County-level map details nation's high rates of sick seniors; Appalachian counties among worst

County-level maps show that two-thirds of Medicare beneficiaries older than 65—especially those in central Appalachia—have multiple chronic conditions, and more than 4 million— about 15 percent—have at least six long-term ailments, according to analysis by USA Today and the Courier-Journal in Louisville, Meghan Hoyer reports for USA Today. "Those sickest seniors account for more than 41 percent of the $324 billion spent on traditional Medicare."

"Yet they also are living longer, leaving them to grapple with diseases such as diabetes, asthma, high blood pressure, high cholesterol, heart failure, depression and even Alzheimer's for years—sometimes decades," Hoyer writes. "The result: neither the medical system nor most seniors are prepared for the financial and emotional crisis ahead."

The number of counties where 75 percent of senior Medicare beneficiaries have multiple chronic conditions has gone up 20 percent since 2008, Hoyer writes. "Diagnoses of kidney disease, depression and high cholesterol have seen double-digit increases in that time. More than half of all Medicare beneficiaries have been diagnosed with high blood pressure; 27 percent have diabetes."

The problem is especially bad in Central Appalachia. Among Kentucky's top 10 counties for sick seniors, nine are located in Appalachia, Laura Ungar reports for the Courier-Journal. Kentucky's top 10 counties all rank in the top 50 nationally. In Clay County, which ranks first in Kentucky and 12th nationally, nearly 38 percent of the population lives below the poverty level, almost double the state average of 19 percent. Two West Virginia counties— Logan and Mingo—rank in the top 50. (For an interactive version, click here)