000 likely having diabetes, and 502,000 having pre-diabetes - in total, a whopping 43% of the population has diabetes or pre-diabetes ("The Burden of Diabetes in West Virginia," American Diabetes Association, March 2023).  

9. The Heart Attack Capital of the U.S.

"According to a recent report by the West Virginia Health Statistics Center (2019), West Virginians rank first in the country for heart attacks, have the second-highest obesity rate and prevalence of mental health problems in the country, along with the fourth-highest rate of diabetes and fifth-highest rate of cancer" (2022 academic study, published on the National Institutes of Health website, emphasis added).

10. An Expensive and Dangerous Place to Have a Baby

"West Virginia ranks #1 in worst states to have a baby" (WTRF-TV (Channel 7 News, Wheeling, West Virginia), June 10, 2026).

11. Bad Teeth

"West Virginia ranks 49th out of 51 states and D.C. for dental health"(West Virginia Dental Association, accessed August 8, 2026, emphasis added); and "West Virginia ranks last in national dental health study" (WVVA (Channel 6, Bluefield, West Virginia), January 20, 2026).

12. Understaffed Hospitals

"West Virginia hospitals continue to struggle to fill thousands of healthcare positions... according to the West Virginia Hospital Association’s 2025 Workforce Report. The report... found more than 4,500 vacant positions across 13 critical hospital occupations at participating hospitals, with nursing continuing to experience the greatest workforce pressures..." (WV News, July 15, 2026, emphasis added). 

13. Healthcare Workers Stealing Narcotics--Sometimes from Patients--in Order to Get High

"WVU Health Systems knew for years that employees were stealing highly addictive drugs... Federal officials found systemwide theft and lax record keeping, and said the state’s biggest hospital system failed to stop nurses and other staff from stealing controlled substances... a patient complained she did not receive her Percocet, a mild painkiller, according to the settlement. Records show the suspected thief, a medical provider, was seen nodding off at the nurse’s station... As to where the drugs went, Kevin McWilliams, a DEA spokesman for the Louisville Field Office, which oversees West Virginia, said that the investigators concluded most were being abused by the medical providers who took them" ("WVU Health leadership failed to address painkiller thefts as opioids devastated West Virginia," Mountain State Spotlight and the Associated Press, July 20, 2026).

I almost hesitate to blame the healthcare workers involved. If you had to work in such a miserable and wretched healthcare system, you might be desperate for escape too!    

14. Shifting Costs to the Poor  

"In 2022, West Virginia spent about $6,000 per capita on hospital care, nearly $2,000 more than the national average, much of which fell on patients to pay" (West Virginia Center on Budget & Policy, October 15, 2025). And that's a problem, because West Virginians are among the poorest in the nation.

15. Low-Income West Virginians Kicked Off Medicaid, In Order to Please the Rich

"West Virginia, Oregon and New Mexico are the three states that will see the most people disenrolled from Medicaid as a result of changes in the One Big Beautiful Bill, according to a new RAND analysis" (Governing, March 31, 2026, emphasis added). And of course, we know that this is being done in order to give tax breaks to millionaires and billionaires, so that they can secure more sustainable luxury, build more dynastic wealth, and purchase more politicians, and thereby keep the U.S. caste system going.

16. Inadequate Wastewater Management 

"The state faces growing challenges, with approximately 500,000 customers, over half the population, lacking access to public sewer systems [and] Many of the 336 regulated sewer utilities are aging or operating beyond capacity..." "2025 Report Card for West Virginia's Infrastructure," American Society of Civil Engineers, p. 204, emphasis added). 

Raw sewage is a big problem because it contains "bacteria, parasites, and viruses that can cause short-term problems like diarrhea, eye infections, respiratory infection, and long-term problems like cancer, Dementia, and Diabetes" (West Virginia Public Broadcasting, January 16, 2015).  

17. Black Lung

"Black lung cases surge in West Virginia, Kentucky and Virginia coal miners, study finds" (WV News, August 7, 2026), while the Trump Administration delays "implementation of new regulations that would protect miners from deadly silica" (Yale Environment 360, April 30, 2026). 

