LOST CREEK, Ky. (NewsNation) — As President Joe Biden visited parts of Eastern Kentucky Monday that were devastated by deadly flooding and poised for more severe weather events worsened by climate change, a whole host of other problems are piling up for Appalachia.

From 2010 to 2019, the mainly rural region that encompasses portions of 13 states with about 26 million residents lost about 3% of its population in Virginia, West Virginia and New York. The national average was 6% growth.

The population trends follow a sharp decline in the coal industry, where jobs in that industry were cut from about 56,000 positions to 24,000 from 2010 to 2020.

The opioid crisis is also taking a toll on the region. Overdose deaths are 54% higher than the rest of the United States.

James Maples, a sociology and Appalachian studies professor at Eastern Kentucky State University, said the problems facing the region are starting to pile up.

“When I saw these floods starting to happen, I was just like, ‘Man, it’s just another, you know, a big drop in a bucket,’” said Maples. “And it just gives people all the more reason to maybe choose to move out of the area. 

But Maples also echoed President Biden’s resilient tone he struck while visiting areas hit hardest by flooding.

“I still think there’s going to be people stay behind and rebuild,” said Maples. “And, you know, Eastern Kentucky, especially, we’re not going anywhere.”

In a joint appearance with Kentucky Gov. Andy Beshear, Biden said the nation has an obligation to help all its people, declaring the federal government would provide support until residents were back on their feet.

“We never give up. We never stop. We never bow. We never bend. We just go forward,” said Biden.

While Appalachia’s future is uncertain, the president expressed staunch support for the flood-ravaged communities and the lengthy rebuilding process ahead.

“The bad news for you is I’m coming back because I want to see it,” the president said.

The Associated Press contributed to this report.