Appalachian Diseases of Despair, a new report from the Appalachian Regional Commission (ARC) co-authored by Michael Meit from the East Tennessee State University Center for Rural Health and Research and Megan Heffernan at the NORC Walsh Center for Rural Health Analysis, finds that diseases of despair mortality decreased by 4% in the Appalachian Region between 2021 and 2022, while remaining virtually unchanged in the rest of the United States. However, the diseases of despair mortality rate in 2022 was still 37% higher in the Appalachian Region than in the non-Appalachian U.S.
“Diseases of despair” is a term used to describe mortality from drug and/or alcohol overdose, suicide and alcoholic liver disease.
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 diseases of despair 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.