Unconscious addicts are so frequently dumped in the hospital parking lot that administrators developed a special alert system to treat them. Paramedics have plucked overdose victims from roadside ditches, from the Walmart parking lot, and from living rooms across town. It has become routine for children to see a passed-out parent jolted to life with a dose of Narcan.
“Do you know how many houses we go into that the kids are sitting on the couch watching us?” said paramedic Christine Lerussi. …
The despair here echoes across the country. But the opioid crisis is particularly acute in Ohio. Last year, a record 3,050 people in the state died of drug overdoses. Overdoses from the potent opioid fentanyl more than doubled, to 1,155.
Spend a few days in East Liverpool and it’s easy to see why. Drug dealers from out of state flock to the desolate streets, selling powerful highs for $10 or $15 a pop. For too many residents, there’s little else: No jobs. No recreation. No long-term addiction treatment.
The fuck is this shit?
Pardon my language, but I have a tiny computer that fits in my pocket and lets me instantly access almost the entirety of human knowledge, talk to people from all over the globe, and play Angry Birds any time I want to. My TV offers hundreds of entertainment channels 24 hours a day. My kids are so ceaselessly entertaining and cute, you don’t want to get me started about all of the great things they did today. Like the good folks of East Liverpool, I have woods to walk in, rivers to boat in, lakes to fish in, a garden to tend, libraries to enjoy, and neighbors to chat with.
Where, exactly, does “recreation” come from? The magic recreation fairy? Is it dropped from the sky? Does it happen when someone builds a museum and starts showing Broadway musicals? (This is why no one does drugs in NYC, of course.)
Is there something about the soil in East Liverpool that prevents its residents from going on picnics, forming a sewing club, or reading a good book?
OF COURSE NOT.
There was no heroin epidemic here in the ’50s. Was there more “recreation” then?
No, there was far less. We had like 4 TV channels, and they stopped broadcasting at night. People didn’t have microwaves or clothes dryers, so housewives spent hours every day cooking and cleaning. With no AC and no video games, kids ran around outside, climbed trees, or rode their bikes. On Sunday they went to church. They had far less recreation and they still managed not to overdose on heroin in front of their children.
Recreation comes from people. Jobs come from people. Culture comes from people.
The ugly truth of the matter is that people today would rather drug themselves into oblivion than go on living.
South Precinct officers responded just before 9 p.m. to an apartment at Tom Brown Village public housing community on Fifth Court North. Neighbors called 911 after hearing the children crying inside the apartment and checked on them, only to find the mother and father unconscious inside.
When police arrived on the scene, they found the 30-year-old father dead on the kitchen floor. The 35-year-old mother was unresponsive on the couch but did have a pulse. Rescue workers were able to revive her with Narcan, and she was taken to St. Vincent’s Hospital.
South Precinct Lt. David Rockett said officers found four children inside, all of whom belonged to the couple: a 7-year-old girl, a 3-year-old boy, a 2-year-old boy and a 1-month-old girl.
For more than a day, the 7-year-old girl had been trying to wake her parents.
Dutifully, she got dressed in their apartment outside Pittsburgh on Monday morning and went to school, keeping her worries to herself. But on the bus ride home, McKeesport, Pa., police say, she told the driver she’d been unable to rouse the adults in her house.
Inside the home, authorities found the bodies of Christopher Dilly, 26, and Jessica Lally, 25, dead of suspected drug overdoses, according to police.
Also inside the home were three other children — ages 5 years, 3 years and 9 months.
IF YOU CANNOT LIVE FOR YOURSELF, THEN AT LEAST LIVE FOR YOUR CHILDREN. If you are unconscious, overdosed, or dead, what the hell do you think is going to happen to you baby? If it weren’t for the police, these children would all be dead. Oh, and by the way:
…authorities told NBC affiliate WPXI that the double overdose at the 7-year-old’s home was the second they had responded to on that block in less than a day. … ” In the past year alone we lost over 3,500 Pennsylvanians — a thousand more lives taken than the year before.” … Nationwide, opioids such as heroin and prescription pain relievers killed more than 28,000 people in 2014, more than any year on record, according to the Centers for Disease Control and Prevention. At least half of all opioid overdose deaths involved a prescription drug, the CDC said, adding that the number of overdose deaths involving opioids has nearly quadrupled nationwide since 1999.
