Study: Communities Most Affected By Opioid Epidemic Also Voted For Trump

Voting patterns show that areas where Donald Trump did well were also places where opiate overdoses and deaths occurred. NPR's Scott Simon speaks with Shannon Monnat who led the study.

SCOTT SIMON, HOST:

Shannon Monnat was watching election returns last month when she thinks she noticed a pattern. Professor Monnat's an assistant professor of rural sociology and demography at Penn State University, and she's been studying drug and alcohol mortality rates. She joins us now from Lowville, N.Y. Thanks very much for being with us.

SHANNON MONNAT: Thanks, Scott.

SIMON: What did you look at, and what did you find?

MONNAT: Well, so this was part of a larger project where I've been trying to understand the common characteristics of places with high rates of mortality from drugs, alcohol and suicide - these kinds of deaths of despair. And as you mentioned, I was watching the returns come in on election night and sort of noticed that the states where Trump was performing more strongly than expected, like Pennsylvania and Ohio and Michigan, were states that have seen major upticks in drug overdoses and other deaths of despair over the past decade.

So I started looking at the data, especially within regions of the country where the opiate epidemic has received a lot of attention. And what I found was that Trump outperformed the previous Republican candidate Mitt Romney the most in counties with the highest drug, alcohol and suicide mortality rates.

SIMON: And to take the chance of getting you a little bit out of your area of academic expertise for a moment, do you infer a lot of people who live in these areas heard a message of hope in Mr. Trump?

MONNAT: You know, I think in many of the counties where he did the best, economic distress has really been building, and social and family networks have been breaking down for several decades. And so I think these findings reflect larger economic and social problems that sort of go beyond drug and alcohol abuse and suicide. It's really about downward mobility and the dismantling of the American dream at a larger community level. And Trump really has sort of capitalized on and exploited the feelings of the people in these communities. In a lot of these places, good-paying jobs and the dignity that goes along with those good-paying jobs has been replaced by suffering and hopelessness and the belief that people in power don't really care about them or their communities.

SIMON: So on top of everything else, those of us who report politics and live in a bubble - we missed the importance of the opioid epidemic?

MONNAT: I'm not so sure that it was missed, per se. I think it's been there at the forefront of the news for a really long time. I just don't think that we saw the potential that it would impact the election in the way that it did, insofar as it's tied up in these other economic and social struggles that are occurring within the same communities.

SIMON: And to be clear again, you're not saying that people that have a problem with opioids or drug or alcohol voted for Donald Trump so much as people who live in those communities that have been affected by it statistically in your study voted for Donald Trump.

MONNAT: Well, that's right. And I can't say necessarily who voted for Donald Trump, but we have to remember that addiction and depression and these diseases and deaths of despair go far beyond the individuals themselves who are affected by them. They affect friends and family members and coworkers and first responders and service providers and employers in communities who are dealing with the struggles of these and experience the same sort of frustration and anxiety that are associated or wrapped up within diseases and deaths of despair.

SIMON: You conclude your study by - I believe the quote is community level well-being played an important role in this election.

MONNAT: Yeah, that's right. So I think what we're seeing is the consequence of this perfect storm of decades of decline in these decent-paying jobs and benefits, especially for folks without a college degree, and little hope that those kinds of jobs will ever come back mixed with really easy access to pain pills and cheap and potent heroin. And on top of that, there's a lack of comprehensive and affordable health care services, including mental health and substance abuse treatment.

SIMON: Professor Monnet, what do you hope a President Trump can do to help people who live in communities like this?

MONNAT: Well, it seems to me that the policies really need to reflect the economic and health challenges of rural and small city America in the same ways that they've tried to target large urban cities. And that includes good-paying stable jobs, especially for those without a college degree. That needs to be the staple of any economic policy. What people really want is to be able to support themselves and their families.

SIMON: Shannon Monnat, assistant professor of rural sociology and demographics at Penn State University, thanks so much for being with us.

MONNAT: Thanks for having me, Scott.

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