Medical Mistrust in Appalachia

Book Cover Design

Client: UT Press
Art Direction and Design: Elisa Razak

COVID was a key turning point in a culture of medical mistrust in the rural South. I experienced it firsthand living in East Tennessee during peak pandemic when vaccine hesitancy was rampant. The book examines beyond the skepticism to reveal the exploitation of the underserved, an ongoing war on science and how providers can treat with humility. It was an eye opener for me and it challenged my own misconceptions. The selected cover takes inspiration from narrative quilting to construct the future of Appalachian healthcare. It is one that honors the culture and community it serves. The quilt weaves traditional medicine with Appalachian folk medicine such as herbal remedies, faith practices and spiritual healing.

Alternate Cover

We explored a second cover inspired by a sketch provided by the authors. It depicts a copperhead in the form of the Rod of Asclepius — the ancient Greek symbol of medicine — aggressively reaching towards people. While evocative and eye catching, it felt quite dark and didn’t fully capture the essence of the book. The authors eventually decided on the quilt cover for a more hopeful and forward-looking interpretation.