Overall, the mortality rate of diseases of despair in Appalachia in 2022 was still 37%
higher than the rest of the United States outside of Appalachia.  

“Appalachian Diseases of Despair,” a new report from the Appalachian Regional Commission (ARC) co-authored by East Tennessee State University’s Michael Meit, found that diseases of despair mortality in Appalachia decreased by 4% between 2021 and 2022 while remaining virtually unchanged in the rest of the United States.  
 
“Diseases of despair” is a term used to describe mortality from drug and/or alcohol overdose, suicide and alcoholic liver disease. 
 
Overall, the mortality rate of diseases of despair in Appalachia in 2022 was still 37% higher than the rest of the United States outside of Appalachia.  
 
Meit, director of the ETSU Center for Rural Health and Research in the College of Public Health, co-authored the report with Megan Heffernan of the NORC Walsh Center for Rural Health Analysis.  
 
The Appalachian Region continues to experience higher rates of mortality from the diseases of despair for all age groups, most notably the 35 to 44 age group, which represents individuals in their prime working and child-rearing years. This has significant implications, particularly in terms of economic development and children’s health and well-being. 
 
While such mortality rates appear to have either peaked or plateaued in 2021 during the COVID-19 pandemic, the rates remain higher than in the “pre-pandemic” year of 2019, when declines had occurred following the previous peak in 2017. 
 
"The data revealed the devastating impact of the COVID-19 pandemic beyond the deaths directly attributable to the virus," said Michael Meit, director of the East Tennessee State University Center for Rural Health and Research. "Like the rest of the United States, the Appalachian Region experienced economic and other challenges as a result of the pandemic – including the increased isolation and limitations on access to in-person treatment and recovery support, which exacerbated deaths due to diseases of despair. However, the Appalachian Region appears to be rebounding more quickly than the rest of the country.”  
 
To address the issues around substance use across Appalachia, ARC awarded nearly $11.5 million to 39 projects through its Investments Supporting Partnerships in Recovery Ecosystems (INSPIRE) Initiative, which aims to address the impact of substance use disorder (SUD) in Appalachia with investments in projects that create or expand services in the recovery ecosystem leading to workforce entry and re-entry.  
 
ARC’s 2024 INSPIRE grantees will strengthen the SUD recovery ecosystem in 127 counties in nine Appalachian states—Kentucky, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia, and West Virginia— by expanding recovery-focused partnerships, peer support and other wraparound services, and skills and workforce training programs that help prepare individuals in recovery for meaningful job opportunities.  
 
Learn more about ARC’s INSPIRE Initiative and the newest INSPIRE grantees here. 
 
Earlier this year, ETSU also announced the creation of the Regional Public Colleges and Universities (RCPU) Central Appalachia Health Consortium, part of ARC’s Appalachia Regional Initiative for Stronger Economies, to address health care workforce challenges, foster economic development and promote regional prosperity in Central Appalachia.  
 
The consortium will explore a variety of strategies for working together and impacting health and economic outcomes in central Appalachia. These include articulation agreements, local pipeline development, cross-institution internships, in-state tuition arrangements, elective options, streamlined applications and preferred admissions.  
 
To learn more about the ETSU Center for Rural Health and Research, visit https://bit.ly/3TGN2su.   

East Tennessee State University was founded in 1911 with a singular mission: to improve the quality of life for people in the region and beyond. Through its world-class health sciences programs and interprofessional approach to health care education, ETSU is a highly respected leader in rural health research and practices. The university also boasts nationally ranked programs in the arts, technology, computing, and media studies. ETSU serves approximately 14,000 students each year and is ranked among the top 10 percent of colleges in the nation for students graduating with the least amount of debt.

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