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Doctor of Social Work (DSW)


For nearly 100 years, Central Appalachia has been characterized by some of the highest poverty rates in the nation. Not coincidentally, the region has also been characterized by some of the highest rates of substance use. Despite decades of funding and support, Central Appalachia continues to foster a symbiotic relationship between poverty and substance use. The purpose of this project was to explore the missing link that ties the two poor determinants of health together and to provide a name to a phenomenon otherwise omitted from social work and policy making practice within Central Appalachia.

The first product of this capstone was a systematic literature review focused on identifying historical oppression as means of maintained substance use within the Central Appalachian region. From the research, a relationship between historical oppression and sustained substance use was identified and explored.

The second product, a conceptual review, utilized the conclusions established within the systematic review to ground the relationship between historical oppression and substance use within theoretical constructs. Anchoring the relationship to the principles of Colonialism and Rational Choice Theory led to the formulation of an oppressed rationale, a decision-making system that is forged in an oppressive landscape. The concept of an oppressed rationale granted explanation for perpetuated substance use within Central Appalachia despite numerous social and economic interventions.

Product three applied the concepts of products one and two to a case application. Focusing on House Bill 427. The case application product utilized the relationship between oppression and sustained substance use through a case example and explored potential modification for practice that would allow House Bill 427 to better serve the Central Appalachians within Kentucky.

Available for download on Thursday, May 02, 2024

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