Graphic: rock and lichen formations in Virginia's Sand Cave, Cumberland Mountains; photo by Annette Sorah

Although composed predominantly of Indo-European settlers, populations from Asia, Africa, and Central and South America, as well as indigenous Indian Nations and Melungeons (a unique ethnic group of mysterious origin), have contributed diverse skills for building and maintaining the region's farmlands, industrial and urban centers, and its distinctive mountain music, dancing, literature and graphic arts. La Raza, "people who are descendants of or come from Mexico, Central America, South America, and the Antilles," now form a significant part of the labor force, some but not all of it migrant, for Appalachian agriculture.

Graphic: In the Blue Ridge Mountain region of Tennessee and Virginia, Shenandoah River-South Fork

For a number of reasons -- including education, air and water pollution, employment and wage levels, access to modern health facilities, and dietary tradition -- Appalachian citizens still fall below national norms on various scales of medical well-being. For instance, to quote from a January 1999 Associated Press article: "Americans die from heart disease at a significantly higher rate in the Appalachian region than in the nation as a whole, government health officials said. The Centers for Disease Control and Prevention reported that coronary death rates were 19 percent higher for white men and 21 percent higher for white women living in the mountain and highland region, compared to national rates. Death rates for Appalachian black men were slightly higher than those for black men nationwide, and the rate for black women was almost the same in Appalachia and the nation, the CDC said. The rates for Appalachian blacks, as in the nation were higher than for whites. The CDC defined Appalachia as West Virginia and parts of Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia." Targeted and large-scale effort throughout the twentieth century by federal and state governments -- most particularly programs of Roosevelt's New Deal and Johnson's Great Society -- altered the socio-economic quality of Appalachian life. Currently funded programs concentrate on rural health education, creation of affordable clinic facilities, acquisition of up-to-date diagnostic tools, and financial incentives attracting personnel trained in techniques of modern medicine to Appalachia's backcountry areas.

Graphic: One of Tennessee's atali(Cherokee: mountain)-ringed TVA lakes

Through friendship and war, European settlers incorporated from tribes of the Indian Nation nomenclature and agricultural techniques into a nascent and enveloping New World culture. The three major indigenous Appalachian populations are: Shawnee throughout what is now Kentucky; Cherokee in Tennessee and North Carolina; and Choctaw through Alabama and Mississippi. Among other regional tribes are: in Alabama, Mobile and Creek; in Mississippi, Biloxi and Taposa; in Georgia, Yuchi; in South Carolina, Catawba; in North Carolina, Saponi and Tatelo; in Virginia, Monacan and Conoy; in West Virginia, Unami, Nanticoke and Iroquois; in Pennsylvania, Susquehanna and Munsee; in New York, Pequot; in Massachusetts, Massachuset; in Vermont and New Hampshire, Nauset, Nipmuc and Mohican; in Maine, Pennacook, Passamquoddy and Penobscot.