We estimate the mortality impact of local labor market exposure to the 1994 North American Free Trade Agreement (NAFTA) as well as to other local area shocks, and provide a parsimonious empirical explanation for differently-signed mortality estimates across different sources of local labor market contractions. Leveraging spatial variation in exposure to Mexican important competition from NAFTA, we find that more exposed areas experienced larger increases in mortality. In the 15 years post-NAFTA, an area with average NAFTA exposure experienced an increase in annual, age-adjusted mortality of 0.68 percent (standard error = 0.19), an increase that more than erases prior estimates of the welfare gains from NAFTA’s nationwide economic benefits. Mortality increases appear across all broad age by sex groups, but are particularly pronounced among working-age men, a demographic that also experienced disproportionate NAFTA-induced declines in (primarily manufacturing) employment. Additional evidence from other local labor market shocks reveals a systematic pattern: declines in local area manufacturing employment increase mortality, while declines in local area non-manufacturing employment decrease mortality. These findings suggest that the sign and magnitude of any mortality impacts of future economic shocks likely depends critically on the extent to which employment declines are concentrated in the manufacturing sector.

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