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the inequality keeps growing and growing and growing

October 1st, 2018 | 1 min read

By Matthew Loftus

I have really been appreciating Alec MacGillis’ careful reporting on the places that have been left behind in our current economy, and this ProPublica report from Dayton, Ohio (that also frequently references Baltimore, another struggling place) is no exception:

In fact, happiness is an emotion on scant display in Dayton these days. The city has been one of the hardest hit by the opioid epidemic: nearly 400 people died of fatal overdoses in Montgomery County, which includes Dayton, in just the first half of last year, eclipsing the county’s total for the entire year prior. Montgomery County Coroner Kent Harshbarger has deployed refrigerator truck back-ups usually reserved for mass fatality events. The overdose rate abated slightly over the second half of the year, as the fentanyl strains in the local heroin supply weakened. That drop-off sadly did not happen in Baltimore, which ended 2017 with a stunning tally of 761 fatal overdoses.

For all the talk about the opioid epidemic leaving few places untouched, the fact is that it’s hit far harder in struggling cities than in winner-take-all ones. And once the struggling cities become known as thriving markets for illegal opiates, they draw ever more addicts from nearby towns and suburbs, who avail themselves both of the drug supply and of local social services: shelters, soup kitchens, and drug treatment programs that aren’t available in the communities from which they’ve come. It’s a dark inversion of the winner-take-all dynamic in prosperous cities: instead of drawing ever more wealthy professionals, the struggling cities draw ever more people in desperate straits.


Matthew Loftus

Matthew Loftus teaches and practices Family Medicine in Baltimore and East Africa. His work has been featured in Christianity Today, Comment, & First Things and he is a regular contributor for Christ and Pop Culture. You can learn more about his work and writing at