Since the middle of the twentieth century, white rural Americans have suffered multiple forms of loss. Cycles of economic decline, population loss, and out‐migration on one side, and in‐migration, gentrification, and development on the other, have transformed the cultural, economic, and political landscapes of many rural communities. Amid this context, Evangelical Christian churches, especially non‐denominational and charismatic congregations, have emerged as critical meaning‐making institutions, enabling congregants to lament these grievances, interpret their losses, and envision an alternative future beyond governmental reach. Drawing on 18 months of ethnographic research conducted across Oregon between 2020–2022, this article underscores how the COVID‐19 pandemic inflamed feelings of loss and dispossession among white rural communities in the United States. Due to the perception of heightened governmental incursion through public health mandates, the pandemic hardened an already embedded “us” vs. “them” mentality among white rural populations in Oregon, whereby long‐time white residents perceived governmental and public health officials as menacing outsiders aiming to eliminate their autonomy and self‐determination. This environment of simmering distrust cemented the entrenched role of Evangelical Christianity as the medium through which residents simultaneously expressed their sense of governmental betrayal and advanced an alternative Christian‐based vision of health, authority, knowledge, and the future.
BackgroundUnprecedented increases in substance-related overdose fatalities have been observed in Texas and the U.S. since the onset of the COVID-19 pandemic and have made clear there is considerable need to reduce harms associated with drug use. At the federal level, initiatives have called for widespread dissemination and implementation of evidence-based harm reduction practices to reduce overdose deaths. Implementation of harm reduction strategies is challenging in Texas. There is a paucity of literature on understanding current harm reduction practices in Texas. As such, this qualitative study aims to understand harm reduction practices among people who use drugs (PWUD), harm reductionists, and emergency responders across four counties in Texas. This work would inform future efforts to scale and spread harm reduction in Texas.MethodsSemi-structured qualitative interviews were conducted with N = 69 key stakeholders (25 harm reductionists; 24 PWUD; 20 emergency responders). Interviews were transcribed verbatim, coded for emergent themes, and analyzed using Applied Thematic Analysis with Nvivo 12. A community advisory board defined the research questions, reviewed the emergent themes, and assisted with interpretation of the data.ResultsEmergent themes highlighted barriers to harm reduction at micro and macro levels, from the individual experience of PWUD and harm reductionists to systemic issues in healthcare and the emergency medical response system. Specifically, (1) Texas has existing strengths in overdose prevention and response efforts on which to build, (2) PWUD are fearful of interacting with healthcare and 911 systems, (3) harm reductionists are in increasing need of support for reaching all PWUD communities, and (4) state-level policies may hinder widespread implementation and adoption of evidence-based harm reduction practices.ConclusionsPerspectives from harm reduction stakeholders highlighted existing strengths, avenues for improvement, and specific barriers that currently exist to harm reduction practices in Texas.
This book offers a wide exploration of deep learning theory and applications to tabular data, integrating and documenting novel methods and techniques.
