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McDowell County was established in 1858 and it is located in the southern region of the state. With a population of approximately 22,113 the county has a total area of 535 square miles, and the county seat is Welch.
In 2015, McDowell County had the highest rate of drug-induced deaths of any county in the United States, with 141 deaths per 100,000 people.
The median income for a household in the county was $22,154 and the median income for a family was $28,413.
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