Honors Thesis
I used a multi-level geographic approach which started at the international level and drilled down to the county level. I focused on the Appalachian Region, the area of the country that was hit the hardest by the epidemic.
There are two primary characteristics of the region that made it vulnerable to opioids: the composition of the economic sector and the concentration of rural counties. The region relied heavily on manufacturing and mining jobs which have high rates of work-related injuries. These lead to people suffering from chronic pain and subsequently seeking out prescription pain relievers – opioids.
The job make up also made the region more susceptible to the negative effects of globalization compared to the rest of the US. Factory shutdowns on account of international trade were most prevalent in Appalachia and between 1999 and 2015, opioid overdose rates were higher in counties where job loss was greater (Dean and Kimmel 2019).
The large number of rural counties in Appalachia created obstacles in mitigating the crisis – limited access to healthcare (and a lack of adequately trained health professionals), treatment, resources and social programs.
Aly Axman 