Generational Change, Folk Medicine, and Medical Self-Care in a Rural Appalachian Community

This paper reports on a study of the potential impact of folk medicine on health care delivery in a rural community in southwestern Virginia. The intent of the investigation was to examine some commonly held stereotypical notions within and outside the medical community about rural Appalachians and medical self-care. Interviews were completed with 102 respondents aged 60 and over who were asked what they would do today and what their parents did when they were growing up to treat 65 symptoms of illness. Responses were grouped into 11 treatment categories, including botanical, non-processed natural substances, foods, home articles, proprietary medicines, other commercial medicines, magico-religious, and formal medical care and then analyzed in terms of generational change. Our findings indicate that dependence on folk medicine has declined considerably from one generation to the next, particularly with regard to the application of traditional home remedies and magico-religious beliefs and practices. Contrary to popular belief about rural Appalachians, a theodicy of suffering as related to the cause of illness was not evident. Faith healing, as manifested in either personal or communal prayer, was advocated by the majority of our respondents, but, not to the exclusion of conventional medicine. While folk medical beliefs and practices have not vanished entirely, our findings indicate that the patterns of medical self-care of our respondents are largely congruent with mainstream American culture and, that an essentially positive attitude toward conventional medicine exists in the community.