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Import Competition and Racial Disparities in Mortality: Evidence From the Japanese Trade Shock

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Abstract

This paper examines the effects of increased trade between Japan and the U.S. on mortality rates in the U.S. using a shift-share instrumental variables approach. Overall, we find that an increase in Japanese imports is associated with higher rates of cardiovascular disease (CVD) mortality and lower rates of mortality from accidents. Effects of Japanese imports on deaths of despair are inconsistent, but there is a positive association between imports and drug-related deaths. These effects exhibit significant racial disparities. Specifically, a $1000 increase in import competition is associated with a 3.0% increase in CVD deaths per 100,000 Black individuals aged 20–64 years old, while there is no statistically significant effect among whites. Additionally, a $1000 increase in import competition is associated with a 13.5% increase in drug-related deaths per 100,000 Black individuals aged 20–64 years old compared to a 7.8% increase among white individuals. Effects on mortality rates from accidents are driven by deaths among whites. Our findings also indicate that the rise in CVD and drug-related mortality is concentrated among males and in regions with relatively high shares of employment in the automobile or computer industries.

Original languageEnglish
Pages (from-to)265-293
Number of pages29
JournalHealth Economics (United Kingdom)
Volume35
Issue number2
DOIs
StatePublished - Feb 2026

Keywords

  • deaths of despair
  • mortality
  • racial disparities
  • trade liberalization
  • trade shocks

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