Martinsville

Martinsville is a small Virginia city whose industrial rise and collapse give the book a concrete setting for examining the social conditions surrounding the opioid crisis. Once a textile and furniture center, it experienced profound job losses as production moved overseas; by 2012 it had endured Virginia’s highest unemployment rate for twelve years. The narrative connects the city’s economic distress to broader patterns of food insecurity, disability and declining access to stable work.

Industrial City and Setting

An hour south of Roanoke, Martinsville had about thirteen thousand residents in 2012. For much of the twentieth century it was Virginia’s industrial powerhouse, with textile and furniture factories and, by the account in the book, more millionaires per capita than any other city in the nation. That prosperity was closely tied to manufacturing employment, leaving the city especially exposed when those jobs disappeared.

Deindustrialization and Economic Distress

The book traces the loss of nearly half the city’s jobs to the relocation of textile work to Honduras and Mexico after the North American Free Trade Agreement took effect in 1994, followed by the movement of furniture production to China. It sets Martinsville’s experience within a wider economic story: promises that workers displaced by global trade would move into better jobs often went unfulfilled, while retraining offered an uncertain route back to comparable wages.

The effects were visible in Martinsville and surrounding Henry County. Unemployment rose above 20 percent, food-stamp claims more than tripled, and disability rates increased by 60.4 percent. These figures make the downturn more than a story of factory closures: they show how the loss of work coincided with growing reliance on public assistance and disability support. In the book’s broader account, economic collapse and the expanding availability of painkillers are linked as conditions that helped intensify the opioid crisis, rather than as separate problems.

The Decline on the Ground

The author recalls two images from reporting on the recession in 2008 for the Roanoke Times, later developed in the 2014 book Factory Man. At area food pantries, people began arriving two hours before opening; older visitors sometimes relied on canes or walkers. The scenes made hunger a daily, visible consequence of the region’s economic deterioration.

A second image came from nearby Bassett, Virginia, where an abandoned furniture factory burned after an unemployed thirty-four-year-old tried to remove copper wiring to sell. The attempted theft was tied to the effort to make money from the factory’s remains, and the fire destroyed the shuttered building. Together, the pantry lines and the ruins of the factory place individual hardship alongside the physical evidence of lost industry.

Place in the Book’s Wider Argument

Martinsville functions as a local measure of structural change. Its employment losses, rising disability and food insecurity illustrate how economic insecurity can shape health and the resources available to respond to illness. The book’s argument does not reduce the opioid crisis to unemployment alone: it places the collapse of work alongside the expansion of painkiller supply and the weaknesses of social support.

The city’s significance also lies in the way the narrative moves between statistics and observed scenes. County-level increases in unemployment, food assistance and disability become legible through people waiting for pantry doors to open and through a factory left idle until it became a target for scrap. Martinsville is therefore both a particular former manufacturing center and an example of the rural economic distress that the book treats as part of the setting for the opioid crisis.