Trade Liberalization and Mortality: Evidence from US Counties

We investigate the impact of a large and persistent economic shock on deaths of despair. We find that areas more exposed to a plausibly exogenous change in international trade policy exhibit relative increases in fatal drug overdoses, specifically among whites. We show that these results are not driven by pre-existing trends in mortality rates, that the estimated relationships are robust to controls for state-level legislation pertaining to opioid availability and health care, and that the impact of the policy change on mortality coincides with a deterioration in labor market conditions and uptake of disability insurance.