2007 DriventoDespairAsylumDeathsinth

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Subject Headings: U.S. Opiate Epidemic, Overdoes, Despair.

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Abstract

The U.S.’s unprecedented opiate epidemic was an important theme of the 2016 presidential campaign. Both Hillary Clinton and Donald Trump expressed concern about the crisis and offered strategies to deal with it. The opiate crisis also pervaded many key campaign issues, including international trade, immigration, and health care. Recent analyses suggest a relationship between Trump support and opiate overdoses in key states and provide potential explanations for why Trump received so much support in America’ s new post-industrial “heroin beltway” 1. Over the past decade, nearly 400,000 people in the U.S. died from accidental drug overdoses and drug-induced diseases. Nearly 400,000 more committed suicide , and over 250,000 died from alcohol-induced diseases like cirrhosis of the liver 2. Approximately a fifth of these drug, alcohol and suicide deaths involved opiates (prescription pain relievers or heroin), suggesting that opiates are part of a larger problem 3. M ortality rates from these ‘deaths of despair’ are much higher among non - Hispanic whites than among other racial/ethnic groups 4 . This decade - long increase in deaths from drug overdoses, suicides, and alcohol - induced diseases has been substantial enough to significantly increase the overall mortality ra te for middle - age non - Hispanic whites , especially those without a college degree living in small cities and rural areas 5 . Here I examine the relationship between county - level rates of mortality from drugs , alcohol and suicide ( 2006 - 2014 ) and voting patterns in the 2016 Presidential election. I focus on three regions where the drug epidemic has re ceived considerable attention: the Industrial Midwest, Appalachia, and New England 6 . Because much of the narrative surrounding Trump’s election success has e mphasized the role of economic distress 7 and working - class voters , I include these factors in my analyses .

KEY FINDINGS

Trump over-performed the most in counties with the highest drug, alcohol and suicide mortality rates.

Much of this relationship is accounted for by economic distress and the proportion of working-class residents.

Trump performed best in counties with high economic distress and a large working class.

Drug, alcohol and suicide mortality rates are higher in counties with more economic distress and a larger working class.

Many of the counties with high mortality rates where Trump did the best have experienced significant employment losses in manufacturing over the past several decades.

Trump Over-Performed the Most in Counties with the Highest Drug, Alcohol and Suicide Mortality Rates

Donald Trump did better than Mitt Romney in 2,469 (79.5 percent) of the 3,106 counties included in these analyses (See Table 1) 8 . This includes 51 percent of large urban counties, 70 percent of small urban counties, 84 percent of micropolitan counties, and 92 percent of rural counties 9 . Trump performed even better in the Industrial Midwest (88.5 percent of counties) and Appalachia (91 percent of counties). Even in New England, where Hillary Clinton won every state, Trump received a larger share of v otes than Romney in 69 percent of counties.

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 AuthorvolumeDate ValuetitletypejournaltitleUrldoinoteyear
2007 DriventoDespairAsylumDeathsinthHarmit Athwal
Jenny Bourne
Driven to Despair: Asylum Deaths in the UK2007