Report: 'Deaths of despair' decrease across the country, but Appalachia still sees the highest mortality rates

Opioids are one of the biggest drivers of deaths of despair
in Appalachia. (Photo by S. Pollio, Unsplash) 

The U.S. mortality rate from "deaths of despair" has declined by 5%, according to a report by researchers at the University of Chicago and East Tennessee State University. The decrease means such deaths, which are commonly linked to drug overdoses, alcohol and suicide, are hovering near pre-pandemic levels, reports Liz Carey of The Daily Yonder. 

Despite the encouraging news, deaths of despair remain disproportionately high in Appalachia, where drug overdoses are considered the "primary factor driving the difference."

Michael Meit, the director of the Center for Rural Health and Research at ETSU and a co-author of the report, believes the reasons for the higher rate of deaths of despair in Appalachia aren't fully known. He told Carey, "I think there are a lot of complexities to it, and I don’t know if we know all of the answers."

The new report is the "latest update to research started in 2017," Carey explains. "At that time, Appalachian mortality from overdose, alcohol, and suicide was 44% higher than it was in the rest of the country." Despite a decreasing mortality rate since 2017, the number of Appalachian deaths of despair remains stubbornly higher than the rest of the U.S.

The decrease in the number of deaths by despair isn't happening evenly across all age groups. Millennials are a generation that has lost thousands of lives to deaths of despair. Carey reports, "According to a report by Trust for America’s Health, the largest number of deaths from overdoses, alcohol, and suicide in the 25- to 44-year-old demographic has steadily increased since 2017." 

The report singled out opioid addictions and overdoses as the biggest driver of Millennial deaths of despair. As a result of those findings, the Appalachian Regional Commission awarded "nearly $11.5 million in 2023 to nearly 40 projects across the region to address the impact of substance use disorder," Carey writes.

But regional progress is slow. Meit told the Yonder, "You don’t necessarily see a region-wide impact, but you see really strong community-based efforts that impact those communities. And as you reduce numbers in any given community, that has a broader impact across the region.”

Federal grant cuts over DEI leave rural students and teachers with few options to replace funding and its benefits

Canceled federal grant money is more difficult for rural
schools to replace. (Adobe Stock photo)

Efforts to root out inclusion and equity programming prompted the Trump administration to slash educational grants, leaving rural schools in a lurch. 

The lost grant money, which funded additions such as counselors to teach mental health education, additional academic tutoring options for students and learning initiatives for teachers, is difficult for rural communities to replace.

"Federal dollars make up roughly 10% of education spending nationally, but the percentage is significantly higher in rural districts," reports Annie Ma of The Associated Press. "When the funding is reduced, many districts have no way to make up the lost money."

Since President Donald Trump returned for a second term, his administration has cut millions of dollars earmarked for "programs supporting mental health, academic enrichment and teacher development," Ma writes. Republican lawmakers defended the cuts, saying the canceled grants focused on diversity and inclusion agendas -- not academics.

In Kentucky, the loss of grant funding means student counselors and supportive programming in rural counties will most likely come to a premature end, along with the student and staffing advantages they provided. 

In Shelby County, Ky., where federal spending "makes up about 18% of schools’ budgets," Ma reports. "The programs are not political, Superintendent Joshua Matthews said, and the funding loss only hurts students."

Matthews told Ma, "We’re not promoting anything one way or the other.”

The Department of Education recently announced a new round of mental health grants, but these funds require schools to hire psychologists, not counselors. Unfortunately, there is a national shortage of school psychologists and rural schools that attempt to recruit one will compete with larger, more urban schools.