Booneville, KY—like many small towns across Central Appalachia—is medically underserved due to a combination of geographic isolation, limited healthcare infrastructure, and persistent poverty. Located in the heart of Appalachian Kentucky, Booneville has no hospital and only minimal clinic services, forcing residents to travel 35–60 minutes or more for emergency or specialist care—delays that can be life-threatening. The town sits in Owsley County, one of the most economically distressed counties in the region, and has been designated medically underserved since 1978. These challenges—low provider-to-population ratios, high chronic disease rates, aging populations, limited transportation, and severe staff shortages—are echoed in many neighboring communities. In Booneville and beyond, access to mental health care remains especially strained due to a lack of in-network providers. The healthcare access crisis in Booneville reflects a broader regional struggle faced by rural Appalachian towns throughout Eastern Kentucky and beyond.