Health Affairs August 14, 2024
Southern Illinois, bordering Missouri to the west and Indiana to the east, is a unique case study into the US’s evolving opioid epidemic. In many ways, it’s the polar opposite—politically and socially—of Chicago, which is some five hours north on I-55. Southern Illinois is a rural, red-leaning region that thrived on coal mining before automation upended the industry in the 1990s. Today, it’s a mishmash of Dollar Tree and Dollar General stores, fast food restaurants, and farming fields—and, surprisingly, plays host to a vibrant LGBTQ+ community and a glut of queer-friendly social spaces. It also has some of rural America’s largest pride celebrations, a number lavishly celebrated in June across the region.
The “everybody knows everybody” nature of rural communities...
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