Want to stop the drug epidemic? Put people who’ve overdosed in the stocks and let everyone throw rotten tomatoes at them. For a second offense, lashings. Drug dealers are serial killers and should be publicly executed. Set a few dealers twisting in the wind, and I guarantee that far fewer people will be willing to sell drugs.
Then stop making excuses, go out into the world, and LIVE.
By the way, guys, I have not been able to write as much as I would like to, lately, so I am dropping the Wed. post and only going to be updating 4 times a week. Hopefully I’ll get more time soon. :)
It is very easy to dismiss Appalachia’s problems by waving a hand and saying, “West Virginia has an average IQ of 98.”
But there are a hell of a lot of states that have average IQs lower than West Virginia, but are still doing better. For that matter, France has a lower average IQ, and France is still doing pretty well for itself.
So we’re going to discuss some alternative theories.
(And my apologies to WV for using it as a stand-in for the entirety of Greater Appalachia, which, as discussed a few days ago, includes parts of a great number of states, from southern Pennsylvania to eastern Texas. Unfortunately for me, only WV, Kentucky, and Tennessee fall entirely within Greater Appalachia, and since it is much easier to find data aggregated by state than by county or “cultural region,” I’ve been dependent on these states for much of my research.)
At any rate, it’s no secret that Appalachia is not doing all that well:
The Death of Manufacturing
Having your local industries decimated by foreign competition and workforces laid off due to automation does bad things to your economy. These things look great on paper, where increasing efficiency and specialization result in higher profits for factory owners, but tend to work out very badly for the folks who have lost their jobs.
Indeed, the US has barely even begun thinking about how we plan on dealing with the effects of continued automation. Do 90% of people simply become irrelevant as robots take over their jobs? Neither “welfare for everyone” nor “everybody starves” seem like viable solutions. So far, most politicians have defaulted to platitudes about how “more education” will be the solution to all our woes, but how you turn a 45-year old low-IQ meat packer who just got replaced by a robot into a functional member of the “information economy” remains to be seen.
Of course, economic downturns happen; fads come and go; industries go in and out. The Rust Belt, according to Wikipedia, runs north of Greater Appalachia, through Pennsylvania, New York, northern Ohio, Detroit, etc. These areas have been struggling for decades, but many of them, like Pittsburgh, are starting to recover. Appalachia, by contrast, is still struggling.
This may just be a side effect of Appalachia being more rural; Pittsburgh is a large city with millions of people employed in a variety of industries. If one goes out, others can, hopefully, replace it. But in a rural area with only one or two large employers–sometimes literal “company towns” built near mines–if the main industry goes out, you may not get anything coming back in.
Appalachia has geography that makes it difficult to transport goods in and out as cheaply as you can transport them elsewhere, but then, so does Switzerland, and Switzerland seems to be doing pretty well. (Of course, Switzerland seems to have specialized in small, expensive, easy to transport luxury goods like watches, chocolate, and bank deposits, while Appalachia has specialized in cheap, heavy, unpleasant to produce goods like coal.)
But I am being over-generous: America killed its manufacturing.
We killed it because our upper classes look down their noses at manufacturing; such jobs are unpleasant and low-class, and therefore they cannot understand that for some people, these jobs are the only thing standing between them and poverty. Despite the occasional protest against outsourcing, our government–Republicans and Democrats–has forged ahead with its free-trade, send-everything-to-China-and-fire-the-Americans, import-Mexicans-and-fire-the-Americans, and then reap-the-profits agenda.
Too Much Regulation
Over-regulation begins with the best of intentions, then breaks your industries. Nobody wants to die in a fire or a cave-in, but you can’t regulate away all risk and still get anything done.
