Declining union membership could be making working-class Americans less happy and more susceptible to drug overdoses
In a thought-provoking analysis, recent studies reveal a significant connection between union membership and public health, highlighting the broader societal impacts of declining union power. Conducted by economists focused on labor and health issues, the research underscores that lower unionization not only affects wages and job security but also correlates with increased unhappiness and public health crises, particularly the opioid epidemic. The findings indicate that as union membership declines, so too does the overall happiness of working-class individuals. A study analyzing data from the General Social Survey between 1993 and 2018 found that a 1% increase in union membership in counties near state borders led to a 15% increase in the likelihood of low-income residents reporting themselves as “very happy.” This trend is particularly pronounced in states without right-to-work laws, where union dues are mandatory and unions can negotiate more effectively for workers’ rights.
The research also delves into the alarming rise in opioid overdoses, linking it to the weakening of unions due to the proliferation of right-to-work laws. An upcoming paper reveals that states that adopted these laws saw significant increases in both fatal and nonfatal opioid overdoses within six years of implementation. The study specifically highlights vulnerable demographics, particularly men and male teens in high-stress, low-security jobs, who are more likely to turn to opioids as a coping mechanism for job-related despair. This connection underscores a critical public health concern, suggesting that the erosion of union strength may contribute to a broader social malaise, characterized by job insecurity and increased substance abuse.
As union membership in the U.S. has halved over the past four decades—from over 20% in 1983 to under 10% in 2024—the implications for public health and community well-being are profound. The opioid crisis, which has claimed over 105,000 lives in 2023 alone, highlights the urgent need to reassess the role of labor unions in advocating for better working conditions and mental health support. While governmental efforts have focused on reducing opioid supply, the research suggests that addressing the underlying economic and social conditions that drive despair is equally crucial. As the authors continue to explore these connections, they aim to investigate whether the decline in union membership may have multigenerational effects, influencing the well-being of future generations. This research not only illuminates the intricate ties between labor dynamics and health outcomes but also calls for a reevaluation of policies that support workers and their communities.
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Protesters gather at a union-organized rally outside the U.S. Capitol in February 2025.
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When fewer people belong to unions and unions have less power, the impact goes beyond wages and job security. Those changes can hurt public health and make people more unhappy.
We’re
economists
who research labor and health
issues. Those are
two of the main findings
of studies that we have conducted.
More unionization, more happiness
In the first study on this topic that we
published in 2023
, we found that increasing levels of union membership tends to make working-class people happier.
We zeroed in on a question in the
General Social Survey
, which the University of Chicago makes available. It asks respondents to choose whether they are “very happy,” “somewhat happy” or “not at all happy” with their life.
We found that, from 1993 to 2018, when the share of workers in counties along the borders of states with and without
right-to-work laws
who belong to unions rose by 1 percentage point, the average level of happiness for low-income residents moved 15% closer toward being “very happy” – a seemingly modest but noticeable change.
Right-to-work laws let workers skip paying union dues when they’re employed by a company that has negotiated a contract with a labor union. In states without right-to-work laws, those dues are mandatory. As a result, right-to-work laws
weaken unions’ ability to negotiate better working conditions
and reduce the share of workers who belong to unions.
But a higher rate of union membership didn’t significantly affect the happiness of higher-income people.
Right-to-work laws
The first right-to-work laws were
adopted by states
in the 1940s. After a long lull, the pace picked up around 2000. These laws were in force in 26 states as of late 2025.
Four of those states made the switch between 2001 and 2015: Oklahoma in 2001, Indiana in 2012, Michigan in 2012 and Wisconsin in 2015. We used data collected in these four states to conduct what is known in economics as an “
event study
” – a research method that provides before-and-after pictures of a significant change that affects large numbers of people.
Michigan repealed its right-to-work law in 2024
, but our data is from 2001-2015, and Michigan became a right-to-work state during that period and remained one for the rest of that time.
Less unionization, more opioid overdoses
In a related
working paper
that we plan to publish in an upcoming edition of an academic journal, we looked into other effects of right-to-work laws. Specifically, we investigated whether, as more states adopted those laws, the gradual decline in union strength those statutes produce was contributing to an increase in opioid overdoses.
We used a research technique called the
synthetic control method
to assess whether declining union power has affected the number of opioid overdoses.
We drew our data from a variety of sources, including the
Treatment Episode Data Set
, the Centers for Disease Control and Prevention’s
Multiple Cause of Death
database, the Census Bureau’s
Current Population Survey
, the
union membership and coverage database
, and the Bureau of Labor Statistics’
Survey of Occupational Injuries and Illness
and
Census of Fatal Occupational Injuries
.
We found that both fatal and nonfatal opioid overdoses increased within six years of the enactment of right-to-work laws in all four of the states we studied.
We primarily found a connection between opioid overdoses and right-to-work laws among men and male teens between ages 16 and 64 –
making them of working age
– with dangerous jobs, such as roofing or freight moving, and little job security. They were people who tend to feel more job stress because they don’t have control over their work tasks and schedules.
We didn’t observe those same results for women or deaths from non-opioid drugs, such as cocaine.
Lower levels of unionization are
linked to weaker job security
and reduced workplace protections, previous research has shown. Our work suggests these factors may play a role in increasing demand for opioids.
Declining union membership
The share of
U.S. workers who belong to unions has fallen by half
in the past four decades, declining from just over 20% in 1983 to a little under 10% in 2024.
Because unions advocate for
better and safer working conditions
, they can
raise wages and living standards for their members
. Interestingly, some of these benefits can also
extend to people who don’t belong to unions
.
An
opioid use disorder
crisis has
devastated communities across the U.S.
for more than 25 years. The
death toll from drug overdoses soared from 17,500 in 2000
to
105,000 in 2023
. The number of overdose deaths did
fall in 2024, to about 81,000
, but it remains historically high. Most fatal drug overdoses since the crisis began have been
caused by opioids
.
Throughout this crisis
, government policies have focused largely on
reducing the supply of prescription opioids
, such as OxyContin, and illegal opioids,
especially fentanyl
,
distributed outside the health care system
.
Causes of despair
Despite successful interventions to
shut down pill mills
– clinics that
prescribe opioids without a valid medical reason
– and expand access to prevention and treatment,
drug overdoses remain a leading cause of death
.
And we believe that our findings support results from earlier studies that determined
despair is not just an emotional or biological reaction
– it can also be a response to social and economic conditions.
We are continuing to research the connections between
union membership and public health
. The next question we are working on is whether a decline in union membership can have a multigenerational impact, going beyond the workers employed today and affecting the lives of their children and grandchildren.
The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
