Native American "deaths of despair" and economic conditions.

"Deaths of despair" - deaths caused by suicide, drug use, and alcohol use - have increased among non-Hispanic whites who do not have a college degree. We analyze confidential-use data from the National Center for Health Statistics that contains death certificates from 2005 to 2017 (total of 21,177,490 records) linked with measures of local labor market activity. We show that deaths of despair are proportionally larger among Native Americans than non-Hispanic white Americans and that economic conditions have a different relationship with deaths of despair among Native Americans than for non-Hispanic white Americans. Improvements in economic conditions are associated with decreased deaths from drug use, alcohol use, and suicide for non-Hispanic white Americans. On the other hand, in counties with higher labor force participation rates, lower unemployment, and higher ratios of employees to residents, there are significantly higher proportions of Native American deaths attributed to alcohol and drug use.