Every regulation, every record-keeping requirement, every mandated compliance, is a tax on efficiency–and thus on profits. Some regulation, of course, probably increases profits–for example, I am more likely to buy a medicine if I have some guarantee that it isn’t made with rat poison. But beyond that guarantee, increasing requirements that companies test all of their products for toxins imposes more costs than the companies recoup–at which point, companies tend to leave for more profitable climes.
Likewise, while health insurance sounds great, running it through employers is madness. Companies should devote their efforts to making products (or services,) not hiring expensive lawyers and accountants to work through the intricacies of health care law compliance and income withholding.
The few manufacturers left in Appalachia (and probably elsewhere in the country) have adopted a creative policy to avoid paying health insurance costs for their workers: fire everyone just before they qualify for insurance. By hiring only temp workers, outsourcing everything, and only letting employees bill 20 hours a week, manufacturers avoid complying with employee-related regulations.
Oh, sure, you might think you could just get two 20-hour a week jobs, but that requires being able to schedule two different jobs. When you have no idea whether you are going to be working every day or not until you show up for work at 7 AM, and you’ll get fired if you don’t show up, getting a second job simply isn’t an option.
I have been talking about over-regulation for over a decade, but it is the sort of issue that it is difficult to get people worked up over, much less make them understand if they haven’t lived it. Democrats just look aghast that anyone would suggest that more regulations won’t lead automatically to more goodness, and Republicans favor whichever policies lead to higher profits, without any concern for the needs of workers.
New York Times columnist Thomas L. Friedman recently encapsulated this view in a piece called “Start-Ups, Not Bailouts.” His argument: Let tired old companies that do commodity manufacturing die if they have to. If Washington really wants to create jobs, he wrote, it should back startups.
Friedman is wrong. Startups are a wonderful thing, but they cannot by themselves increase tech employment. Equally important is what comes after that mythical moment of creation in the garage, as technology goes from prototype to mass production. This is the phase where companies scale up. They work out design details, figure out how to make things affordably, build factories, and hire people by the thousands. Scaling is hard work but necessary to make innovation matter.
The scaling process is no longer happening in the U.S. And as long as that’s the case, plowing capital into young companies that build their factories elsewhere will continue to yield a bad return in terms of American jobs. …
As time passed, wages and health-care costs rose in the U.S. China opened up. American companies discovered that they could have their manufacturing and even their engineering done more cheaply overseas. When they did so, margins improved. Management was happy, and so were stockholders. Growth continued, even more profitably. But the job machine began sputtering.
The 10X Factor
Today, manufacturing employment in the U.S. computer industry is about 166,000, lower than it was before the first PC, the MITS Altair 2800, was assembled in 1975 (figure-B). Meanwhile, a very effective computer manufacturing industry has emerged in Asia, employing about 1.5 million workers—factory employees, engineers, and managers. The largest of these companies is Hon Hai Precision Industry, also known as Foxconn. The company has grown at an astounding rate, first in Taiwan and later in China. Its revenues last year were $62 billion, larger than Apple (AAPL), Microsoft (MSFT), Dell (DELL), or Intel. Foxconn employs over 800,000 people, more than the combined worldwide head count of Apple, Dell, Microsoft, Hewlett-Packard (HPQ), Intel, and Sony (SNE) (figure-C).
Companies don’t scale up in the US because dealing with the regulations is monstrous. Anyone who has worked in industry can tell you this; heck, even Kim Levine, author of Millionaire Mommy (don’t laugh at the title, it’s actually a pretty good book,) touches on the subject. Levine notes that early in the process of scaling up the manufacture of her microwavable pillows, she had dreams of owning her own little factory, but once she learned about all of the regulations she would have to comply with, she decided that would be a horrible nightmare.
