Creating a Culture of Health in Appalachia: Disparities and Bright Spots is an innovative research initiative sponsored by the Robert Wood Johnson Foundation (RWJF) and the Appalachian Regional Commission (ARC) and administered by the Foundation for a Healthy Kentucky. This multi-part health research project will, in successive reports: measure population health and document disparities in health outcomes in the Appalachian Region compared to the United States as a whole, as well as disparities within the Appalachian Region; identify "Bright Spots," or communities that exhibit better-than-expected health outcomes given their resources; and explore a sample of the Bright Spot communities through in-depth, field-based case studies. Taken together, these reports will provide a basis for understanding and addressing health issues in the Appalachian Region. This research initiative aims to identify factors that support a Culture of Health in Appalachian communities and explore replicable activities, programs, or policies that encourage better-than-expected health outcomes that could translate into actions that other communities can replicate.This first report, Health Disparities in Appalachia, measures population health in Appalachia and documents disparities between the Region and the nation as a whole, as well as disparities within the Appalachian Region