Rural America has seen a sharp uptick in deaths from drugs, alcohol and suicide in recent years because of declining economic conditions, and that despair is part of why rural America went strongly for Donald Trump. Or so goes the popular narrative of the past few years. Only it's not proven, Bill Bishop writes for The Daily Yonder: "Yes, there has been a startling increase in overdose deaths, but no
research has ever found that declining economies were the primary cause.
Nor has this increase in drug-related deaths in rural areas
than urban ones," as The Rural Blog reported Jan. 8.
The idea first gained traction after Princeton University economists Angus Deaton and Anne Case published a study in 2015 about the increase in deaths among white men by overdose, alcohol and suicide. They labeled these "deaths of despair" and suggested that the increase was partially because of economic decay. The study came just in time for journalists trying to explain why rural America voted for Trump. "After all, Trump spoke often about the country’s decline and described 'carnage' in American communities. It all fit: failing economies in isolated places led to suicide, drug addiction and a Trump victory," Bishop writes.
But Deaton and Case argued in an op-ed for The Washington Post that the news media "gets the opioid crisis wrong" and that the rise in overdoses isn't disproportionately rural. Other research supports their argument; a paper by University of Virginia professor Christopher Ruhm that found that economic decline accounted for only a tenth of the increase in drug overdose deaths, at most. Ruhm also corroborated Deaton and Case's assertion that drug overdoses have increased more in urban areas than rural.
Ruhm concluded that the increase in drug overdose deaths was driven by the increasing prescription of opioids like OxyContin from 1999 to 2010; after that, illegal drugs like heroin and fentanyl caused the most overdoses. "There was another change. From 1999 to 2010, overdose deaths increased rapidly for older white men while they dropped for younger white men. In 2010, those trends reversed. Overdoses increased rapidly among young men," Bishop writes. So people who were most likely to use drugs (and overdose on them) changed over time to younger urban men, which is a demographic prone to risky behavior. That means the trend wasn't driven by despair, according to Ruhm.
"With this latest paper by Ruhm and the further studies from Deaton and Case, maybe we can call an end to the stories that try to show that addiction is related to where you live or who you vote for," Bishop writes. "America has a drug problem. Everywhere." That being said, research also shows that rural areas have less access to drug treatment, which arguably worsens the impact of the problem in those areas. And Trump did better than Mitt Romney “in counties with the highest drug, alcohol and suicide mortality rates,” wrote researcher Shannon Monnat of Penn State.
The idea first gained traction after Princeton University economists Angus Deaton and Anne Case published a study in 2015 about the increase in deaths among white men by overdose, alcohol and suicide. They labeled these "deaths of despair" and suggested that the increase was partially because of economic decay. The study came just in time for journalists trying to explain why rural America voted for Trump. "After all, Trump spoke often about the country’s decline and described 'carnage' in American communities. It all fit: failing economies in isolated places led to suicide, drug addiction and a Trump victory," Bishop writes.
But Deaton and Case argued in an op-ed for The Washington Post that the news media "gets the opioid crisis wrong" and that the rise in overdoses isn't disproportionately rural. Other research supports their argument; a paper by University of Virginia professor Christopher Ruhm that found that economic decline accounted for only a tenth of the increase in drug overdose deaths, at most. Ruhm also corroborated Deaton and Case's assertion that drug overdoses have increased more in urban areas than rural.
Ruhm concluded that the increase in drug overdose deaths was driven by the increasing prescription of opioids like OxyContin from 1999 to 2010; after that, illegal drugs like heroin and fentanyl caused the most overdoses. "There was another change. From 1999 to 2010, overdose deaths increased rapidly for older white men while they dropped for younger white men. In 2010, those trends reversed. Overdoses increased rapidly among young men," Bishop writes. So people who were most likely to use drugs (and overdose on them) changed over time to younger urban men, which is a demographic prone to risky behavior. That means the trend wasn't driven by despair, according to Ruhm.
"With this latest paper by Ruhm and the further studies from Deaton and Case, maybe we can call an end to the stories that try to show that addiction is related to where you live or who you vote for," Bishop writes. "America has a drug problem. Everywhere." That being said, research also shows that rural areas have less access to drug treatment, which arguably worsens the impact of the problem in those areas. And Trump did better than Mitt Romney “in counties with the highest drug, alcohol and suicide mortality rates,” wrote researcher Shannon Monnat of Penn State.
This team of journalists was embedded in drug-ravaged urban neighborhoods for months:
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