Hornell is a city located in Steuben County and close to the town of Rochester. The population of Hornell is estimated at around 8,300 people with a median age of 38 years old. Much of the economy in the city is based on manufacturing, health care, educational services, oil and gas, and transportation. The rate of poverty within the city is approximately 20%. From 1960 to 2018, the city of Hornell has lost half of its population and it continues to drop. Much of the city's prosperity from the late 1800s to 1960 was due to the railroad. Many small communities such as these, struggle with issues connected to substance abuse. The addiction problems are often connected to people being unemployed, bored, and struggling to find work. According to a Steuben County Community Health Assessment (CHA) for 2019-2021, there is significant attention placed on developing support systems and care for opioid users at risk of overdose. Steuben County is part of an eight-county region in the western part of New York State. Despite lessening populations, unemployment within the Finger Lake region has declined since 2012. Much of this is due to an increasingly aging population of people over the age of 65. In 2017 within Steuben County, approximately 26% of the population is over the age of 65. Substance abuse does impact this age group, and typically this involves alcohol or prescription drugs. When older people are struggling with a drug or alcohol addiction, they must receive drug treatment with proper medical care. There are often underlying health problems requiring extensive care during the rehabilitation process.