This study revisited automotive plant closures in 112 manufacturing-intensive US counties from 1999 to 2016. It extended a 2020 opioid analysis to other drug classes, suicide and alcohol-related deaths. Staggered difference-in-differences and event-study models used restricted-use National Vital Statistics System mortality data and six socioeconomic measures. Closures were associated with 6.0 more overdose deaths per 100,000, including 7.9 more from opioids. Stimulant and benzodiazepine deaths each rose by 2.0 per 100,000, and labour-force non-participation by 1.7 percentage points. The design is observational and county-level, and an exploratory pathway analysis found no significant indirect associations.
Why it is interesting: The association with plant closures extends beyond opioids to stimulant and benzodiazepine deaths. An exploratory test found no significant indirect association through the measured socioeconomic conditions.
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