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The book is based on a collection of late 19th century photographs by Jackson County, Wisconsin photographer Charles Van Schaick, mostly in the city of Black River Falls, and local news reports from the same period. It emphasizes the harsh aspects of Midwestern rural life under the pressures of crime, disease, mental illness, and urbanization.
The film, which was directed by James Marsh, was released in 2000. In a docudrama style, and shot entirely in black-and-white (except for contrasting sequences of modern life in the area, in color), it combined re-enactments of some of the events described in the book with a voice-over narration by Ian Holm. Its visual style was intended to carry the content of the film - as Marsh said:
The book inspired the Pictorialist album by the band Static-X, a song by the Bethel, Maine-based thrash metal band Theory of Negativity off of their 1994 self-titled album, and an opera entitled Black River (composed 1975, revised 1981) by Conrad Susa. A song by Jerry Joseph also shares a name with the book; but it is not clear whether the song was also inspired by the book.
Most recently, the book was adapted into a bluegrass, roots-rock opera by Tim Raphael and composer Jeff Berkson, making its world premiere at Georgetown University's Davis Performing Arts Center on February 1, 2008.
The Australian author Rod Jones cites Wisconsin Death Trip as an inspiration for his novel Billy Sunday. American best-selling author, Robert Goolrick, also cites Wisconsin Death Trip as an inspiration for his novel A Reliable Wife.
According to the director's commentary on the 2-disc DVD release of the Bob Dylan biopic I'm Not There, director Todd Haynes explained that much of the imagery for the town of Riddle in the Richard Gere segment of the film was inspired by Lesy's book of photographs.