In three publications (2015, 2017, 2020), Case and Deaton identified the alarming trend in “deaths of despair” (DOD) among White middle-aged Americans with less education and proposed that declining economic conditions may have contributed to the high rates of DOD among this population.
Ruhm set out to address the question: can DOD be accounted for by declining economic conditions? This “working paper” (meaning it has not been subjected to peer review) measured deaths due to alcohol and drug poisoning, overdoses, and suicide. Demographic data was collected on county of residence, age, gender, race/ethnicity, education, year and weekday of death between 1999 and 2015. County-level data was used to identify economic conditions.
Economic conditions accounted for less than one-tenth of the rise in drug and opioid mortality rates. The disproportional rise in deaths of despair among Whites is not likely due to economic conditions as non-White groups face harsher economic challenges. Also, this pattern is not being seen in other countries. At the end of the Great Recession, there was a strong upsurge in opioid overdose deaths in spite of improving economic circumstances.
Ruhm concluded that changes in the drug environment played a bigger role in deaths of despair than did economic conditions. “Efforts to improve economic conditions in distressed locations, while desirable for other reasons, are not likely to yield significant reductions in drug mortality” (p. 1).
Ruhm, C. J. (2020). Deaths of despair or drug problems? (Working paper No. 24188). National Bureau of Economic Research. https://doi.org/10.3386/w24188.
©Jennie Dilworth, Ph.D