This is the third installment in the Herald’s series, “Stomping Grounds,” local stories that will define the election.

Imagine a hillbilly from Eastern Kentucky. A particular image probably comes to mind: a mountain man with fewer brain cells than he does teeth, making moonshine and marrying his cousin. You probably don’t imagine Yale students being produced in the same environment that produced this stereotype, yet here we are, and I am one.

This damning stereotype of inability becomes a larger problem when it results in a ongoing cycle of poverty. My town, Paintsville — in the heart of Eastern Kentucky, known to us as coal country — is poor. Really poor. Nine of the 30 poorest counties in the US are found in Eastern Kentucky. And every year, Eastern Kentucky gets poorer.

This isn’t the way it’s always been, however. In fact, during the coal boom of the 1980s, it was quite wealthy (relative to the average Kentucky county). Through the early ’90s, Eastern Kentucky was, on account of its abundance of coal, seen as the next big economic contender. Nevertheless, as the century turned, so did the region’s fortune.

When the 2000s hit, so did the evolution of energy manufacturing. Coal — the black gold of Eastern Kentucky — was quickly replaced with other energy sources, such as natural gas and renewable energy. Economically, it wasn’t as viable, and environmentally, it destroyed our planet. Because of this, Eastern Kentucky’s economy plummeted. What was once a place of hope became a place of fear and uncertainty.

And then it got worse. Since 2011, over two-thirds of all of the coal jobs have disappeared; with them, went the health of the community. When people become jobless, they are twice as likely to have depression. When entire regions become jobless, a health crisis forms. Today, Eastern Kentucky, what was once the country’s coal capital, is now considered the opioid capital — the US Health & Human Services deemed it a public health emergency in 2016. We have some of the highest rates of drug abuse and overdoses in the country. Statewide, nearly one in 100 people overdose on opiods annually; in my region, the numbers are even worse. Owsley County, for instance, has the third highest poverty rate in the country at 45.2 percent. Those now-depressed, jobless people have largely turned to drugs to find happiness again. The coal industry was replaced with “pill-doctors” and opportunity was replaced with addiction.

Most people have heard about the opioid crisis, but most people don’t realize just how bad it is. As someone from the area, it seems like nobody cares. We rarely get any governmental help. Our healthcare is plagued by over-prescribed opioids and our schools are underfunded. (My high school couldn’t afford more than one pack of paper per teacher.) It looks like nothing will ever change, and this makes sense. First, Eastern Kentuckians have no group to cling to. Eastern Kentuckians are primarily white, Protestant Christians — over a quarter are Baptist alone — and that’s the majority of the United States. There is no identity to rally behind to cry for help. People don’t care if a portion of their country is suffering if there is no defining and identifiable characteristic of that group. People believe that Eastern Kentuckians are white trash, and that group deserves whatever misfortune comes their way. Second, our problem relates to mental health. The U.S.’s view of mental health is one characterized by social stigma: drug abuse is for people with weak morals and willpower. When your region is dying from prescriptions, people are quick to say that you just should get over it and stop taking pills.

I don’t have a solution, but no one seems to. A simple solution is hard to find for a crisis this complex. I’m just asking for someone to actually pay attention. Some of our poorest, unhealthiest areas are not reported about, despite our “desire” for economic equality. This problem is a national problem, and it deserves national attention.

When I walk down the streets of my hometown, I see people strung out on whatever drug they could get their hands on. I see new businesses that have opened and closed within a year. I see a general state of depression. What I don’t see is that Eastern Kentucky hillbilly. That stereotypical hillbilly — the jolly, dumb, old drunk who has fallen prey to the arms of poverty. He fell to the lack of governmental foresight and is now stuck because of a lack of care. That hillbilly is dying from oxycontin, heroin, fentanyl. He cries out, but nobody listens. For he is just a hillbilly, what would he know?

Looking for a Fix was originally published in The Yale Herald on Medium, where people are continuing the conversation by highlighting and responding to this story.