Henry County in Virginia

Henry County in Virginia, particularly the Martinsville and Bassett area, is a place where the book makes the connection between lost work, material hardship, and the opioid epidemic concrete. Its account moves from shuttered furniture factories and strained households to a broader argument: addiction cannot be understood apart from the economic and health-care conditions in which it spreads.

Setting and industrial decline

In the book’s account of rural Virginia, Henry County is among the counties battered by globalization, automation, and the decline of coal. Martinsville and the surrounding county experienced unemployment above 20 percent; food-stamp claims more than tripled, and disability rates increased by 60.4 percent. These measures register more than a downturn in income: they describe communities losing access to stable work while more residents depended on public assistance or disability benefits.

The furniture industry gives that change a local form. Bassett, near Martinsville, had been shaped by factory work, but the area’s employers shed jobs as the global economy changed. Bassett Furniture CEO Rob Spilman described the dismissal of roughly eight thousand workers from his payroll as necessary for the company’s survival, not as a social experiment. The book places that business calculation beside the consequences for workers: cheaper consumer goods did not compensate those who had lost the wages that once let them buy them.

The scale of hardship appeared in everyday scenes the author observed while reporting on the recession in 2008 for the Roanoke Times and later researching Factory Man, published in 2014. Adults of different ages and races arrived at food pantries as much as two hours before they opened; some relied on canes or walkers. In Bassett, a shuttered furniture factory burned after an unemployed thirty-four-year-old trying to remove copper wire for resale accidentally started a fire. The pantry queue and the ruined factory stand as distinct images of the same contraction: need accumulating where dependable work had vanished.

Economic distress and the opioid crisis

The book treats Henry County’s economic losses as part of the setting for the opioid epidemic, not as a complete explanation of individual addiction. It describes a wider pattern in which collapsing employment was followed by rising disability and a flood of painkillers promoted by pharmaceutical companies and approved by regulators. In this account, job loss and opioid supply were connected pressures: communities had fewer routes to economic stability even as potent prescription drugs became more available.

Researcher Shannon Monnat’s analysis provides the book with a way to frame that relationship. Declining workforce participation was not confined to rural areas, but it was less severe in places with fewer opioid-prescribing physicians and more college graduates. Her interpretation locates the crisis in structural conditions that narrow people’s options, rather than reducing it to private failings. Henry County’s combination of industrial decline, food insecurity, and increased disability gives that argument a particular geographic weight.

Health coverage and care

The county’s circumstances also belong to a statewide story of limited access to care. Virginia repeatedly rejected Medicaid expansion after the Affordable Care Act, leaving federal funding and insurance coverage for roughly four hundred thousand low-income residents unrealized. The book contrasts Virginia with states where expansion helped pay for treatment, counseling, and addiction medications, including for people too poor to afford private insurance but not eligible for traditional Medicaid.

That policy context mattered to rural communities where the safety net was already thin. The book describes uninsured residents elsewhere in rural Virginia piecing together care through charitable clinics and mobile services; these examples illustrate the wider consequences of the state’s coverage decisions, rather than establishing that a particular Henry County resident used those services. In the book’s broader account, the practical barriers to treatment—cost, availability, and insurance—compounded the economic insecurity that accompanied the loss of work.

Narrative significance

Henry County’s significance lies in how its statistics and physical landscape make a structural argument legible. Unemployment above 20 percent, food assistance claims more than tripling, and disability rising by 60.4 percent are matched by the early-morning pantry line and the burned furniture factory. The location is not merely a backdrop to the opioid epidemic: it shows how industrial change can weaken household security and public health at once.

The book’s proposed counterweight is not treatment in isolation but the rebuilding of rewarding activities and relationships. Historian Nancy D. Campbell argues that lasting protection from drug use and drug-related crime requires work, play, and the social ties around which people build their lives. Applied to Henry County’s story, that perspective widens the question from how to treat addiction to how a community can restore the conditions that make stable lives possible.