Trump Won Counties with High Rates of Opioid Overdose

By Zachary Siegel 12/12/16

Trump’s message spoke directly to the suffering experienced by working class voters, particularly those with addiction.

A sad woman stands in front of a brick wall.

A dark correlation was found in voting data among the counties that helped elect Donald Trump. Throughout the Industrial Midwest, Rust Belt and Appalachia, Trump won the most votes in counties with higher than average rates of suicide, alcohol poisoning, and drug overdose.

Shannon M. Monnat, an assistant professor of rural sociology and demography at Pennsylvania State University, analyzed county-level voting data in her paper provocatively titled: “Deaths of Despair and Support for Trump in the 2016 Presidential Election.”

Wherever suicide and drug overdose rates were highest, Monnat found that Trump outperformed Romney’s 2012 run by an average of 16.7 points. By contrast, Trump only won by 8.1 points in counties with the lowest mortality rates.

Monnat told Business Insider that she wasn’t surprised by what she found. "I expected to see it,” she said, “because when you think about the underlying factors that lead to overdose or suicide, it's depression, despair, distress, and anxiety."

The conclusion many are drawing from this disturbing trend is that Trump’s message spoke directly to the suffering experienced by working class voters, particularly those with addiction. While this may be accurate, correlation does not equal causation. In this case, that means one cannot conclude that Trump supporters are opiate-addicted, alcoholic, or suicidal.

The dominant narrative since Trump’s upset has been that working class counties that historically voted Democrat instead went red due to their ongoing economic hardships. Taking economics into account, Monnat’s paper also examined what she termed “economic distress,” measured by unemployment, poverty, living on public assistance, and being without health insurance.

What she found was another strong correlation: the higher a county ranked on her economic distress index, the better Trump performed. These regions have experienced “decades of automation, consolidation, and relocation,” wrote Monnat, which has led to “increased unemployment and wage stagnation.”

This correlation was also expected, Monnat concludes, because poor economic conditions create all sorts of public health problems, suicide and addiction in particular.

Though we cannot definitively conclude from this study that Trump supporters are dying “deaths of despair,” we also cannot ignore the prevalence of suffering in the counties that voted for him.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.

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