18. Deaths of Despair

"West Virginia has had one of the nation's highest rates of deaths of despair: fatalities attributed to suicide, drug overdoses and alcohol-related disease" (U.S. News & World Report, September 1, 2021, emphasis added). 

19. Not Enough Mental Health Services to Handle the Despair 

"WV’s shortage of psychiatrists worst in the nation, report says" (West Virginia Watch, April 21, 2026).

"WV and VA patients forced out‑of‑network for mental health care amid “catastrophic” shortages" (WVVA (Channel 6, Bluefield, West Virginia), March 10, 2026). 

20. Not a Nice Place to Grow Up 

"West Virginia has the nation’s second-highest level of hardship among children, according to a 2026 WalletHub study examining poverty, health, education and family stability" (WV News, August 6, 2026, emphasis added).

And if you're a child with a disability, the hardship might be compounded by being put on a waitlist for help: "Waitlist for disability services in WV climbs to more than 1,000; mostly children waiting for help" (West Virginia Watch, October 23, 2025). 

Above: A WPA dental clinic, assisted by a worker (at left) from the New Deal's National Youth Administration (NYA), in Kanawha County, West Virginia, between 1935 and 1943. The WPA conducted dental clinics all across the country for lower-income folks who couldn't afford dental work. Photo from the National Archives.

My Observations and Experiences

From my own time living in West Virginia, I have experienced the following with respect to myself or, more often, my family: 

1. Patient dumping, in the form of dangerous discharge attempts from the emergency room and constant pressure to remove a patient from the hospital after admittance. 

2. Doctors blocking patients from receiving needed treatment, even when the doctor has no specialty in the treatment area (e.g., an emergency room or floor doctor blocking a patient from seeing an oncologist or receiving radiation therapy). 

3. Extreme medicine mismanagement (for example, failure to give the patient's normal cancer medicine while the patient is in the hospital).

4. Months-long waitlists for community resources--such as the Lighthouse Program, which assists seniors in their homes--due to a lack of funding.

5. Lack of insurance coverage or community assistance for certain types of non-emergency medical transport (NEMT), e.g., a disabled person getting to a PET scan for necessary cancer imaging and analysis.

6. Nursing home bed shortages, in nursing homes that are understaffed, that routinely neglect patients, and that are potentially abusive.

7. Threat of home loss if one is admitted to a nursing home, because of (a) nursing home cost, which immediately takes the patient's Social Security, pension, and assets; thereby leaving little or no money for home upkeep, e.g., property tax, homeowners insurance, and electricity (and this is a problem because... what if the nursing home resident is discharged? Where will they go?), and (b) Medicaid Estate Recovery, where the state will force the sale of a deceased person's house, causing distress to both the nursing home patient (while they are alive and wishing to give something to their children) and to the children or heirs who, while grieving the loss of their loved one, also learn that the house--perhaps the childhood home--will be effectively confiscated to re-pay Medicaid (this would be akin to taking the house of a deceased trucker, to re-pay highway funds). 

And Medicaid Estate Recovery is happening, by the way, after decades of estate tax cuts for the super-rich... to benefit nepo-babies, i.e., less intergenerational wealth for the working-class and poor, and more intergenerational wealth for the super-rich. Welcome to America.

8. Little or no financial aid, even for lower-income elderly patients on hospice (West Virginia University is especially stingy and cruel, as compared to healthcare providers in Maryland and Virginia).

Above: This is part of a financial aid denial letter, from WVU, that one of my family members received while in WVU hospice. The family member makes $38,000 (Social Security and pension), which is lower middle-class. But WVU can't grant one penny of assistance for an earlier hospital stay, even though the person has a very modest income and is in hospice (that's how cruel the WVU healthcare system is). Also, note the threatening tone of the letter regarding any future appointments. Only a sociopathic healthcare system sends a letter like this to a hospice patient (or any patient for that matter). This is what America--a supposedly Christian nation--has devolved into.

