More on Deaths of Despair: New Study Links Early Job Loss to Higher Rates of Overdose Deaths and Suicides

A new study published in the Journal of Epidemiology and Public Health (hat tip reader ma) gives more granular insight into the triggers of so-called deaths of despair, as in the AIDS-level rise of deaths of the middle aged with high-school-only educations. We’ve embedded the study at the end of this post; the data supplement is here.

The article uses a large data set of United AutoWorkers at GM in Michigan, with workers hired as far back as 1938, including mortality information. The authors scrubbed the data to focus those who joined after 1970 in three plants, one in Detroit, one 50 miles west of Detroit, and one in a more rural area. All plants were downsizing prior to their closures in 2012, 2010, and 2014 respectively. Women were excluded because there were so few suicide and overdose deaths among them.

The authors describe the contract terms that suggest that job departures before the age of 55 were likely to be involuntary. They found that employees who stopped working were 16 times as likely to die of suicide or overdose as ones who stayed employed. The odds of death were highest among workers in rural areas, likely due to the difficulty of finding a new job:

Of the three study plants, Plant 2 had the highest incidence rate of suicide in this study. This plant was located at the site of Willow Run, a factory in southeastern Michigan renowned for the mass production of fighter planes during World War II….By 1970, it employed 10 000 workers making automatic transmissions. Plant 2 closed in 2010 as part of GM’s bankruptcy proceedings. In 1970, the population of the surrounding township was 30 000; today it is 20 000.

Nearly all the drug deaths occurred at Plant 2 in runup to its closure. This would also have been during the financial crisis, which could have hit older workers with investments.1

The authors also push back mildly on the popular notion that deaths of despair are a white phenomenon. The plant in Detroit, which did have a lower suicide rate, was where nearly all the African Americans work. Angus Case and Anne Deaton speculated that the higher death rates among lesser educated whites was due to Hispanics and blacks having stronger family/informal social safety nets. That may be conflated by the fact that working class Hispanics and blacks are more concentrated in cities that rural areas, so the quiet impoverishment of rural America would hit older, not well educated whites, who by virtue of being in the most disadvantaged communities, would suffer the most. From the paper:

Case and Deaton were the first to note rising midlife mortality rates among Caucasian, non-Hispanic Americans aged from 35 to 54 with a high school education or less. They identified drug overdose, suicide and alcohol-related liver disease mortality as the causes of the increase and attributed these ‘deaths of despair’ to reduced economic opportunity among less educated adults.

Increases in these ‘deaths of despair’ have since been identified across multiple race and ethnic groups and geographic contexts. Rising mortality rates have been reported for US African Americans, Hispanics, Asians and Pacific Islanders, 25–64 years of age, with drug overdoses the leading cause of the recent increases in all these subpopulations. Reversing decades of steady decline in all-cause mortality for African Americans and Caucasians, these disturbing shifts are particularly pronounced for midlife individuals without a bachelor’s degree. Suicide rates have also increased by 33% since 2000, with the steepest increase for Caucasian men. Though the rise has been less dramatic for suicide than for overdose, it emerged in 2016 as the fourth leading cause of death among adults, aged 35–54. Rural counties had consistently higher suicide rates than metropolitan counties.

The authors take as a given that the “China shock” after its WTO entry in the early 2000s was a crippling blow to US manufacturers already in decline. And just as that policy (as well as NAFTA and successful anti-union efforts) decimated blue-collar workers, studies of variation in state policies suggests that higher minimum wages and earned income tax credits would reduce suicides (but not overdose deaths).

The Detroit Free Press spoke to the UAW about the study:

UAW President Rory Gamble has three words of advice for his family and his union brothers and sisters who are contemplating an early job exit: Don’t do it.

Gamble has been around long enough to see what happens when workers exit a job ahead of retirement age without a “defined path” for the future and the financial acumen to stay solvent.

“They get hit with major disappointment when that package money runs out,” Gamble told the Free Press. “Reality sets in and they lose their health care and that leads to declining health, declining mental health and then you combine that with the mental shock and here we are, we get high incidents of folks committing suicide and dying early.”

Gamble has a growing concern over the high rates of suicide and overdoses among union members. That’s why he said he will encourage his successor to push the Detroit Three automakers, in the 2023 contract negotiations, to provide for added services such as extended mental health and financial counseling benefits as part of any early incentive plans the companies offer union members to leave the job.

