Appalachian Diseases of Despair research study released
JOHNSON CITY (March 10, 2023) – “Appalachian Diseases of Despair,” a new report from the Appalachian Regional Commission co-authored by Michael Meit from the East Tennessee State University Center for Rural Health Research, finds that diseases of despair mortality had begun to decline between 2017 and 2018, but dramatically surged in 2020, likely due to the COVID-19 pandemic.
Between 2019 and 2020, the diseases of despair mortality rate increased by 24% in the Appalachian region and 20% in the non-Appalachian United States. In 2020, the rate was 37% higher in the Appalachian region than the rest of the U.S.
“Diseases of despair” is a term used to describe three types of health conditions, notably drug and/or alcohol overdose, suicide and alcoholic liver disease.
“This is now the third time that we have analyzed these data for the Appalachian region. Our analysis of 2018 data left us with optimism as we had seen a modest decline in overdose mortality. That was short-lived, however,” said Meit, director of ETSU’s Center for Rural Health Research in the College of Public Health and NORC senior fellow, who led the research study. “Our latest data, from 2020, include the first year of the COVID-19 pandemic, which created new stressors in our region, and we have seen rates spike once again. We need to leverage the strength, resilience and creativity of our Appalachian people to regain our lost footing and re-establish the progress that we were making in 2018.”
When it came to the individual diseases of despair mortality rates, the region’s overdose rate was 50% higher, the suicide rate was 25% higher, and the liver disease/cirrhosis rate was 16% higher in Appalachia than the rest of the country. More detailed analyses of opioid-related overdose deaths showed that in 2020, opioids caused 77% of overdose deaths in Appalachia (7,011 total deaths).
Within Appalachia, all subregions experienced a notable increase in diseases of despair mortality between 2019 and 2020. In 2020, North Central and Central Appalachia had the highest and second-highest rates of 140.6 deaths and 137.7 deaths, per 100,000, respectively. Between 2019 and 2020, Central Appalachia experienced a 41% increase in diseases of despair mortality, and South Central and North Central Appalachia both experienced increases of at least 30%.
The Appalachian Diseases of Despair research study was conducted by the Walsh Center
for Rural Health Analysis at NORC at the University of Chicago and the Center for
Rural Health Research at ETSU, and it draws on 2020 mortality data from the Centers
for Disease Control and Prevention. The report is a follow-up to similar research
released in 2020 when both the Appalachian region and the non-Appalachian U.S. experienced
the first decline in the all-cause mortality rate since 2011 to 2012.
About the Walsh Center for Rural Health Analysis
NORC’s Walsh Center for Rural Health Analysis, established in 1996, conducts timely
policy analysis, research and evaluation that address the needs of policymakers, the
health care workforce and the public on issues that affect the health and well-being
of rural Americans. The Walsh Center is part of NORC at the University of Chicago,
an objective, non-partisan research institution that delivers reliable data and rigorous
analysis to guide critical programmatic, business and policy decisions.
About ETSU’s Center for Rural Health Research
Founded in 2019, the Center for Rural Health Research is housed within the East Tennessee State University College of Public Health. The Center works in partnership with local, regional, statewide and national organizations and topic-area experts to identify and study innovations to improve health and enhance the quality of life of people living in rural communities across Tennessee, Central Appalachia and around the nation.