9. Lack of telehealth and doctor house calls which, in combination with the lack of NEMT, results in doctors ghosting their patients (because the patient can no longer make it to the doctor's office, and most doctors don't want the hassle of calling or visiting their used-to-be-easy patients).

10. Woefully underfunded hospice services that don't even provide haircuts or nail care (although you might luck out and get a home health aide that will do those things in an unofficial capacity).

To be fair, there are some great healthcare workers in West Virginia--doing their best in an extremely underfunded, understaffed, and psychopathic system--but the West Virginia healthcare system, taken as a whole, is abhorrent and lethal. 

Above: A new tuberculosis hospital in Roneys Point, West Virginia, financed by the New Deal's Public Works Administration (PWA), 1936. This hospital helped fill a desperate need for more facilities and beds for tuberculosis patients in West Virginia. Photo from the National Archives.

Most of West Virginia's Policymakers Couldn't Care Less About the State's Health Problems

It goes without saying that most of West Virginia's policymakers couldn't care less about any of the problems I've highlighted above. They're much more focused on getting tax cuts for their wealthy donors (and themselves)--both at the state and federal level--than with correcting the state's healthcare catastrophe.

Back in February of this year, I wrote to my federal "representatives"--Senator Jim Justice, Senator Shelley Moore Capito, and Congressman Riley Moore--explaining the stress of healthcare and family caregiving, and requested: "I would like to know what legislation you are working on, or are currently supporting, to help family caregivers and those they care for." Justice wrote back on February 23, "Your message has been shared with the appropriate member of my team for review." That was the last thing I heard. Capito and Moore never responded at all. It's been half-a-year, and not one of my federal representatives has answered my simple inquiry. And that, of course, is because they are not really my representatives. They are representatives of the wealthy (and wealthy themselves), and so family caregiving is not an issue for them. If the need arises, they can put their loved ones in the best nursing homes or just hire round-the-clock caregivers.

The real tragedy here, of course, is that middle and low-income West Virginians keep voting for people who don't care about them. They're duped into voting a certain way, usually over some cultural issue that has little impact on their health or daily lives, and then they're pounded into the ground with inadequate healthcare, dirty drinking water, and whole host of regressive taxes, tolls, fees, fines, and other revenue burdens (see, e.g., "West Virginia," Institute on Taxation and Economic Policy, accessed August 8, 2026).

West Virginia is a public health, healthcare, and human rights disaster area. Will it ever change? One would hope so, but I'm not holding my breath. If you value your health, and you're not rich, you would do well to avoid West Virginia as a place of residence. I hate to say that, because there are nice things here too, for example, the natural beauty of the mountains, forests, and parks - but there's nothing more important than your health and the health of your family. To put it another way: scenery, fishing, and hiking are nice, yes... but you can't enjoy those things if you're dead.

Above: Gone are the days when West Virginia had representatives in Congress who cared about the people. Here, we see a newspaper excerpt from 1971 (Beckley Post-Herald (Beckley, WV), Feb. 9, p. 10), reporting on an attempt by Jennings Randolph, Democratic U.S. Senator from West Virginia, to "reactivate" the WPA in order to provide jobs and improve sanitation and healthcare across the country (note that the article gets some of the details about the original WPA wrong, such as the 1962 reference in the third column). The effort ultimately failed when Republican President Richard Nixon vetoed the bill. Randolph was a huge supporter of the New Deal, and West Virginia voters liked his policy positions. They put him in the U.S. House of Representatives from 1933-1947 and the U.S. Senate from 1958 to 1985, a total of 41 years in Congress. Unfortunately, since Randolph's time, Reagan Republicans and neoliberal Democrats have largely abandoned the people and focused more--or even exclusively--on representing their wealthy donors (e.g., tax cuts for the rich, shareholder primacy, financial de-regulation, letting infrastructure crumble, undermining unions, and allowing investors and executives to export good-paying American jobs). The result, especially for West Virginia, has been a public health, healthcare, and human rights catastrophe. Image from newspapers.com, and used here for educational and non-commercial purposes.