CINCINNATI (AP) - Poverty, lack of health insurance and unhealthy lifestyles give Appalachian counties in southern Ohio some of the state's highest death rates, researchers say.

"It's a combination of all those factors," Susan Isaac, who leads a state Appalachian Task Force, told The Cincinnati Enquirer for a story yesterday. "We're talking about some of the deepest poverty in the state."

Pike County had the highest death rate in Ohio, 47 percent higher than Delaware County north of Columbus, which had the lowest rate in the state, a Cincinnati-based agency reported in a new study.

The study of the 15 leading causes of death finds that Adams, Pike, Scioto, Vinton, Jackson and Lawrence counties are among the 11 counties with the highest death rates in the state. The Health Planning & Resource Development Association of the Central Ohio River Valley completed the report.

Congress could help by making prescription drugs more affordable to the public, said Rep. Ted Strickland, D-Ohio, who represents much of rural southern Ohio.

"There still are many thousands of people, including children, who do not qualify for any existing health care program," Strickland said.

Strickland had not seen the study, but said the results described in the newspaper did not surprise him.

Gary Roberts, director of Pike County's Family Health Center in Waverly, said some members of his family have developed problems because of smoking and poor eating habits.

"I try to live a healthy lifestyle, but there's a resistance here toward seeking out preventive health care," Roberts said. "People won't change their diets or start exercising."

High unemployment rates are linked to the death rates, experts said. The unemployment rate for Adams County last June was 7.8 percent. An estimated 28 percent of residents lack health insurance, compared with the state average of around 11 percent.

Smoking rates are high, obesity is common and dietary habits are poor, health experts said.

"There's a sort of fatalism in Appalachian people," Roberts said. "They say, 'We're all going to die anyway. Something's going to get you, so why bother?'."

In many rural counties, cuts in federal grants have forced health clinics to educate residents.

Joe Doodan, executive director of the Ohio Primary Care Association, said rural health care problems have been overlooked for too long.

"None of these problems is new," Doodan said. "The question is, what are we going to do about them? We need to get out there, pick some communities and see if we can make some change."