Catlin of County Health Rankings said Boone County's experience is a common one for many rural counties, and explains why their premature death rates have spiked in some such counties, countering a nationwide trend.
"You really can't pinpoint any single factor," Catlin said. But "rural counties struggle with lack of access to jobs, to health care, to physical activity."
"There isn't always a safe place to exercise."
Catlin said it's possible that fatal drug overdoses might be more prevalent in rural counties "because of a lack of medication than can prevent overdoses."
That medication, naloxone hydrochloride, can reverse the effects of opiods.
Naloxone is not universally available from pharmacies nationwide without a prescription. West Virginia's legislature passed a bill in its recently concluded session that would allow pharmacists to dispense naloxone without a prescription.
"When somebody overdoses there isn't always time to get them to a hospital," Catlin said. "That's why it's so important than first responders carry [naloxone] with them, and use it if necessary. We need to get it in the hands of a lot more people."
Last November, the U.S. Food and Drug Administration approved Narcan Nasal Spray, the first nasal spray version of naloxone, which is made by Adapt Pharma.
In January, Adapt Pharma said it will offer a free carton of Narcan Nasal Spray to all U.S. high schools through state education departments, and work with the Clinton Health Matters Initiative to increase naloxone access nationwide.
In addition to the schools initiative, Adapt Pharma is also partnering with other organizations like the National Association of School Nurses to provide free nasal spray to first responders, caregivers and local and state authorities.