IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v364y2025ics0277953624009833.html
   My bibliography  Save this article

Beyond social determinants: Fiscal determinants of overdose death in U.S counties, 2017–2020

Author

Listed:
  • Lindenfeld, Zoe
  • Silver, Diana
  • Mauri, Amanda I.
  • Rothbart, Michah W.

Abstract

A large body of research has been dedicated to understanding the relationship between social determinants of health (SDOH) and overdose death across counties in the United States (U.S). However, this literature has so far focused on demographic and socioeconomic characteristics of counties and has largely overlooked the ways in which county fiscal constraints may be associated with responses to the opioid epidemic. To address this gap, this longitudinal study uses data from the U.S Census of Governments to examine the associations between county governments’ revenues and expenditures, commonly used measures of SDOH, and overdose deaths in U.S counties from 2017 to 2020. We find that along with SDOH, higher per capita police spending, but not health expenditures, was associated with overdose deaths in U.S counties. Furthermore, we find that the link between police spending and overdose mortality depends on the amount of revenue generated through fines and forfeitures, suggesting it is a particular form of expenditures on policing – those linked to extractive practices– that is associated with overdose. This study heightens understanding on how the strategies counties undertake in generating and utilizing public resources impact overdose outcomes. Future studies should focus on measuring the causal impact of policies that significantly alter local revenue sources and expenditures on overdose deaths at the county level.

Suggested Citation

  • Lindenfeld, Zoe & Silver, Diana & Mauri, Amanda I. & Rothbart, Michah W., 2025. "Beyond social determinants: Fiscal determinants of overdose death in U.S counties, 2017–2020," Social Science & Medicine, Elsevier, vol. 364(C).
  • Handle: RePEc:eee:socmed:v:364:y:2025:i:c:s0277953624009833
    DOI: 10.1016/j.socscimed.2024.117529
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953624009833
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.socscimed.2024.117529?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to

    for a different version of it.

    References listed on IDEAS

    as
    1. Kimberly Cornaggia & John Hund & Giang Nguyen & Zihan Ye, 2022. "Opioid Crisis Effects on Municipal Finance," The Review of Financial Studies, Society for Financial Studies, vol. 35(4), pages 2019-2066.
    2. Siân Mughan, 2021. "Municipal reliance on fine and fee revenues: How local courts contribute to extractive revenue practices in US cities," Public Budgeting & Finance, Wiley Blackwell, vol. 41(2), pages 22-44, June.
    3. Alan B. Krueger, 2017. "Where Have All the Workers Gone? An Inquiry into the Decline of the U.S. Labor Force Participation Rate," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(2 (Fall)), pages 1-87.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Chen, Chong & Huang, Qianqian & Shi, Chang & Yuan, Tao, 2024. "Opioid epidemic and corporate innovation," Journal of Corporate Finance, Elsevier, vol. 86(C).
    2. Baridhi Malakar, 2024. "Fiduciary Duty in the Municipal Bonds Market," Papers 2406.15197, arXiv.org.
    3. Alexander Cheung & Joseph Marchand & Patricia Mark, 2022. "Loss of Life and Labor Productivity: The Canadian Opioid Crisis," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 303-323, September.
    4. Michaela Vine & Colleen Staatz & Crystal Blyler & Jillian Berk, "undated". "The Role of the Workforce System in Addressing the Opioid Crisis: A Review of the Literature," Mathematica Policy Research Reports a01ba8436deb4800b7f49b7e9, Mathematica Policy Research.
    5. Ilaria Natali & Mathias Dewatripont & Victor Ginsburgh & Michel Goldman & Patrick Legros, 2023. "Prescription opioids and economic hardship in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(9), pages 1473-1504, December.
    6. Jeremy Greenwood & Nezih Guner & Karen A. Kopecky, 2022. "The Downward Spiral," NBER Working Papers 29764, National Bureau of Economic Research, Inc.
    7. Amy Finkelstein & Matthew Gentzkow & Dean Li & Heidi L. Williams, 2022. "What Drives Risky Prescription Opioid Use? Evidence from Migration," NBER Working Papers 30471, National Bureau of Economic Research, Inc.
    8. Bhashkar Mazumder, 2023. "The Effects of Prescription Drug Monitoring Programs on Labor Market Activity and Credit Outcomes," Working Paper Series WP 2023-13, Federal Reserve Bank of Chicago.
    9. Richard K. Crump & Stefano Eusepi & Marc Giannoni & Aysegul Sahin, 2019. "A Unified Approach to Measuring u," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 50(1 (Spring), pages 143-238.
    10. Jonathan Willis & Didem Tuzemen, 2017. "How Has Job Polarization Contributed to the Increase in Non-Participation of Prime-Age Men?," 2017 Meeting Papers 1516, Society for Economic Dynamics.
    11. Holzer, Harry J., 2023. "Can Workforce Development Help Us Reach Full Employment?," IZA Discussion Papers 16624, Institute of Labor Economics (IZA).
    12. Simone Balestra & Helge Liebert & Nicole Maestas & Tisamarie B. Sherry, 2021. "Behavioral Responses to Supply-Side Drug Policy During the Opioid Epidemic," NBER Working Papers 29596, National Bureau of Economic Research, Inc.
    13. Karen A. Kopecky & Jeremy Greenwood & Nezih Guner, 2022. "Substance Abuse during the Pandemic: Implications for Labor-Force Participation," Working Papers 1335, Barcelona School of Economics.
    14. Alicia H. Munnell & Geoffrey Sanzenbacher & Alice Zulkarnain, 2020. "What Factors Explain the Decline in Widowed Women’s Poverty?," Demography, Springer;Population Association of America (PAA), vol. 57(5), pages 1881-1902, October.
    15. Holzer, Harry J., 2019. "The US Labor Market in 2050: Supply, Demand and Policies to Improve Outcomes," IZA Policy Papers 148, Institute of Labor Economics (IZA).
    16. Pinghui Wu, 2022. "Wage Inequality and the Rise in Labor Force Exit: The Case of US Prime-Age Men," Working Papers 22-16, Federal Reserve Bank of Boston.
    17. Patricia G Rice & Anthony J Venables, 2021. "The persistent consequences of adverse shocks: how the 1970s shaped UK regional inequality," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 37(1), pages 132-151.
    18. Grigoli, Francesco & Koczan, Zsoka & Topalova, Petia, 2020. "Automation and labor force participation in advanced economies: Macro and micro evidence," European Economic Review, Elsevier, vol. 126(C).
    19. McGranahan, David & Parker, Timothy, 2021. "The Opioid Epidemic: A Geography in Two Phases," Economic Research Report 327197, United States Department of Agriculture, Economic Research Service.
    20. Bogdan Savych & David Neumark & Randall Lea, 2019. "Do Opioids Help Injured Workers Recover and Get Back to Work? The Impact of Opioid Prescriptions on Duration of Temporary Disability," Industrial Relations: A Journal of Economy and Society, Wiley Blackwell, vol. 58(4), pages 549-590, October.

    More about this item

    Keywords

    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:364:y:2025:i:c:s0277953624009833. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.