{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T13:11:04Z","timestamp":1790255464908,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["P2CHD058484"],"award-info":[{"award-number":["P2CHD058484"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Sociology Health &amp; Illness"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Research on urban community effects on health has considered a range of collective social processes as potential links between economic disadvantage and health. We extend this focus to deaths of despair (DoD; drug overdose mortality and suicide) in rural counties by examining the association between a novel indicator of economic cynicism (perceptions that local communities have been \u2018left behind\u2019 economically) and DoD. We also consider a range of other aspects of social climate potentially relevant to health, including social network ties, collective efficacy and social and physical disorder. We draw on data from the 2018 Ohio Community Resilience Study to estimate county\u2010level social process measures. Multilevel models of 2018\u20132022 age\u2010adjusted DoD rates in 39 rural Ohio counties indicate that economic cynicism is associated with prepandemic rates of DoD and COVID\u201019 pandemic\u2010associated increases in drug overdose mortality. Generalised structural equation models indicate that economic cynicism attenuates the association between economic disadvantage and drug overdose mortality by roughly 27% and the association with suicide by 50%. We discuss the importance of community\u2010level social processes as factors in understanding rural area vulnerability to DoD.<\/jats:p>","DOI":"10.1111\/1467-9566.70227","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:04:48Z","timestamp":1783505088000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Economic Cynicism, COVID\u201019 and Deaths of Despair in Rural Ohio Counties"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7807-3849","authenticated-orcid":false,"given":"Christopher R.","family":"Browning","sequence":"first","affiliation":[{"name":"Department of Sociology The Ohio State University  Columbus Ohio USA"},{"name":"Institute for Population Research The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4390-9447","authenticated-orcid":false,"given":"Bethany","family":"Boettner","sequence":"additional","affiliation":[{"name":"Institute for Population Research The Ohio State University  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4459-1418","authenticated-orcid":false,"given":"Catherine A.","family":"Calder","sequence":"additional","affiliation":[{"name":"Department of Statistics and Data Sciences The University of Texas at Austin  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9566-4031","authenticated-orcid":false,"given":"Elisabeth","family":"Root","sequence":"additional","affiliation":[{"name":"Institute for Disease Modeling Gates Foundation  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"Provisional Drug Overdose Death Counts","author":"Ahmad F. 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