Michael Meit Publishes on Appalachian Diseases of Despair

Michael Meit, Director of Research and Programs for the East Tennessee State University College of Public Health’s Center for Rural Health Research, has co-authored an article in the Journal of Appalachian Health.  The article, “Tracking the Impact of Diseases of Despair in Appalachia—2015 to 2018,” provides an update on mortality due to diseases of despair within the Appalachian Region, comparing 2015 to 2018.

Lead author Megan Heffernan and co-authors Margaret Cherney and Victoria Hallman are members of NORC at the University of Chicago.

The concept of diseases or deaths of despair originated from research by Case and Deaton that highlighted rising morbidity and mortality among white non-Hispanic Americans from three main causes: alcoholic, prescription drug, and illegal drug overdose; suicide; and alcohol liver disease/cirrhosis of the liver. The initial Case and Deaton article was published in 2015, at a time when life expectancy in the U.S. fell for the first time in decades, and many researchers began to hypothesize what may be contributing to this decline. This also marked the beginning of the surge in drug overdose deaths in the U.S., driven by rapid increases in deaths from synthetic opioids, such as fentanyl.

Between 2015 and 2017, the diseases of despair mortality rate increased in both Appalachia and the non-Appalachian U.S., and the disparity grew between Appalachia and the rest of the county. In 2018, the diseases of despair mortality rate declined by 8 percent in Appalachia, marking the first decline for the Region since 2012. Diseases of despair continue to impact the working-age population, and while males experience a higher burden of mortality due to diseases of despair, the disparity between Appalachia and the rest of the United States is greater for females. Overdose mortality rates in Appalachia increased between 2015 and 2017, followed by a decline in 2018. During this same time frame, suicide also increased notably within the Appalachian region, and the disparity between Appalachia and the non-Appalachian U.S. increased by 50 percent.

These findings document that the diseases of despair continue to have a greater impact in the Appalachian Region than in the rest of the United States. While the declining trends between 2017 and 2018 are promising, data has shown that these rates are likely to increase again, particularly as a result of the COVID-19 pandemic.