A recent study published in the medical journal JAMA Internal Medicine has shown that automotive assembly plant closures are associated with an increase in opioid overdose mortality. These findings highlight the importance of eroding economic opportunity as a factor in the U.S. opioid overdose crisis.
The authors of the report, Dr. Atheendar Venkataramani, Elizabeth Bair, Rourke O’Brien and Dr. Alexander Tsai, specifically focused on the automotive industry because plant closures are often unexpected, discrete and both culturally and economically significant events, thus providing an opportunity to estimate the potential consequences of an acute, sustained decline in economic opportunities. They compared changes in working-age adults living in manufacturing counties before versus after automotive assembly plant closures occurred compared with similar changes in manufacturing counties where plant closures did not occur.
The study included 112 counties situated in 30 commuting zones, which were primarily distributed across the midwest and southern U.S. During the time frame, from 1999-2016, of the sample counties, 29 were exposed to an automotive assembly plant closure and were located in 10 commuting zones. The remaining 83 counties in 20 commuting zones were not exposed. Among the sample counites, plant closures occurred during the period of 2002 to 2009.
Opioid overdose mortality increased in each of the exposed counties during the first five years after a plant closure and plateaued thereafter. Five years after exposure to a closure, mortality rates from opioids had increased by 8.6 deaths per 100,000 in exposed vs. unexposed counties, or an 85 percent increase. The authors found a similar pattern of results when they examined prescription vs. illicit opioid overdose mortality separately. Five years after exposure, prescription opioid overdose mortality had increased by 4.4 deaths per 100,000. Similarly, illicit opioid overdose mortality increased by 5.8 deaths per 100,000.
“The study is important because it shows that when economic opportunities collapse, it not only has consequences for people’s economic wellbeing, but it might adversely affect their health, too,” Venkataramani, assistant professor at the University of Pennsylvania Perelman School of Medicine, told CNN. “Economic opportunity matters for our health, and as the forces that are shifting economic opportunities for people are continuing to evolve, we have to think about how policies can both make people resilient — from a health sense — to the negative change that might happen, and we also have to think about what types of policies on the economic side may actually give people opportunities, which may bolster their health.”