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Appalachian Alabama in 2025

Marcus J. Hopkins
3 hours ago5 min read

Updated: 13 minutes ago

The image is a color-coded map of Alabama, illustrating the percentage of Appalachian adults who read at or below an 8th-grade level. The map uses a gradient color scale on the left, ranging from green at the bottom (42.4%) to red at the top (80.5%). Each county in Alabama is delineated and shaded according to the percentage it represents in this statistic. Counties such as Macon and Hale are in darker red, indicating a higher percentage. In contrast, counties like Limestone and Lauderdale are lighter, suggesting a lower percentage. The title at the top reads "Appalachian Learning Initiative." On the right, there's a text that states "Percentage of Appalachian Adults in Alabama Who Read At or Below an 8th Grade Level." At the bottom, there is the logo and name of "APPLI - Appalachian Learning Initiative" and a note indicating data from the National Center for Education Statistics, 2020. The bottom right corner shows social media icons and the text "Follow us @APPLIORG" alongside their website link.
Nearly 2 out of every 3 adults aged 16-65 read at or below an 8th Grade level, according to the most recent data from the National Center for Education Statistics

By: Marcus J. Hopkins

January 30th, 2025


In 2025, the Appalachian Learning Initiative (APPLI, pronounced like "apply") is doing a major overhaul of the state-level pages on our website.


These improvements will centralize all state-specific data and resources into each state's respective page, allowing site visitors to easily locate information that is relevant to their needs.


They will also add new data for visitors to explore, including data and infographics for over 35 different health conditions, such as asthma, arthritis, high blood pressure, and more, and over 20 different social determinants of health and learning, such as poverty, housing costs, energy costs, and other factors that are likely to contribute to both health and learning outcomes.


Alabama's page was the first to receive this overhaul, and we have been exceedingly proud to debut these changes over the past month. We invite visitors to explore these new data while we wait to see whether or not the current presidential administration will allow the Nation Center for Education Statistics to release the county-level findings from the 2023 round of testing using the Programme for the International Assessment of Adult Competencies.


As of the most recent data release, nearly 2 out of every 3 adults aged 16-65 (65.6%) living in Alabama's Appalachian counties read at or below an 8th Grade level, including more than 1 out of every 4 (26.3%) who read below a 3rd Grade level or are unable to read at all. When compared with the Appalachian counties in the other 12 states within the region, Alabama's Appalachian counties have the 5th lowest literacy proficiency rates. In 2024, Alabama received $10,431,377 in federal funds from the U.S. Department of Education through the Adult Education and Family Literacy Act (AEFLA), Title II of the Workforce Innovation and Opportunity Act (WIOA).


The image is a map of Alabama highlighting the percentage of Appalachian adults who struggle with basic math, presented by the Appalachian Learning Initiative. Counties are color-coded based on the percentage, with a gradient scale on the left indicating ranges from 52.2% to 90.0%. Each county is outlined in black and labeled with its name. Counties like Lauderdale and Colbert have higher percentages (indicated in red), while Limestone and Shelby have lower percentages (indicated in green). The map also displays a legend on the left with the color gradient and percentage scale. The top of the image reads "Appalachian Learning Initiative." There is a section at the bottom with a logo and text stating "Follow us @APPLIOrg" with various social media icons.
Nearly 3 out of every 4 adults aged 16-65 struggle to solve math problems with more than three steps

In addition to reading proficiency issues, nearly 3 out of every 4 adults (74%) struggle with bath math. These adults have trouble solving math problems with more than three steps, struggle with fractions and percentages, & are unable to perform basic tasks, like making correct change or budgeting finances.


When compared with the Appalachian counties in the other 12 states within the region, Alabama's Appalachian counties have the 6th lowest numeracy proficiency rates.


Adults with low literacy and numeracy proficiency rates face significant real-world implications and impacts.


Adults with low literacy skills face more difficulty finding and keeping jobs that provide wages capable of sustaining a family than their peers with higher literacy skills and are less likely to advance in their careers as a result of lower reading, digital, and critical thinking skills that might afford them more opportunities (Vineis, 2024).


Adults with low numeracy skills face similar difficulties, being less likely to be employed, less likely to earn sufficient wages, and often report being less healthy and having lower levels of life satisfaction. Additionally, modern technology has allowed companies across every sector to automate many manual labor jobs that traditionally employed adults with lower levels of literacy and numeracy (Organisation for Economic Co-operation and Development, 2024).


APPLI will continue to gather and report data that highlight educational disparities in Appalachian Alabama and across the region.

 

Health Outcomes in Appalachian Alabama

The image is a composite graphic illustrating high blood pressure prevalence in Alabama. On the left is a map of Alabama, color-coded by counties to indicate the prevalence of high blood pressure, ranging from 36.8% to 49.6%, with a gradient from light pink to deep red. Counties such as Hale and Macon, highlighted with the highest rates (49.6% and 48.4% respectively), are separately outlined on the right. The central section has figures representing adults, with a pink gradient indicating different blood pressure levels. Above, a caption reads "High Blood Pressure in Alabama." Below, a statement notes that 42.5% of adults in Appalachian Alabama have high blood pressure. The bottom of the image includes data attribution to the Behavioral Risk Factor Surveillance System, 2024. The background features a blurred image of a building and a clear blue sky.
More than 4 out of every 10 adults living in Alabama's Appalachian counties has been diagnosed with hypertension (high blood pressure) according to 2025 findings from the Behavioral Risk Factor Surveillance System (BRFSS)

Alabama's Appalachian counties tend to have significantly higher incidence and prevalence rates of both infectious and non-infectious diseases and health behaviors, including:


  • Higher cancer incidence and mortality rates than the state as a whole (National Cancer Institute, 2024);

  • Higher likelihood of being diagnosed with HIV than adults living in the state, as a whole, or across the nation (AtlasPlus, 2024);

  • Higher prevalence rates of asthma, arthritis, chronic obstructive pulmonary disorder (COPD), coronary heart disease, depression, and obesity than those living in the state, as a whole, or across the nation (Behavioral Risk Factor Surveillance System, 2024).


