Could health care jobs replace coal in Appalachia?

The hospital in Pikeville, Ky., employs 3,100 people.

A recent PBS NewsHour broadcast explored whether health care can replace coal as the main source of jobs in rural Appalachia, a region with more than its share of health problems. It was the first installment in a series called "The Future of Work," examining how jobs are being affected by increasing automation and globalization.

Amna Nawaz focused on Pikeville, Ky., population 6,700, in a county of about 65,000. High-paying coal jobs were once its lifeblood, no longer. "Some experts say to make up for the wages and revenue lost in that time, it would take 30,000 new jobs today. Pikeville is now trying to fill some of that gap by shifting to health care, and investing in its hospital system, serving 450,000 people across three states," Nawaz reports. "It also employs 3,100 people, nearly half of Pikeville's population."

Nawaz spoke with second-year medical student Olivia Boyette, who comes from a long line of coal miners. Boyette wants to become a doctor because "We have some of the sickest of the sick, when you talk about respiratory cancer or heart disease."

Burton Webb, president of the University of Pikeville, says he's trying to fight brain drain and keep more promising students like Boyette in town. "One of the major purposes of being in a place like this is so that we can retain people who live here," Webb told Nawaz. "They can train here, they can learn here, grow here, and then keep their families here. And it helps that we have an enormous hospital in town. It's a regional medical center. And so there's a place for them to come and to practice and to live."

Boyette said wants to stay in her home town after college because "I don't just want to help people. I want to help my people. Pikeville, Kentucky, and the surrounding areas is a very unhealthy area. There's a lot of tobacco. There's a lot of alcohol abuse. There's a lot of obesity. I feel like I want to give back to my community."

Jessi Troyan of the Cardinal Institute, a the conservative think tank, said he worries that Pikeville's medical boom might not last, since most of the region's patients rely on Medicaid. He asked Nawaz, "Pikeville has really capitalized on the Medicaid type of expansion dollars coming from the federal government, and should the political winds shift, you know, does Pikeville have to rewrite their story again?"