Problems of access to health care facing Appalachia mountain communities are confounded by unemployment, poverty, low education, and local religious beliefs that barrier people from receiving medical care. This proceedings addresses the issues related to health access and health needs. It contains 20 papers and 12 synopses of presentation. The proceedings includes four sections: (1) overviews of health problems in Appalachian region, with discussions on political economic context, health behavioral patterns, anthropological view of mental health, new ways of rural medical practice, financial issues of health care system, and social analysis of illness in the region; (2) empirical research reports on health needs and attitudes, encompassing community survey of health experiences, case study of the homeless people's health needs and rural health care payment system, and field work on health behavior of women, adolescents, and other groups; (3) description and evaluation of demonstrative projects, ranging from rural hospital alliance, services for rural elderly and children, to community involvement of health care system; and (4) summaries of papers on more specific research topics that may be of interest to narrower audiences. This document contains numerous tables, charts, graphics, and references. (DHP/GGH)