I don’t have time to go into more detail on the subject, but here is a related post from Slate Star Codex:
I started the book with the question: what exactly do real estate developers do? …
As best I can tell, the developer’s job is coordination. This often means blatant lies. The usual process goes like this: the bank would be happy to lend you the money as long as you have guaranteed renters. The renters would be happy to sign up as long as you show them a design. The architect would be happy to design the building as long as you tell them what the government’s allowing. The government would be happy to give you your permit as long as you have a construction company lined up. And the construction company would be happy to sign on with you as long as you have the money from the bank in your pocket. Or some kind of complicated multi-step catch-22 like that. The solution – or at least Trump’s solution – is to tell everybody that all the other players have agreed and the deal is completely done except for their signature. The trick is to lie to the right people in the right order, so that by the time somebody checks to see whether they’ve been conned, you actually do have the signatures you told them that you had. The whole thing sounds very stressful.
The developer’s other job is dealing with regulations. The way Trump tells it, there are so many regulations on development in New York City in particular and America in general that erecting anything larger than a folding chair requires the full resources of a multibillion dollar company and half the law firms in Manhattan. Once the government grants approval it’s likely to add on new conditions when you’re halfway done building the skyscraper, insist on bizarre provisions that gain it nothing but completely ruin your chance of making a profit, or just stonewall you for the heck of it if you didn’t donate to the right people’s campaigns last year. Reading about the system makes me both grateful and astonished that any structures have ever been erected in the United States at all, and somewhat worried that if anything ever happens to Donald Trump and a few of his close friends, the country will lose the ability to legally construct artificial shelter and we will all have to go back to living in caves.
The current socio-economic system is designed by rootless, soulless, high-IQ, low-time preference, money-/status-grubbing homo economicus for benefit of those same homo economicus. It is a system for designed for intelligent sociopaths. Those who are rootless with high-IQ and low-time preference can succeed rather well in this system, but it destroys those who need rootedness or those who are who are low-IQ or high time preference.
Kevin says, “Nothing happened to them. There wasn’t some awful disaster.” But he’s wrong, there was a disaster, but no just one, multiple related disasters all occurring simultaneously. …
Every support the white working class (and for that matter the black working class) had vanished within less than a generation. There was a concerted effort to destroy these supports, and this effort succeeded. Through minimal fault of their own the white working class was left with nothing holding them up.
Personally, I lack good first-hand insight into working class cultural matters; I have no idea how much Hollywood mores have penetrated and changed people’s practical lives in rural Arkansas. I must defer, there, to people more knowledgeable than myself.
While death rates have been falling for the rest of the developed world and for America’s blacks and Hispanics, death rates have been rising over the past couple of decades for American whites–middle aged and younger white women, to be exact. They’re up pretty much everywhere, but Appalachia has been the hardest hit.
The first thing everyone seems to cite in response is meth. And indeed, it appears that there is a lot of meth in Appalachia (and a lot of other places):
But I don’t think this explains why death rates are headed up among women. Maybe I’m wrong, (I know rather little about drug use patterns,) but it doesn’t seem like women would be more likely to OD on meth than men. If anything, I get the impression that illegal drugs that fuck you up and kill you are more of a guy thing than a gal thing. Men are probably far more likely to die of alcohol-related causes like drunk driving and cirrhosis of the liver than women, for example, and you don’t even have to deal with criminals to get alcohol.
So, while I agree that drugs appear to be a rising problem, I don’t think they are the problem. (And even still, drug overdoses only beg the deeper question of why more people are using drugs.)
As I mentioned a few posts ago, SpottedToad ran the death rate data by county and came up with three significant correlations: poverty, obesity, and disability. (I don’t know if he looked at meth/drug use by county.)
I, for one, am not surprised to find out that disabled, overweight people are not in the best of health.
Here are SpottedToad’s graphs, showing the correlations he found–I recommend reading his entire post.
Obviously one possibility is that unemployed people feel stressed, binge on cheap crap, get sick, get SSDI, and then die.
But then why are death rates only going up for white women? Plenty of white men are unemployed; plenty of black men and women are poor, fat, and disabled.
Obviously there are a ton of possible confounders–perhaps poor people just happen to make bad life decisions that both make them poor and result in bad health, like smoking cigarettes. Perhaps poor people have worse access to health care, or perhaps being really sick makes people poor. Or maybe the high death rates just happen to be concentrated among people who happen to be fat for purely biological reasons–it appears that the British are among the fattest peoples in Europe, and the Scottish are fatter than the British average. (Before anyone gets their hackles up, I should also note that white Americans are slightly fatter than Scots.)
