“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.

在没有大学学位的非西班牙裔白人中，“绝望死亡”——自杀、吸毒和酗酒导致的死亡——有所增加。我们分析了国家卫生统计中心的机密使用数据，其中包含 2005 年至 2017 年的死亡证明（总共 21,177,490 条记录），并与当地劳动力市场活动指标相关。我们发现，美洲原住民因绝望而死亡的比例高于非西班牙裔美国白人，而且美洲原住民的经济状况与绝望死亡的关系与非西班牙裔美国白人不同。经济状况的改善与非西班牙裔美国白人因吸毒、酗酒和自杀而死亡的人数减少有关。另一方面，在劳动力参与率较高、失业率较低、雇员与居民比例较高的县，因酗酒和吸毒导致的美洲原住民死亡比例明显较高。