Drugs, Suicide, and Crime: Empirical Estimates of the Human Toll of the Shutdown

By Audrey Redford and Thomas K. Duncan. Audrey Redford is the Assistant Professor of Economics at Western Carolina University. Thomas K. Duncan is the Associate Professor of Economics at Radford University. Excerpt:

"A 2017 NBER paper finds a 3.6% increase in the opioid death rate per 100,000 people for a 1% rise in unemployment. There were 14.6 opioid death rates per 100,000 in the US in 2018. If we use the more conservative estimate of a 20% unemployment rate without a quick return to lower levels, then there would be an estimated 59.4% rise in deaths per 100,000, leading to an increase of 8.7 deaths for a total of 23.3 for opioids.

With a current US population of 331 million, there are 3,310 groups of 100,000, meaning there is potential for an additional 28,797 deaths from opioids annually. Consider that for 2018, the CDC reports that there were 67,367 deaths from all-drug deaths, with 46,802 of those coming from opioid use. The 46,802 deaths were considered an opioid crisis. A possible 75,599 should not be dismissed quickly.

The negative effects will not be felt just through opioid use either. The numerical increase in deaths provided above is only for opioid users, but the all-drug death number will rise as well. In a 2018 study, Bruguera, et al, found that of the 180 drug users they surveyed about use during the Great Recession, 58.3% reported an increase in use while only 25.6% reported decreasing use, resulting in greater all-drug use for the period. Similarly, Mulia, et al, (2014) connects a rise in alcoholism to economic loss during the Great Recession. The CDC estimates that 2,200 people die in the US just from alcohol poisoning annually, not to mention the additional alcohol-related deaths that occur. In 2017 alone, there were also 22,246 deaths resulting from alcoholic liver disease.  As the jobless rate increases and the economic losses continue to mount, these numbers are likely to rise.

The deaths related to economic downturns go beyond those from chemical dependency, also. The mental toll is not inconsequential. For example, Blakely, et al, (2003) find that being unemployed may also increase the risk of suicide two to threefold. Milner, et al. (2014) similarly finds that unemployment is associated with a higher relative risk of suicide, with prior mental health issues being a key factor in that association. While a study by Kerr, et al, (2018) did not find that unemployment is directly linked to suicides, it did find a significant link between poverty, suicide, and alcoholism.

When breaking the population into age groups, Lin and Chen (2018) do find that unemployment does have a direct impact on older portions of the population, the portion of the population many of the current shutdowns are most meant to protect. Whether it is the direct unemployment effect or the potential poverty produced from the economic shutdown that leads to greater suicides, an increase from the 48,344 suicides and 1,400,000 suicide attempts in the US in 2018 should give decision-makers pause during their response to this pandemic.

Increased harm to oneself is not the only harm caused by economic downturns. There is also the threat of rising crime in general. Ajimotokin, et al, (2015) estimate that a one percent change in unemployment will increase the property crime rate by 71.1 per 100,000 people and the violent crime rate by 31.9 per 100,000 people.

With our estimated 16.5% rise in unemployment, we could see a significant increase in both property and violent crimes. The violent crime also may add to the death toll in this period.  Kposowa and Johnson (2016) find that unemployed workers are over 50% more likely to become homicide victims than those who are employed. They also find people not in the labor force to be 1.3 times more likely to victims than those who are employed. As workers become discouraged due to an inability to find jobs during a recession, their lives as well as their livelihoods are called into question."