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Photo: David McNew / Getty

The phrase "deaths of despair" gained wide use after economists Anne Case and Angus Deaton reported that life expectancy for middle-aged Americans without a college degree was falling due to rising suicides and deaths related to drugs and alcohol.

Quick take: Case and Deaton argue that the primary cause of the trend is economic, but in a new paper, economist Christopher Ruhm places the blame on drug price and availability.

The background: In their paper last March, Case and Deaton said deaths of despair "are primarily the result of a 40-year stagnation of median real wages and a long-term decline in the number of well-paying jobs for those without a bachelor’s degree."

But Ruhm said that when he controlled for the down economy in which many addicts live, he found it less compelling than factors like the number of doctors per resident and the availability of a mandatory drug dispensary reporting program.

  • "If we were to improve the economies of these depressed rural and rust-belt areas where much of the opiate crisis is taking place," Ruhn says, "that would be great, but that’s not going to be the solution to the drug problem."
  • The most-controllable factor through public policy, he said, is the cost and availability of drugs.

But but but: In an email to Axios, Deaton sticks with his theory:

  • The difference comes when you study a long time frame — starting in the 1970s — and not the shorter period since 1999 that Ruhm examined.
  • The longer span suggests a link between opioid deaths and wage declines, Deaton said, in addition to "conditions of marriage, childrearing, religious affiliation, labor force participation, and involves morbidity as much as mortality."

Go deeper

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Trump leaves White House for the final time

President Trump took off on Marine One at 8:17 a.m on Wednesday morning, departing the White House for the last time, en route to Florida.

The big picture: Trump's final hours will be marked by snubbing his successor and granting pardons to many of his allies who have been swept up in corruption scandals.

Inauguration Day dashboard

Screenshot: Fox News

President Trump has left the White House en route to a farewell event at Andrews Air Force Base, kicking off the day that will culminate with President-elect Joe Biden taking office.

What's next: The inaugural celebration for young Americans is being livestreamed, starting at 10am.

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Janet Yellen said all the right things to reassure the markets

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Treasury Secretary nominee and former Fed chair Janet Yellen's confirmation hearing before the Senate Finance Committee on Tuesday showed markets just what they can expect from the administration of President-elect Joe Biden: more of what they got under President Trump — at least for now.

What it means: Investors and big companies reaped the benefits of ultralow U.S. interest rates and low taxes for most of Trump's term as well as significant increases in government spending, even before the coronavirus pandemic.