“We need to craft language that provides firm support going forward, that helps folks moving forward and helps their transitions,” said Gamble, who has no plans to seek reelection after his term expires in 2022. “I see us doing that, given the numbers.”

The problem, as readers know all too well, on America’s present trajectory with Covid-19, a lot of people are or face the real risk of being out of work, with few ready prospects for re-employment. $1200 checks are better than nothing but they won’t go far. With entire sectors of the economy facing auto-industry level downsizings, on a much more compressed timeframe, desperation will lead to high costs: more deaths, more divorces, more violence at home, more crime. And tellingly, the official fixation is on more policing rather than more jobs and social support.


1 If you pooh pooh the idea, you are showing your class bias. Workers with good paying manufacturing jobs in areas with modest costs of living could accumulate a lot of savings; I know of paper mill workers with ~ $1 million in retirement and savings accounts.

00 autoworker deaths of despair study
Print Friendly, PDF & Email


  1. skippy

    I’ll just come and say after the Bernays neoliberal thingy blew up in the GFC, compounded by endless expeditionary wars, and post GFC wage income got crammed down more that the preceding decades, all whilst demands on that income have increased to satisfy investor demands …. wellie covid was just the last proverbial straw for some.

    Not to mention without work, in a historical context, some people will just find time to indulge some of their worst behavioral traits, add on some internet poison Jim Jones sorts or collective Facedoodle like antics and you might as well put your head in the microwave …. and fell the power as Williams said.

    In the early years of this blog I referenced a book by someone that had a gander at the historical obituary record in reference to the wildly over romanticized wild west period and it was not pretty. Women committing suicide from being removed from social – family networks to live and work in isolation for first mover advantage to gain property, men sticking their heads over a hole in one case with lit dynamite because a crop failed et al E.g. the future became a black hole where there was no opportunity to better oneself no matter how hard you tried.

    On another note PM Jacinda Ardern seems to be have a good run as well our Queensland MP.

  2. Sound of the Suburbs

    Why make a mistake once, when you can make the same mistake loads of times across the entire Western world?
    Those ”anywheres” have a bad idea, and spread it around across the Western world, so everyone makes the same mistakes.
    Let’s have a knowledge based economy and make sure the majority get degrees.

    Just because you have an IQ over 100, what about the other half that have IQ’s of 100 and below?
    Who cares!
    They’re off, with one of their half-baked ideas, they will roll out everywhere.

    It soon becomes apparent in the US that the number of jobs requiring degrees hasn’t grown with the number of new graduates.
    The US starts concocting worthless degrees that will help the “anywheres” meet their targets for the number of people with degrees.
    The US starts to get in trouble with defaulting student loans.
    In the US, a new underclass develops of people with degrees and massive student debts who have to live in their parents basements as they can never afford to move out with the lousy service sector jobs they have managed to get.

    “Oh well, it’s too late now” the “anywheres”
    The West will just have to suffer the consequences of our hubris.

    1. skippy

      Educational standards dictate I.Q. more than some silly notion of ethic ability, profit incentives are not a good long term standard.

      This ebbs and flows with national imperatives throughout history.

      1. Sound of the Suburbs

        In the UK, we used to have two paths for those that were more practical and those that were more academic.

        We used to have Grammar Schools and Secondary Moderns.
        The Grammar Schools were for the more academic.
        The Secondary Moderns were for the more practical.

        Many people I know went to Secondary Moderns and did pretty well for themselves as self-employed builders, electricians, plasterers, ….. etc ….; or set up small firms in areas that matched what they were good at.
        You would be amazed at how much money people who set up sandwich rounds actually make in the UK.
        Early on, many of these people were doing better than me, who had taken the academic route.

        We used to have Universities and Polytechnics.
        Universities were more academic.
        Polytechnics more practical.

        I was a student engineer, who did a degree, and I worked with many apprentices, who were more practical, and even though they had started off down this path a few moved over to the more technical side and most made perfectly good managers.
        Engineers can be somewhat lacking in their interpersonal skills and many apprentices were actually better managers
        The best engineers usually make pretty bad managers.
        It’s a different skill set.

        1. Sound of the Suburbs

          The practical approach v’s the academic approach.
          Which one is best?
          It depends on what you are doing.

