A Glimpse into Menstrual Health Literacy in Appalachian Ohio

Abstract

Evidence supports that health literacy is intricately linked to education level. Appalachian Ohio reports the second lowest percentage of postsecondary education in Appalachian states, which falls 10% below the national average. Coshocton, Ohio is located in North Central Appalachia and is classified as a high poverty rural area. Prior research has established that youth across the United States often lack adequate menstrual health education, which could lead to delayed recognition of serious health issues. Currently, the Ohio Department of Education does not require menstrual education as part of broader sexual health education in schools. Given the low rates of higher education, and thus health literacy, along with lack of state required menstrual education, low levels of menstrual health literacy might disproportionately affect this area. Within the same month at an outpatient clinic in Coshocton, Ohio, two adolescent females and their mothers, who also grew up in Appalachian Ohio, presented with menstrual concerns. Both parties expressed concerns about early menarche, cycle length, menstrual flow, and clots. In both cases, the patients were experiencing clinically normal menstruation. The patients and their mothers were counseled on normal range menses. Research surrounding menstrual health literacy in rural areas is lacking. The presented cases may point to a pattern of inadequate menstrual education in Coshocton, Ohio, as the patients and parents were unaware of normal menstrual patterns. In order to progress patient care, further research should aim to discern whether this area and greater Appalachia demonstrate lower levels of menstrual health literacy. Patients in Appalachia demonstrate lower education levels, which is correlated to lower health literacy. These cases highlight potentially inadequate menstrual education in Coshocton, Ohio. Further research and improved menstrual education should be pursued in the area.