And as many people have noted, SSI/SSDI are welfare for people who wouldn’t otherwise qualify.
In my correspondence with an observing teacher in the hill country of western Pennsylvania, she reported that in her school a condition was frequent in the families, namely, that the children could not carry prescribed textbook work because of low mentality. This is often spoken of, though incorrectly, as delayed mentality. In one family of eight children only the first child was normal. The mental and physical injuries were increasingly severe. The eighth child had both hare-lip and a double cleft palate. The seventh child had cleft palate and the sixth was a near idiot. The second to fifth, inclusive, presented increasing degrees of disturbed mentality.
In my cabin-to-cabin studies of families living in the hill country of North Carolina, I found many cases of physical and mental injury. Among these cases arthritis and heart disease were very frequent, many individuals being bed ridden. A typical case is shown in the upper part of figure 148 [sorry, I can’t show you the picture, but it is not too important,] of a father and mother and their one child. The child is so badly injured that he is mentally an imbecile. They are living on very poor land where even the vegetable growth is scant and of poor quality. Their food consisted largely of corn bread, corn syrup, some fat pork, and strong coffee.
As the title of the book implies, Dr. Price’s thesis is that bad nutrition leads to physical degeneration. (Which, of course, it does.) He was working back when folks were just discovering vitamins and figuring out that diseases like curvy, pellagra, and beriberi were really nutritional deficiencies; figuring out the chemical compositions necessary for fertile soil; and before the widespread adoption of artificial fertilizers (possibly before their invention.) Dr. Price thought that American soils, particularly in areas that had been farmed for longer or had warmer, wetter weather, had lost much of their nutritional content:
My studies of this problem of reduced capacity of sols for maintaining animal life have included correspondence with the agricultural departments of all of the states of the union with regard to maintaining cattle. The reduction in capacity ranges from 20 to 90 per cent… I am advised that it would cost $50 an acre to replace the phosphorus alone that has been shipped off the land in large areas.
There is an important fact that we should consider; namely, the role that has been played by glaciers in grinding up and distributing rock formations. One glacier, the movement of which affected the surface soil of Ohio, covered only about half the state; namely, that area west of a line starting east of Cleveland and extending diagonally west across the state to Cincinnati. It is important for us to note that, in the areas extending south and east of this line, several expressions of degeneration are higher than in the areas north and west of this line. The infant mortality per thousand live births in 1939 is informative. In the counties north and west of that line, the death rate was from 40 49 per thousand live births; whereas, in the area south and east of that Line, the death rate was from 50 to 87.
It is of particular interest to us as dentists that studies show the percentage of teeth with caries to be much higher southeast of this line than northwest of it.
So I Googled around, and found this map of the last glaciation of Ohio:
Okay, I lied, it’s obviously a map of ACT scores. But it actually does look a lot like the glaciation map.
Australia’s soils, from what I understand, are particularly bad–because the continent’s rocks are so geologically old, the soil is extremely low in certain key nutrients, like iodine. Even with iodine supplementation, deficiencies are still occasionally a problem.
Many of the soils in the state are steeply sloping and tend to be shallow, acidic, and deficient in available phosphorus. As early as the late 19th century progressive farmers used rock phosphate, bone meal, and lime to increase crop yield and quality. Since the mid-20th century farmers have used soil tests and corrected mineral deficiencies. Most crop land and much of the pasture land are no longer severely deficient in essential nutrients. West Virginia has always been primarily a livestock producing state. Land on steep slopes is best suited to producing pasture and hay.
Nutritional deficiencies due to poor soil could have been a problem a century ago, just as Pellagra and hookworms were a problem, but they seem unlikely to be a big deal today, given both modern fertilizers and our habit of buying foods shipped in from California.
Looking at statistics from 2005 (the latest for which mortality rates are available) the researchers found that though coal mining brought in about $8 billion to the state coffers of Appalachian states, the costs of the shorter life-spans associated with coal mining operations were nearly $17 billion to $84.5 billion.
