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The demand-side perspective argues that the drug overdose epidemic is a consequence of changes in the economy that leave behind working-class people who lack a college education. In contrast, the supply-side perspective maintains that the epidemic is primarily due to changes in the licit and illicit drug environment, whereas a third, distinct perspective argues that income inequality is likely a key driver of the epidemic. To evaluate these competing perspectives, we use a two-level random intercept model and U.S. state-level data from 2006 to 2017. Contrary to the demand-side approach, we find that educational attainment is not associated with drug-related mortality. In support of the supply-side approach, we provide evidence indicating that opioid prescription rates are positively associated with drug-related mortality. We also find that income inequality is a key driver of the epidemic, particularly the lack of resources going to the bottom 20% of earners. We conclude by arguing that considerations of income inequality are an important way to link the arguments made by the demand-side and the supply-side perspectives.

As part of a larger project to understand the relative health and disorder of St. Louis City neighborhoods, this paper presents estimates of the number of vacant parcels in the city. These estimates, which are considerably higher than previously published ones, are heavily concentrated in the city's disinvested and segregated North side. We term this heavy concentration of vacancy as "urban prairie". After accounting for other factors as well as possible sources of statistical error, we identify both long-term population loss since 1970 and the proportion of African American residents as significant covariates associated with the amount of urban prairie land per neighborhood. These high levels of concentrated vacancy lead us to critique the City's existing approaches as being too limited in scope, and to suggest a range of possibilities for revitalizing portions of North St. Louis while allowing prairie land to continue to exist in others.

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