Death in McCreary County

Depressing article in the Post about a small-town undertaker in McCreary County, Kentucky, where the death rate among women 35 to 59 has increased 75 percent since 2000:

She died alone in the middle of the night, and her body was swiftly autopsied, embalmed and carted 135 miles to a remote Kentucky county where she had been raised. There, Dan Ridener waited. The undertaker watched as the Cadillac Escalade pulled up and the corpse was wheeled inside. Then he removed the blanket covering McCreary County Funeral Home’s newest arrival.

Curly, blond hair. A haggard face. Dark circles under both eyes. Nails bitten and bloodied. A provisional report of death came with the body.

“Name: Lois A. Maxwell.”

“Age: 44.”

“Race: W.”

“Sex: F.”

The document didn’t say anything about a cause of death, but Ridener didn’t need it to know what had happened: Another white woman had died in what should have been the prime of her life. Across America, especially in rural and working-class communities, death rates have been accelerating among middle-aged white women for a generation, and in McCreary County, which is 91 percent white, no one knows this better than the undertaker, who now lifted Maxwell’s body onto an aluminum table.

“She doesn’t look 44,” an assistant said, snapping on blue latex gloves.

“She looks older,” said Ridener, who did the same.

“She looks a lot older than that,” the assistant said. “She looks 60, I’d say.”

Ridener peered down at the body. As with most of the people who end up on his table, he was familiar with Maxwell and the troubled life she had led. In the last decade, Kentucky courts had convicted her of 11 separate drug- and alcohol-related charges. At the time of her death, she was facing four more.

Grim reading. And does anybody know what to do about it? There was recently some scorn on this subject from conservatives who said that first of all people have to leave places where there is no work. But Lois Maxwell did leave. So did most of the characters in J.D. Vance's bestselling memoir, Hillbilly Elegy; the story is built around his family connections with a poor Kentucky county, but his relatives live in Ohio. Travelling to a new place doesn't necessarily change the dynamics of life, especially when the new place has nearly as many problems as the old.