Can Economic Policies Reduce Deaths of Despair?

Dow, William H.; Godøy, Anna Aasen; Lowenstein, Christopher; Reich, Michael

doi:10.3386/w25787

Cited by 55 publications

(39 citation statements)

References 49 publications

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“…For example, higher minimum wages and the earned income tax credit have been shown to reduce suicides but not drug poisoning deaths among adults with lower educational attainment. 31 , 32 Another study by Ruhm 33 found that economic factors are likely to explain only a small fraction of drug poisoning deaths, concluding that the availability and use of drugs is more likely to be the key driver. Ruhm 33 found no association of economic factors with suicide and alcohol-induced death rates.…”

Section: Discussionmentioning

confidence: 99%

Trends in Mortality From Drug Poisonings, Suicide, and Alcohol-Induced Deaths in the United States From 2000 to 2017

et al. 2020

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Key Points Question What are the patterns and trends in US drug poisoning, suicide, and alcohol-induced premature death rates by geography and demographic characteristics? Findings In this serial cross-sectional study using US mortality data from 2000 to 2017, including 1 446 177 drug poisoning, suicide, and alcohol-induced premature deaths, high drug poisoning death rates were clustered in the Northeast through Appalachia but high rates for suicide and alcohol-induced deaths were largely in the West. Death rates varied across these 3 causes by demographic characteristics, county-level characteristics, and over time. Meaning This cross-sectional study found that demographic and geographic patterns varied by cause of death, suggesting that these causes of death were not concentrated in 1 group or region and tailored interventions to each cause are urgently needed.

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Section: Discussionmentioning

confidence: 99%

Trends in Mortality From Drug Poisonings, Suicide, and Alcohol-Induced Deaths in the United States From 2000 to 2017

et al. 2020

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“…Causal models suggest that increasing both by 10% would have prevented 1230 suicides annually, but have no impact on drug overdoses. 30 Another study found that higher state-wide union density was associated with lower mortality rates for suicide and overdose. 31 In a study directly relevant to this one, a difference-in-differences approach estimated an association between county-level automobile assembly closures, from 1999 to 2016, and opioid mortality.…”

Section: Discussionmentioning

confidence: 99%

Suicide, overdose and worker exit in a cohort of Michigan autoworkers

Eisen¹,

Chen

Elser

et al. 2020

J Epidemiol Community Health

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BackgroundIn recent decades, suicide and fatal overdose rates have increased in the US, particularly for working-age adults with no college education. The coincident decline in manufacturing has limited stable employment options for this population. Erosion of the Michigan automobile industry provides a striking case study.MethodsWe used individual-level data from a retrospective cohort study of 26 804 autoworkers in the United Autoworkers-General Motors cohort, using employment records from 1970 to 1994 and mortality follow-up from 1970 to 2015. We estimated HRs for suicide or fatal overdose in relation to leaving work, measured as active or inactive employment status and age at worker exit.ResultsThere were 257 deaths due to either suicide (n=202) or overdose (n=55); all but 21 events occurred after leaving work. The hazard rate for suicide was 16.1 times higher for inactive versus active workers (95% CI 9.8 to 26.5). HRs for suicide were elevated for all younger age groups relative to those leaving work after age 55. Those 30–39 years old at exit had the highest HR for suicide, 1.9 (95% CI 1.2 to 3.0). When overdose was included, the rate increased by twofold for both 19- to 29-year-olds and 30- to 39-year-olds at exit. Risks remained elevated when follow-up was restricted to 5 years after exit.ConclusionsAutoworkers who left work had a higher risk of suicide or overdose than active employees. Those who left before retirement age had higher rates than those who left after, suggesting that leaving work early may increase the risk.

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“…Evidence on the efficacy of strategies to reduce suicide among adolescents, including antidepressants for those with depression, is mixed 3637. Recent evidence suggests that policies raising the incomes of low wage workers are associated with a reduction in suicides, with a 10% increase in the earned income tax credit associated with a 5.5% decline in suicides and a 10% increase in the minimum wage associated with a 3.6% decline in suicides 38…”

Section: Discussionmentioning

confidence: 99%

State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses

Raifman

Larson

Barry

et al. 2020

BMJ

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ObjectiveTo evaluate the association between US state policies that establish age 18 or 21 years as the minimum purchaser age for the sale of handguns and adolescent suicide rate.DesignRegression discontinuity and difference-in-differences analyses.Setting46 US states without policy changes between 2001 and 2017; Missouri and South Carolina, which lowered the age for handgun sales in 2007 and 2008, respectively; and West Virginia and Wyoming, which increased the age for handgun sales in 2010.ParticipantsAdolescents aged 13 to 20 years(554 461 961 from 2001 to 2017) in the regression discontinuity analysis, and adolescents aged 18 to 20 years (168 934 041 from 2002 to 2014) in the main difference-in-differences analysis.Main outcome measureSuicide rate per 100 000 adolescents.ResultsIn the regression discontinuity analysis, state policies that limited the sale of handguns to those aged 18 or older (relative to 21 or older) were associated with an increase in suicide rate among adolescents aged 18 to 20 years equivalent to 344 additional suicides in each state where they were in place between 2001 and 2017. In the difference-in-differences analysis, state policies that limited the sale of handguns to those aged 21 or older were associated with 1.91 fewer suicides per 100 000 adolescents aged 18 to 20 years (95% confidence interval −3.13 to −0.70, permutation adjusted P=0.025). In the difference-in-differences analysis, there were 1.83 fewer firearm related suicides per 100 000 adolescents (−2.66 to −1.00, permutation adjusted P=0.002), with no association between age 21 handgun sales policies and non-firearm related suicides. Separate event study estimates indicated increases in suicide rates in states that lowered the age of handgun sales, with no association in states that increased the age of handgun sales.ConclusionsA clear discontinuity was shown in the suicide rate by age at age 18 in states that limited the sale of handguns to individuals aged 18 or older. State policies to limit the sale of handguns to individuals aged 21 or older were associated with a reduction in suicide rates among adolescents. Increases in suicide rates were observed after states lowered the age of handgun sales, but no effect was found in states that increased the age of handgun sales.

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Can Economic Policies Reduce Deaths of Despair?

Cited by 55 publications

References 49 publications

Trends in Mortality From Drug Poisonings, Suicide, and Alcohol-Induced Deaths in the United States From 2000 to 2017

Trends in Mortality From Drug Poisonings, Suicide, and Alcohol-Induced Deaths in the United States From 2000 to 2017

Suicide, overdose and worker exit in a cohort of Michigan autoworkers

State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses

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