Republican Support and Economic Hardship: The Enduring Effects of the Opioid Epidemic
中文摘要
本文在美国过去数十年最为突出的两大社会发展之间建立了因果联系：阿片类药物危机与共和党、民主党之间的政治阵营重组。利用针对普渡制药诉讼中解封的记录，我们揭示了处方阿片类药物营销在地理上存在丰富差异，这一差异构成了阿片类药物危机暴露程度的准外生来源。我们利用这一差异记录到药物相关死亡率的显著上升，以及对公共转移支付项目依赖程度的加深。由此引发的经济困境导致受阿片类药物危机影响最严重社区的政治格局发生重大变化。我们估计，从21世纪头十年中期到2022年，阿片类药物危机暴露持续提高了众议院、总统和州长选举中的共和党得票率。到2022年众议院选举时，我们的暴露程度指标每增加一个标准差，共和党得票率提高4.5个百分点。从2012年到2022年，众议院得票率的这一提高转化为共和党赢得了额外席位。
Abstract
Abstract In this article, we establish a causal connection between two of the most salient social developments in the United States over the past decades: the opioid epidemic and the political realignment between the Republican and Democratic parties. Drawing on unsealed records from litigation against Purdue Pharma, we uncover rich geographic variation in the marketing of prescription opioids that serves as a quasi-exogenous source of exposure to the epidemic. We use this variation to document significant increases in drug-related mortality and greater reliance on public transfer programs. This induced economic hardship led to substantial changes in the political landscape of the communities most affected by the opioid epidemic. We estimate that from the mid-2000s to 2022, exposure to the opioid epidemic continuously increased the Republican vote share in House, presidential, and gubernatorial elections. By the 2022 House elections, a one-standard-deviation increase in our measure of exposure led to a 4.5 percentage point increase in the Republican vote share. From 2012 until 2022, this increase in the House vote share translated into Republicans winning additional seats.