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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

Study: Fear of debt keeps Latinos out of college

Illustration: Aïda Amer/Axios

Fear of never being able to pay off school loans is keeping many young Latinos in the U.S. from going to college or completing a degree, according to a report published in September.

State of play: Latinos tend to have more difficulty repaying school debt than white student borrowers, according to Federal Reserve data, at the same time that they need more loans in order to afford tuition.

1 hour ago - World

Scoop: Biden administration objects to Israeli settlements plan

Israeli PM Naftali Bennett (L) meets with Secretary of State Tony Blinken. Photo: Olivier Douliery/Pool/AFP via Getty

The Biden administration has privately protested to the Israeli government over its plan to approve the planning and construction of more than 3,000 new housing units in the Israeli settlements in the occupied West Bank, sources briefed on the issue tell me.

Why it matters: The approvals for new homes in the settlements will be the first since President Biden assumed office, and come after Biden and his top aides personally pressed Israeli Prime Minister Naftali Bennett to restrain settlement activity and decrease the number of new housing units.

3 hours ago - World

Pentagon warns of ISIS-K capabilities outside Afghanistan

The site of an airstrike conducted by the U.S. against a planner for ISIS-K in Nangarhar province, Afghanistan in August. Photo: Xinhua via Getty Images

U.S. intelligence believes ISIS-K has the "intent" to eventually launch attacks outside of Afghanistan and could be capable of doing so "somewhere between six or 12 months," a top Pentagon official told senators Tuesday.

Why it matters: The U.S. withdrawal and subsequent Taliban takeover of Afghanistan has raised fears that terrorist groups will reconstitute and potentially pose a renewed threat to the U.S. homeland.