The Silk Road of Ashes: Exposure to NAFTA and Adult Mortality

The implementation of the North American Free Trade Agreement (NAFTA) in 1994 resulted in a great restructuring in industry composition in the US, with substantial heterogeneity across local areas. In this paper, we investigate the effects of NAFTA on the mortality rates of the working-age population. We implement event studies and difference-in-difference analyses to examine dynamic changes in mortality rates in different years relative to NAFTA and in areas with differential exposure to NAFTA. Comparing areas with high versus low trade exposure measures, we find a 2.1 percent rise in the mortality rate of those aged 25-55. A back-of-the-envelope calculation suggests a 7.3 percent rise in mortality for the treated population, who lost their job due to NAFTA. Further analyses using a wide range of alternative data sources suggest that reductions in income-employment, reductions in wealth, increases in disability, decreases in health insurance coverage, decreases in private health insurance, and a higher likelihood of reliance on presumably lower quality public insurance as candidate mechanisms.