The Price Appalachia Paid
By We’re still calculating the ways in which the opioid epidemic hit Appalachia:
The local effects of this decline are well known. “Population losses erode local tax bases, strain the provision of public goods, and generate fiscal pressures that are difficult to reverse, particularly in areas with fixed infrastructure and aging populations,” the authors note.
This describes much of Eastern Kentucky, as The Lantern has documented.
Most of the population decline in the mountains is due to both the demise of the coal industry and the lackluster development policies of federal and state governments.
What these researchers have found is a new cause of the collapse. People were also pushed out by the opioid epidemic. And not only did places lose people, they lost their most educated citizens.
The researchers compared commuting zones, groups of counties tied together economically. They determined which zones had high rates of cancer mortality in 1996, the year Purdue began marketing OxyContin as pain treatment for cancer patients. Records show that Purdue concentrated its sales efforts in these communities – and these are the areas where the opioid epidemic started.
From 1996 to 2019, commuting zones with high cancer rates showed increased outmigration, the researchers found. The people who left were largely those who had more than a high school education. Residents with only a high school diploma also moved out of these areas, but at half the rate of their neighbors with more education.
“Our findings reveal that the epidemic triggered profound demographic adjustments that ultimately reduced population growth in the communities most affected,” the authors wrote, “and that will continue to shape their social and economic trajectories.”
Where did these people go? On average, they moved to areas that had lower cancer mortality rates – and thus away from the growing opioid epidemic.
The authors believe the better-educated migrants experienced a “negative amenity shock.” The opioid epidemic affected “local quality of life.” Crime increased. Neighborhood conditions worsened. Emergency calls surged as “emergency naloxone administrations became commonplace in public spaces.” Homelessness became more common.
When communities collapse politics get hard. 2004:
2008
2012
Opioids aren’t the only reason for this (the process was underway in the 1990s, although the coalitional aspects are weird even then) but it’s definitely one of the contributing causes.