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J.D. Vance’s “Hillbilly Elegy” misses the real crisis in Appalachia

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I started reading J.D. Vance’s 2016 memoir, Hillbilly Elegy, on Election Day 2020. This wasn’t a conscious decision; the book arrived that day because I’d been asked to review the film, and I figured I should read the book first for context. Until then, I’d avoided the memoir, which has resurfaced following Donald Trump’s announcement that Vance would be his running mate. My reluctance stemmed from my familiarity with the culture that Vance saw as “in crisis.” I grew up on Muddy Creek Mountain near Alderson, West Virginia, a small town in the Greenbrier River Valley just southeast of the coal fields.

While I was somewhat prepared for the eugenic genetic arguments in the text and the clichéd cliches in the film, I was shocked by one major omission: despite the abundance of suicide attempts, domestic violence, and drug abuse that occur in both the book and the film, neither addresses the topic of mental health.

Both versions of “Hillbilly Elegy” sidestep this crucial problem in different but equally misleading ways. The book reads like a Frankenstein hybrid of memoir and superficial social science commentary, attributing social ills to bad genes inherited from Vance’s Scots-Irish ancestors. This argument relies heavily on a blog post by a writer known for contributing to racist, far-right publications, making it even more troubling that many critics have been misled by these theories.

Vance, praised by some as a “very astute social critic,” never addresses the mental health issues of his mother and grandmother, who show signs of bipolar disorder. Despite his focus on hereditary genes, he completely misses this crucial aspect.

In his film adaptation, Ron Howard ignores Vance’s overt political commentary, replacing it with garish clichés in lieu of real character development. Glenn Close’s portrayal of Vance’s grandmother is an amalgamation of every stereotypical “mamaw” character Hollywood has ever created. The film relies on melodramatic performances and a sweeping orchestral soundtrack to offset a lackluster storyline.

The film’s problems are manifold. Without Vance’s eugenics diatribes, the story becomes self-indulgent. The visual details the film provides do nothing to enhance the story. Dramatic soundtracks and quick transitions between past and present do little to make up for the weak story. Characters like Vance’s mother Bev, played by Amy Adams, are reduced to stereotypes, stripping them of any depth or complexity.

Appalachia has long been misrepresented in the media, and Howard plays on nearly every stereotype. The shirtless, long-haired redneck, the fiery hillbilly, and the distrustful outsider are all present. Bev is portrayed as the Appalachian parent who hinders her child’s progress, an image that reinforces outdated and damaging clichés.

The 1937 film “Mountain Justice” offers a parallel to Howard’s “Hillbilly Elegy.” Both feature a backward hillbilly who resists progress, a trope that remains damagingly persistent. In Howard’s film, Bev’s shaking hand becomes a similar symbol, representing the barrier between her child and his future.

Ron Howard’s decision to recycle these stereotypes rather than explore more substantial issues is disheartening. Both Vance and Howard avoid addressing mental health, despite its critical relevance. The American Psychological Association warns of a national mental health crisis with serious long-term consequences. Ignoring this crisis while depicting issues like suicide and domestic violence is not only shameful, it’s dangerous.

Vance briefly mentions that his mother “listened too much to the wrong voice in her head” and dismisses counseling as “too weird.” Howard leans into hysteria, showing a scene of Bev lying in the street with bloody wrists, summed up by her mother’s comment, “She just stopped trying.” The film ends with Vance saying, “We choose who we are every day,” a statement that ignores the deeper, systemic issues at play.

Both Vance and Howard make a conscious choice to ignore mental health. Studies show direct links between untreated mental health issues and poverty. In regions like Appalachia, where mental health services are scarce and often require a commute of more than an hour to access, ignoring this issue is negligent.

Ironically, Vance’s fixation on bad genes echoes the eugenics movement. Depicting mental health crises as the result of “racial differences” or hereditary traits harks back to a dark history of eugenics, one that could easily have affected Vance’s family. The Supreme Court’s Buck v. Bell decision, for example, legalized the sterilization of more than 70,000 “unfit” individuals, a move lauded by doctors in Appalachia.

While sterilization is largely a thing of the past, the lack of mental health care in Appalachia is still a real crisis. Access to mental health care is notoriously difficult, and statistics show how little it has improved over time. Local doctors note that a significant portion of their work involves mental health care, but resources are inadequate.

Economic vulnerability, lack of educational opportunities, and reduced access to health services directly worsen mental health, a fact clearly illustrated in former coal mining towns. The closure of the Pocahontas Fuel Company in the 1980s left communities economically and socially devastated, with few mental health resources.

To write a book or make a film about the problems of Appalachia without mentioning mental health is not only a grave mistake, it also shifts the blame from economic exploitation to individual failings. Vance and Howard fail to address the systemic issues underlying the crises they depict, and instead offer a narrative that blames personal and genetic failings.

Toward the end of the book, Vance muses that European countries seem to be better at achieving the American dream, seemingly unaware that social safety nets, including free health care and education, contribute to this success. His disdain for social security ignores how such support systems help people succeed, reinforcing a narrative that personal failures are to blame for systemic problems.

If you are in crisis, call the 988 Suicide and Crisis Lifeline by dialing 988, or contact the Crisis Text Line by texting TALK to 741741.

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