Inflammatory Bowel Disease (IBD) affects an estimated 3.1 million US adults, with an increasing prevalence in recent years1. Of these, 1.1 million live in the CDC classified “Southern” region, which includes the state of Kentucky. The eastern portion of the state is part of the Appalachian region, a low-resourced area with a dense, vulnerable population. The majority of Kentucky’s Appalachian counties are classified as distressed (ranked bottom 10% in the US based on economic development), and suffer a higher prevalence of chronic disease2.