It’s rare that someone’s obituary becomes a worldwide phenomenon, particularly when the deceased is an ordinary resident of a rural community. But the recent death of 30-year-old mother Madelyn Linsenmeir caught the attention of the world. In her obituary, published in The Burlington Free Press, Madelyn’s sister wrote of the devastation addiction had wrought on their family. The opioid epidemic had a face, and a story people could recognize. The scale of the problem is so vast,it is easy to treat it as a condition of the world, rather than a problem that has solutions.
According to the American Psychiatric Association one-third of Americans have been touched by addiction to these drugs. Glance at any recent news story about Appalachia and the ravages of the opioid drug epidemic is likely to be the topic. Or, pick up a story about drug overdoses and you are going to find a mention of the tragic losses in rural areas. Google search trends for overdose, opioid and drug recovery show states like West Virginia, Kentucky, Tennessee, Ohio, and Virginia at the top of the rankings.
Appalachia, particularly its rural areas, face both individual and systemic factors that affect their capacity to help their people. The County Health Rankings, a product of the Robert Wood Johnson Foundation,highlights the role of physical and environmental factors in obtaining indicators of community health.
Specifically, about 50% of the factors determining the length and quality of a person’s life are related to housing, access to services, and education. Rural communities face hospital closures, rising infant mortality rates, and the absence of affordable health insurance or reasonably priced procedures. They are systematically disadvantaged in the fight against addiction. Poisoning is the category where overdose deaths are tallied. In Appalachia, the rate of poisoning is 42% higher than in the US as a whole. Mortality rates for suicide are 18% higher than for the country as a whole. The magnitude of resources required for regional recovery from the drug crisis, as well as its reach across multiple state demands a federal response, but the expertise to implement solutions at the neighborhood level require the focused, local knowledge of community leaders.
This region needs solutions that are scaled for the diversity, geography, and size of an area comprising more than 400 counties across 13 states. That also means one-size-fits-all programs simply won’t succeed. In addition to treating the symptoms of the opioid addiction crisis,by investing in recovery centers, expanding access to health care, and increasing the availability of practitioners, policy makers must also treat the underlying causes, lack of primary care, jobs, education, and affordable,decent housing. Deploying a response of this magnitude requires the front-line,first-hand expertise of community leaders, such as those in the Fahe Network.
In the past decade Fahe has leveraged millions of dollars to directly support drug recovery in Appalachia, saving state governments tens of millions which can be redirected into other critical infrastructure. At the same time, local leaders, supported by the Fahe Network, have woven partnerships across the health, housing, and economic development sectors within the fabric of their communities. Programs like the“Farm”acy in Whiteburg, KY have connected local nursing students with the area farmer’s market, with funding for prescriptions for healthy, fresh, locally sourced foods. The Appalachia HEAT Squad® (AHS) has taken federally funded ARC POWER funds and gone to work repairing homes and restoring shelter that keeps families warm and healthy. The Appalachia Heat Squad eliminates mold, drafts, and reduces the cost of heating and cooling bills.
Fahe believes that in order for all Americans to have a good life, with a stable job, in a healthy community, investments in public health must focus also on socio-environmental determinants. This can seem abstract and complex. However, in Appalachia, as well as other persistent poverty areas, it’s also as simple as fixing up a house at a time, a neighborhood at a time, a community at a time. It’s simple, but not easy. The fact is that the neighborhood a person calls home greatly influences their health. It’s time to invest in that truth. Put simply, if the neighborhood has the elements of a place that can thrive, so will its people. When it doesn’t,they are at much greater risk for addiction, disease, and premature death.