          In the early 1990s I had been promoted to managerial level. I wanted to stay as an engineer, but if I refused this wouldn’t go down well.
          Anyway, I had to interview some fresh graduates in the middle of the early 1990s recession and I couldn’t help feeling sorry for them.
          One young woman had better qualifications than I had, and really deserved better than the sort of jobs that were available at that time.
          She was far too well qualified for the sort of work I needed doing, and with that sort of work a more practical background usually does the job better. I needed a job done quickly, and wanted someone who would hit the ground running.
          It didn’t seem fair, but that’s the way it was.
          In the end I was assigned two young lads to do the work.
          One was a fairly inexperienced graduate and one a fairly inexperienced ex-apprentice.

          Academic qualifications v’s a more practical approach
          The job didn’t need a lot of intelligence and favoured the more practical approach.
          They were both given very similar tasks.
          The ex-apprentice went off and just did it, although he really should have asked a few questions as there were some aspects that weren’t well defined.
          I did have to check his work, and he did make a few mistakes, but this got the job done quickly.
          The inexperienced graduate wouldn’t start the task until he had cleared up all the potential problem areas.
          This got the job done slowly.

          The graduate approach did look familiar.
          That’s what I normally did.
          Perhaps that wasn’t always the best way.

          1. skippy

            Similar case here in Australia until the Tafe or trade school got privatized – see ‘All Trades’ just going into receivership, largest of its sort. Basically just cheap labour hire where students get sent to bulk out work and then let the remediation process[???] fix all the failures. Then some are confused at the loss of skills [knowledge] and its resultant substandard product. Then you have the imported village and its ethnic boss man dynamic that mirrors the war nerd post views without the mortality rate.

            Currently most the skill is in commercial fit outs or highend RE remodels, albeit with corvid fit outs might take a hit.

            Curiously my youngest son goes to a GPS school, but is starting a diesel – heavy equipment mechanic path. Largely facilitated by relative networks more so than what state programs offer.

        2. Tom Bradford

          Whether you went to Secondary Modern or Grammar School was, in my time, decided by the 11+ exam taken at around 11 at the end of Primary School. Hence one’s entire future career path was in a real sense based on a single exam taken on a single day when one was still a child.

          I ‘failed’ the 11+ and hence went to Secondary Modern where over six miserable years I received an introduction to subjects like carpentry, metal-working, technical drawing and all the etceteras preparing me for a trade. However I did well enough in my ‘O’ and ‘A’ levels to go to University where I gained an LLB. Hence I spent my career pushing papers in a solicitor’s office, but could at least do my own carpentry, car maintenance and wiring at home!

          Oh, and the entire experience from starting school at 5 to graduation day at 19 cost my parents nothing that wasn’t voluntary – apart from the school uniform.

          1. Sound of the Suburbs

            If your parents had enough money, you could have been on the fast track from age 4.
            Private school -> Oxbridge -> top jobs

            The eleven plus did select at age eleven, but there is another selection that takes place at age 4.

            Perhaps the old system needed a bit more flexibility, with some movement between grammars and secondary moderns so your path wasn’t set so concretely at age eleven.

  3. VietnamVet

    I just realized yesterday that with cheap quick paper monoclonal antibody tests students and workers could see every morning if they are positive or negative for the virus before leaving home. The coronavirus pandemic will be ended as soon as these tests are available for everyone and Americans agree to join the national public health program to test themselves before going out, staying isolated if positive, receive support, and get free medical treatment if symptoms appear. With the reproductive factor less than 1 the virus will quickly die out. But the Pharmaceutical Industry will lose billions of dollars they will get from a jackpot vaccine and/or patentable treatment. Disease prevention costs them money.

    The acute American tragedy is that these deaths of despair and the 150,000 deaths from the Wuhan coronavirus have the exact same cause; elite greed and arrogance. This is never mentioned by corporate media. Increasing corporate bonuses and shareholder value overrides the safety, health and well-being of 90% of the US population. It is they who are protesting a system that treats them like trash. The loss of the American Dream.

    Government failing them. Federal Agents and Court Buildings have become a symbol of the maltreatment in the Pacific Northwest.

    1. Amfortas the hippie

      i’d like to know more about these cheap and rapid tests.
      are they available?
      available in bulk?(at discount?)
      without a prescription or other unnecessary hoops?
      if yes to all 3, i could definitely sell that to the Town Fathers.

