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When an Auto Plant Closes, Opioid Overdose Death Rates Increase

When an Auto Plant Closes, Opioid Overdose Death Rates Increase

Jan. 10, 2020
A study shows that five years after the plants closed, opioid overdose mortality rates among adults ages 16 to 65 in those counties were 85% higher than compared to counties where plants remained open.

While troubled economic times have led to a variety of health consequences, a new study is showing the extent of that connection.

A study led by researchers at the Perelman School of Medicine at the University of Pennsylvania and the Massachusetts General Hospital examined the relationship between the increase in opioid deaths relative to the closing of auto plants. 

In the study, U.S. manufacturing counties that experienced an automotive assembly plant closure were compared with counties in which automotive plants remained open from 1999 to 2016.

Automotive assembly plant closures were associated with a statistically significant increase in county-level opioid overdose mortality rates among adults aged 18 to 65 years. Of the manufacturing counties examined, 29 experienced an automotive assembly plant closure during the study period.

Results showed that five years after the plants closed, opioid overdose mortality rates among adults ages 16 to 65 in those counties were 85% higher than anticipated compared to counties where plants remained open.

The group with the largest increase in opioid overdose mortality after an automotive plant closure was non-Hispanic white men between 18-34 years old, followed by non-Hispanic white men ages 35-65 years old. Increases in opioid overdose mortality rates after closures were also noted for younger non-Hispanic white women.

“Major economic events, such as plant closures, can affect a person’s view of how their life might be in the future," .said lead author Atheendar Venkataramani, MD, an assistant professor of Medical Ethics and Health Policy. "These changes can have a profound effect on a person’s mental well-being, and could consequently influence the risk of substance use. Our findings confirm the general intuition that declining economic opportunity may have played a significant role in driving the opioid crisis.”

The authors note that although the study shows a robust and large association between plant closures and fatal opioid overdoses, the closures are not the only cause of the opioid crisis. They point to other factors such as prescription rates, which were at the forefront of the crisis in the early 2000s. The crisis, they say, can be attributed to both access to the drugs, and the forces that may lead people to take them and other opioids. Where initial access can be explained by the excessive prescribing rates, which have been in a decade-long decline since 2010, disentangling demand for opioids is more complicated.

“Our results are most relevant for the worsening population health trends in the industrial Midwest and South, regions that have experienced some of the largest increases in opioid overdose deaths and in which the automotive production and other manufacturing industries have long been economically and culturally significant,” Venkataramani said. “While we as clinicians recognize and take very seriously the issue of overprescribing, our study reinforces that addressing the opioid overdose crisis in a meaningful way requires concurrent and complementary approaches to diagnosing and treating substance use disorders in regions of the countries hardest hit by structural economic change.”

The authors also call for broad-based policy changes. 

“Until we can achieve structural change to address the fundamental drivers of the crisis, there are some health care system and health policy changes that can be implemented immediately,” said senior author and co-study lead Alexander Tsai, MD, an associate professor of psychiatry at the Massachusetts General Hospital and Harvard Medical School. “There is an urgent need to rapidly lower the threshold for accessing evidence-based treatment for substance use disorders, for example, at the level of state Medicaid policy and private payor utilization management.”

About the Author

EHS Today Staff

EHS Today's editorial staff includes:

Dave Blanchard, Editor-in-Chief: During his career Dave has led the editorial management of many of Endeavor Business Media's best-known brands, including IndustryWeekEHS Today, Material Handling & LogisticsLogistics Today, Supply Chain Technology News, and Business Finance. In addition, he serves as senior content director of the annual Safety Leadership Conference. With over 30 years of B2B media experience, Dave literally wrote the book on supply chain management, Supply Chain Management Best Practices (John Wiley & Sons, 2021), which has been translated into several languages and is currently in its third edition. He is a frequent speaker and moderator at major trade shows and conferences, and has won numerous awards for writing and editing. He is a voting member of the jury of the Logistics Hall of Fame, and is a graduate of Northern Illinois University.

Adrienne Selko, Senior Editor: In addition to her roles with EHS Today and the Safety Leadership Conference, Adrienne is also a senior editor at IndustryWeek and has written about many topics, with her current focus on workforce development strategies. She is also a senior editor at Material Handling & Logistics. Previously she was in corporate communications at a medical manufacturing company as well as a large regional bank. She is the author of Do I Have to Wear Garlic Around My Neck?, which made the Cleveland Plain Dealer's best sellers list.

Nicole Stempak, Managing Editor:  Nicole Stempak is managing editor of EHS Today and conference content manager of the Safety Leadership Conference.

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