Republican Support and Economic Hardship: The Enduring Effects of the Opioid Epidemic
利用普渡制药诉讼文件中的地理差异，发现阿片类药物营销导致的药物死亡和贫困增加了共和党在众议院、总统和州长选举中的得票率，到2022年众议院选举中，暴露度每增加一个标准差，共和党得票率上升4.5个百分点。
Abstract In this article, we establish a causal connection between two of the most salient social developments in the United States over the past decades: the opioid epidemic and the political realignment between the Republican and Democratic parties. Drawing on unsealed records from litigation against Purdue Pharma, we uncover rich geographic variation in the marketing of prescription opioids that serves as a quasi-exogenous source of exposure to the epidemic. We use this variation to document significant increases in drug-related mortality and greater reliance on public transfer programs. This induced economic hardship led to substantial changes in the political landscape of the communities most affected by the opioid epidemic. We estimate that from the mid-2000s to 2022, exposure to the opioid epidemic continuously increased the Republican vote share in House, presidential, and gubernatorial elections. By the 2022 House elections, a one-standard-deviation increase in our measure of exposure led to a 4.5 percentage point increase in the Republican vote share. From 2012 until 2022, this increase in the House vote share translated into Republicans winning additional seats.