      …and it’s of pretty great import where they’re made, as well as where their constituent parts are made…not only for availability’s sake, but for the marketing/lobbying/convincing part.
      this angle(rapid/cheap tests to facilitate reopening) appears to have legs.
      I’ve seen it mentioned more and more…in comments, as well as in the articles.

      1. Amfortas the hippie

        still haven’t found the cost of the assay device, of course(if you hafta ask, you can’t afford ir,lol)
        it appears, tho, that only authorised labs can obtain it:
        “14 1 The letter of authorization refers to, “laboratories certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C. §263a, to perform high and moderate complexity tests” as “authorized laboratories.””

        i had no idea what a CLIA lab was…but look!:

        we have 3 of them even way out here.
        the fda faq sheet walks through the process…which appears somewhat easier than changing the tires on my kids bike.
        so i’ll keep looking for cost of initial device, as well as operating the thing.
        if it ain’t exorbitant, perhaps lobbying politicians is the wrong tree to bark into.

        1. Amfortas the hippie

          abbott got a clia waiver.
          from what i can tell, not being a doctor or lab guy, and therefore not wanting to “request a quote”, this looks like a no brainer.
          and it appears to be available.
          notably, most of the links that pop up on “covid idnow test kit” are hysterical or near-hysterical “liberal media” huffings and puffings that this test ain’t perfect.
          i think you’re right, and it’s too cheap for the ptb to get behind.
          i’ll ask whichever nurse i run into first if anybody near to hand is even aware of this test.
          sometimes, i really hate my country.

          1. Amfortas the hippie

            to be clear, i went looking for an at-home test, but FDA is standing on the hind leg of that, apparently(and i couldn’t find anything about whether the chems, etc needed for such a test are hard to make, or made domestically)…and the next best thing looked like the abbott thing above.
            Iirc, the “reagents”, etc needed for this latter are made elsewhere, which gets us right back to test shortages…in addition to the approved lab bottleneck.
            is anybody aware of any plans by our wonderful bigpharma to attempt to make those chemicals here?
            does usa even have the wherewithal?
            I could find zero about that, but this may be due to google, and the problem of labspeak, and the paywalls all over.

      2. VietnamVet

        This video was posted by Carla in yesterday’s Links. It is amazingly underground. I’ve heard of the Abbott ID NOW test that protects the White House and allows the President not to wear a face mask since March 31st. But when mentioned by the media it is disparaged as being imprecise. These paper monoclonal antibody tests make public health programs to control the virus simple and effective but could cost a billion dollars that wouldn’t go the Pharmaceutical Industry but to saving American lives.

        Something is going to pop the bubble around the 10%. Since both parties are complicit, the realization that so many people have died for no good reason is a very sharp pin.

        Government pensions where the first thing lost in the fall of Soviet Union. My family’s survival depends on my pension being digitally deposited each month by the Office of Personnel Management.

  4. Adam1

    Not that I don’t disagree with the author, but an important note on the rural suicides… rural Americans are much more likely to be gun owners and a gun greatly increases the odds of a suicide attempt becoming successful.

  5. L

    But just to take up the point about that $1200 checque. If it comes packaged with laws that protect your “employer” if they get you sick, but not you if you die, and it comes with a shiv for Medicare, Medicaid, and Social Security, then the net effect is still far more negative than positive, particularly for the workers as they age.

  6. David in Santa Cruz

    What is Team Dem proposing? More student loans? Re-training? To do what exactly? I challenged Joe Stieglitz in a book-signing line a few years back that it is mathematically impossible for everyone to merit a PhD.

    It’s no wonder that the Professional and Managerial Class are “fine” when the poor and disenfranchised graduate from Oxy and nicotine to fentanyl and meth. We’ll just police you onto a mattress on the floor of a NG armory and set-up a needle-exchange and you’re all set!

    They were careless people, Tom and Daisy – they smashed up things and creatures and then retreated back into their money or their vast carelessness, or whatever it was that kept them together, and let other people clean up the mess they had made.”

  7. d

    find it odd that one of the reasons that some push for all to get back to work is that they are ‘worried’ that some may kill them selves.

    but one never hears that from the same bunch pushing the back to work when companies do mass layoffs. for some reason that just never comes up…

    wonder why that is?

Comments are closed.