| Popis: |
Middle-aged white adults in America are expiring at alarming rates, succumbing to what Case and Deaton term "deaths of despair" as a result of drug overdose, suicide and alcohol-related diseases. This chapter extends theory on deaths of despair to Appalachia, summarizing trends in mortality and morbidity across the region due to these causes. It finds that not only do disparities in deaths of despair affect Appalachia compared to the rest of the United States, but they also appear subregionally, within groups of counties. Central Appalachia carries the highest burden, with widespread overdose deaths, high rates of suicide and many alcohol-related diseases frustrating efforts to improve population health. The chapter also illustrates the potential mediating effects of urbanicity and gender, with those who are male or residing in more urban counties facing smaller disparities (compared to non-Appalachian counterparts) than women or rural dwellers do. The recent uptick in opioid overdose deaths cannot be ignored as a major contributor to the deaths of despair in Appalachia, and the authors present a compelling case for more scholarly attention to opioid overdose in particular. |
