Document Type


Publication Date

Summer 2021


Goal Statement: This social change portfolio aims to increase awareness of deaths of despair and address prevention on the individual, family, and social levels, including advocacy in the broader community.

Significant Findings: The Appalachian Region contains 420 counties across 13 states (Appalachian Regional Commission, n.d) and represents 30% of the national population but accounts for 50% of the premature mortality rate within the United States, in part, due to rising rates of deaths of despair (Scutchfield, 2018). The poverty rate in Appalachia is 1.5 times higher than the national average, with a suicide rate 17.1% higher than the national average. Moreover, an accidental poisoning rate (including alcohol and substances) is 37% higher than the national average, with alcoholic liver disease 1.5% higher. There is also a disproportionately higher rate of mental illness than non-Appalachian regions, and it significantly impacts individuals between the ages of 15-64 (American Psychological Association, 2018). Key findings suggest various risk and protective factors on all levels of the social-ecological model. Research supports the bioecological model for school-based programs that aim to reduce behaviors of despair such as learning disorders, conduct disorders, parenting factors, and social skills (Halsal et al., 2018).

Objectives/Strategies/Interventions/Next Steps: The objective is to educate and inform the audience of the need for more insight into deaths of despair and more complete research data, so prevention and intervention program planning can occur. Strategies should focus on building resiliency in early education through programs that involve a bioecological model of prevention and intervention, such as the longitudinal research program Fast Track. Community partnerships with an agency, such as Fast Track, bring all community forces into action while supporting the most vulnerable stakeholder in the community, the children, who are the most likely to be negatively impacted by all levels of an impoverished environment. The next step is to develop an action plan for advocacy that reaches all levels of local governments and agencies