The economic underpinnings of the drug epidemic

Abstract

U.S. labor markets have experienced transformative change over the past half century. Spurred on by global economic change, robotization, and the decline of labor unions, state labor markets have shifted away from an occupational regime dominated by the production of goods to one characterized by the provision of services. Prior studies have proposed that the deterioration of employment opportunities may be associated with the rise of substance use disorders and drug overdose deaths, yet no clear link between changes in labor market dynamics in the U.S. manufacturing sector and drug overdose deaths has been established. Using restricted-use vital registration records between 1999 and 2017 that comprise over 700,000 drug deaths, I test two questions: First, what is the association between manufacturing decline and drug and opioid overdose mortality rates? Second, how much of the increase in these drug-related outcomes can be predicted by manufacturing decline? The findings provide strong evidence that the restructuring of the U.S. labor market has played an important upstream role in the current drug crisis. Up to 92,000 overdose deaths for men and up to 44,000 overdose deaths for women are predicted by the decline of state-level manufacturing over this nearly two-decade period. These results persist in models that adjust for other social, economic, and policy trends changing at the same time. Critically, the findings signal the value of policy interventions that aim to reduce persistent economic precarity experienced by individuals and communities, especially the economic strain placed upon the middle class.

Robots Don't Pay Taxes: Deindustrialization and Fiscal Decline

“…Examining the changing spatial pattern of economic mobility in the U.S., Connor and Storper (2020) find that intergenerational economic mobility declined substantially in the industrial northeast and Midwest in recent decades, attributed in part to the loss of manufacturing jobs that once dominated the area and served as a key pathway to upward mobility. Examining the upward mobility outcomes of adjacent cohorts in the same community, Seltzer (2020) finds that the number of manufacturing jobs at the time a cohort enters the labor force is positively associated with climbing the income ladder in early adulthood. Looking specifically at the effects of automation, Berger and Engzell (2020) find a large and negative effect of robot penetration in the commuting zone and upward mobility, particularly for white men.…”

“…A parallel story is emerging in the field of population health, where deindustrialization is contributing to not only the overall decline in longevity-driven by rising 'deaths of despair' (Case and Deaton 2018)-but also increasing spatial variation in health outcomes. For example, manufacturing job loss has been linked to increased mortality in studies examining both acute shocks stemming from plant closure (Sullivan & von Wachter 2009;Venkataramani et al 2020;Browning & Heinsen 2012) as well as those examining long-run trends including the rise of automation (O'Brien et al 2021;Charles, Hurst, Schwartz 2018;Seltzer 2020). Here, too, the impact of deindustrialization on government spending is asserted as one pathway through which manufacturing decline impacts the broader community; an assertion firmly supported by empirical evidence identifying public sector expenditures as a key determinant of health outcomes (see, e.g.,…”

“…The economy of the United States (U.S.) has undergone a massive restructuring in recent decades. From 1980 to 2020 the share of workers employed in a goods-producing industry fell from one in four to just one in ten (Seltzer 2020;Fort, Pierce & Schott 2018). This structural shift is the result of multiple factors (Kollmeyer 2009;Alderson 1999;Brady & Denniston 2006) including competition from foreign trade and the adoption of new technologies, particularly the use of industrial robots to automate tasks previously done by human workers.…”

“…A bevy of recent social science research reveals how deindustrialization is reshaping nearly every facet of American social life, from fertility and marriage to employment and wages to health and political polarization (Wilson 1987(Wilson , 1994Autor, Dorn & Hanson 2019;Fort et al 2018;Acemoglu & Restrepo 2020;Autor, Dorn & Hanesen 2020;Kollmeyer 2018;Kollmeyer & Pichler 2013). Population health researchers point to the decline of manufacturing jobs as a key driver of increasing 'deaths of despair' due to alcohol, drugs and suicide, particularly among males without a college degree (Case & Deaton 2017;Seltzer 2020;O'Brien, Bair and Venkataramani 2021).…”

Death by Robots? Automation and Working-Age Mortality in the United States

“…The most common explanations attribute this troubling trend to structural changes in the U.S. economy which have reduced opportunity and increased precarity for working-age adults without a four-year college degree. A growing body of empirical research supports this contention (Coile & Duggan 2019;Venkataramani et al 2020b;Naik et al 2019;Seltzer 2020). Much of this work examines the impact of the decline in economic opportunities in domestic manufacturing, a sector that historically served as a path to the middle class for those without a college degree (Cherlin 2014).…”