West Virginia has long been notorious as the worst white state in the country, and the recent White Death has hit West Virginia whites harder than any other state’s whites, with death rates among whites 45-54 years old increasing 41% from 1999-2013.
Ohio isn’t as badly off as West Virginia, but the middle-aged death rate was up 20%, worse than the national average.
Pennsylvania’s White Death rate, however, was up only 4%.
I get a vague impression that Pennsylvania has been in general pulling ahead of Ohio in this century.
One reason is because Philadelphia, for all its problems, is still a giant east coast city. Meanwhile, Pittsburgh seems to have repositioned itself rather nicely to serve as a regional hub for things like medical care.
Another reason is that Pennsylvania had better mortgage regulations than more laissez-faire Ohio, so it sidestepped the worst of the subprime grift.
Also Pennsylvania has pockets of oil and natural gas that only recently became profitable to pump from again due to innovations in technology.
I’m reading reporter Sam Quinones’ book on the spread of painkillers and heroin, Dreamland, and much of that is set in southern Ohio. I don’t know, however, why this quiet plague doesn’t seem to have hit Pennsylvania all that hard.
Is there a cultural difference with Pennsylvania (more Central European Catholics) and West Virginia (more Scots-Irish)?
But I don’t really know what else is going on.