Donald Trump. AP Photo/Matt Rourke Over the last few years, economists have found that surging imports from China may have led to millions of job losses in U.S. factory towns, confirming what plenty Americans already assumed about the dark side of trade. Now, another important but similarly unsurprising new study suggests that this rapid hollowing out of industrial communities across the country may have driven up suicide and drug overdose rates among working-class whites.

The draft paper, by Federal Reserve Board economist Justin Pierce and Yale School of Management professor Peter Schott, looks at how mortality rates changed across the country after the United States decided to grant permanent normal trade relations to China in 2000. According to the pair's previous research, that move contributed to the swift collapse in American manufacturing employment during that decade by giving U.S. companies the certainty that they could offshore production or start purchasing from Chinese suppliers without worrying about sudden tariff hikes. Their new study builds on that work. It shows that, compared to the rest of the country, counties where local manufacturing businesses were more vulnerable to Chinese competition saw their job markets deteriorate more severely, and experienced greater increases in deaths by suicide and “accidental poisoning”—a category that includes drug overdoses. They found “mixed” evidence of increased deaths from alcohol-related liver disease.