Analysis: drug overdose deaths not tied to rural despair - Entrepreneur Generations

Rural Americans have 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 voted so overwhelmingly for Donald Trump, or so goes the popular narrative of the past few years. Only it's not exactly true, 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 been worse in rural areas than urban ones."

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 media "gets the opioid crisis wrong" and that the rise in overdoses isn't just a rural phenomenon. Other research supports their assertion, like 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 best. 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 reports. 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."

from The Rural Blog http://ift.tt/2DGSOos Analysis: drug overdose deaths not tied to rural despair - Entrepreneur Generations

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