The image is a graphic illustrating barriers to healthcare access in Appalachia, featuring five interconnected rounded squares with orange borders, each containing a category: Geographic, Transportation, Communication, Income, and Age & Disability. Each category lists specific challenges written in white text on a blue background. The background is a gradient of different blue shades resembling rolling hills. At the bottom, in large white letters, is the main title, "Barriers to Healthcare Access in Appalachia." Below it is the logo for APPLI, Appalachian Learning Initiative, with its web address and social media icons.
The Social Determinants of Health are external non-medical factors that influence health outcomes (World Health Organization, 2025)

The link between educational attainment and poor health outcomes has long been established. Essentially, higher levels of educational attainment generally result in people making better health decisions and having greater access to employment opportunities and financial resources that enable easier access to high-quality health services (Shankar et al., 2013). Similarly, additional research also indicates that the health of learners can have profound impacts on educational attainment. Learners who are living with chronic illnesses, such as asthma, autoimmune diseases, diabetes, and other illnesses and syndromes, are more likely to miss school than their peers, which can impact their ability to complete work on time, take part in exams, participate in school and group activities, and/or physically maneuver through their learning environment. These factors can result in lower or poor academic performance (Victoria State Government, 2012).

 

Health Outcomes in Appalachian Alabama

The image is a graphic illustrating the energy cost burden in Alabama’s Appalachian counties. On the left is a map of Alabama divided by counties, with shades ranging from yellow to dark purple to represent energy costs as a percentage of gross household income. The legend below the map indicates that the scale ranges from 5% to 11%. Four counties, Fayette, Macon, Pickens, and Talladega, are highlighted in dark purple in the center of the image, each showing an 11% energy cost burden. The right side features text with a caption stating that Alabama’s Appalachian households spend an average of 8.4% of their income on energy, and that spending over 6% is considered a high energy burden. At the bottom right corner, there is a logo for the Appalachian Learning Initiative with a sunset and tree silhouette background.
Households located in Alabama's Appalachian counties pay an average of 8.4% of their annual incomes on energy costs compared to the statewide average of 7% and the national average of 8% (Greenlink Analytics, 2024)

In addition to facing significant health issues that may hinder educational attainment and outcomes, adults living in Alabama's Appalachian counties face substantial barriers—called social determinants—that may impact both health and learning.


For example:


  • Nearly 1 out of every 5 adults (19%) are living with a disability, compared to 16.2% statewide and 13.5% nationally;

  • More than 1 out of every 7 residents (15.9%) live in extreme poverty, earning less than 100% of the Federal Poverty Level (FPL), compared to 15.6% statewide and 12.4% nationally;

  • More than 1 out of every 7 adults (15%) have not graduated from high school or achieved an equivalent certification, compared to 11.8% statewide and 10.7% nationally;

  • More than half of households (56%) spend more than $200 per month on electricity costs, compared to 52.2% statewide and 33.3% nationwide.


The image is an infographic titled "Barriers to Learning in Appalachia" set against a background of abstractly illustrated hills in shades of yellow, orange, and red. Central to the image are five rounded squares containing lists of barriers related to geographic, transportation, communication, income, and health & ability factors. Each square has a yellow background with a blue outline. The geographic section lists issues like rural locations and educator salaries. The transportation section highlights long-distance travel and weather-related issues. The communication section notes low technology access and language barriers. The income section includes affordability issues. The health & ability section mentions disability prevalence and social isolation. At the bottom, there is a logo for the Appalachian Learning Initiative with their website, followed by social media icons and the handle "@APPLIOrg."
SDOLs are social and structural factors outside the individual learner, often beyond the traditional reach of teachers and schools, that can affect learning (Levinson & Cohen, 2023)

Similar to how social determinants can impact health, they also impact learning—a framework called the Social Determinants of Learning™ (SDOL™). SDOLs are social and structural factors outside the individual learner, often beyond the traditional reach of teachers and schools, that can affect learning (Levinson & Cohen, 2023). These include healthcare access and quality, economic stability, neighborhood and built environments, social inclusion and non-discrimination, educational access, the quality of educational opportunities and institutions, and family group and structural conflicts.


You can discover more information about social determinants and health issues in Alabama's Appalachian counties on our dedicated page:


 
The image features a light beige background with a series of horizontal, curved stripes in shades of brown, red, orange, and yellow, emanating from the left side toward the right. In the upper left corner, there is a logo of the Appalachian Learning Initiative (APPLI) with a stylized illustration of a bridge in yellow and black. In the middle of the image, there is a black and white QR code. Text at the top reads, "Help support our research, reporting, and advocacy." At the bottom, the text reads, "https://www.appli.org/donate."

APPLI will be working to update these data across all of Appalachia throughout 2025 to ensure they are current.


We know that many people living and working in Appalachia are struggling, and hope that you will consider making a donation, if you are able to do so. APPLI operates entirely off of donations, which cover all the costs associated with running a non-profit, including website hosting, content creation, research, and software licenses. We try to keep costs as low as possible, with the entirety of APPLI's team serving in a volunteer capacity.


To donate, please visit our donation page:



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