Coal mining areas in Appalachia were found to have nearly 11,000 more deaths each year than other places in the nation, with 2,300 of those attributable to environmental factors such as air and water pollution.
The Nation reports that:
In 2010, an explosion at the Upper Big Branch coal mine in southern West Virginia killed twenty-nine miners. Later that year, an explosion at a West Virginia chemical plant killed two workers and released toxic fumes into the surrounding areas. This past year, West Virginia led the nation in coal-mining deaths. …
One study found that residents of areas surrounding mountaintop-removal coal mines “had significantly higher mortality rates, total poverty rates and child poverty rates every year compared to other…counties.” Another study found that compared to residents of other areas in the state, residents of the state’s coal-mining regions were 70 percent more likely to suffer from kidney disease, over 60 percent more likely to develop obstructive lung diseases such as emphysema and 30 percent likelier to have high blood pressure.
In 2014, the Elk River Chemical spill left 300,000 residents of West Virginia without potable water. Five months later, another spill happened at the same site, the fourth in five years. (The chemicals involved are used int he processing/washing of coal.)
Overloaded coal trucks are a perpetual menace on the narrow, winding roads of the Appalachian coalfields. From 2000 to 2004, there were more than seven hundred accidents involving coal trucks in Kentucky alone; fifty-three people died, and more than five hundred were injured. …
After the coal is washed, a slurry of impurities, coal dust, and chemical agents used in the process remains. This liquid waste, called “coal sludge” or “slurry,” is often injected into abandoned underground mines, a practice that can lead to groundwater contamination. … In public hearings, many coalfield residents have attributed their health problems to water wells polluted after the coal mining industry “disposes” its liquid waste by injecting coal slurry underground. The primary disposal practice for coal slurry is to store it in vast unlined lagoons or surface impoundments created near mountaintop-removal mines. Hundreds of these slurry impoundments are scattered across the Appalachian coalfields. Individual impoundments have been permitted to store billions of gallons of waste. … In 2000 a slurry impoundment operated by the Martin County Coal Company in Kentucky broke through into abandoned mineworks, out old mine portals, and into tributary streams of the Big Sandy River. More than 300 million gallons of coal slurry fouled the waterway for a hundred miles downriver.
So, living near a coal mine is probably bad for your health.
Concentration of Land
Wikipedia claims that land in Appalachia (or maybe it was just WV) is highly concentrated in just a few hands–one of those being the government, as much of Appalachia is national parks and forests and the like. Of course, this could be an effect rather than a cause of poverty.
Appalachia may be “isolated” and “rural,” but it’s quite close to a great many cities and universities. Parts of West Virginia are close enough to DC that people apparently commute between them.
In the early 1900s, so many people left Appalachia for the industrial cities of the Northeast and Midwest that U.S. Route 23 and Interstate 75 became known as the “Hillbilly Highway.” (BTW, I don’t think Appalachians like being called “hillbillies.”)
Compared to Appalachian areas in Arkansas or Oklahoma, West Virginia and Kentucky are particularly close to the industrial regions and coastal universities. As a result, they may have lost a far larger number of their brightest and most determined citizens.
While the Appalachian states don’t have particularly low IQs, their IQ curve seems likely to be narrower than other states’. West Virginia, for example, is only about 3% black, 1% Hispanic, and 0.5% Asian. MA, by contrast, is 9% black, 11% Hispanic, and 6% Asian. Blacks and Hispanics tend to score lower than average on IQ tests, and Asians tend to score higher, potentially giving MA more people scoring both above and below average, while WV may have more people scoring right around the middle of the distribution. With its brightest folks heading to universities outside the region, Appalachia may continue to struggle.
And finally, yes, maybe there is just something about the kinds of people who live in Appalachia that predispose them to certain ailments, like smoking or over-eating. Perhaps the kinds of people who end up working in coal mines are also the kinds of people who are predisposed to get cancer or use drugs. I don’t know enough people from the area to know either way.
To the people of Appalachia: I wish you health and happiness.