Deindustrialization is not the culprit
"What may be responsible is the broader hourglass economy, which comes together precisely when the structural break in deaths of despair occurs in the early-1990s, a decade before the China shock and many decades into the secular decline of manufacturing employment."
I don't see how this rules out deindustrialization, unless you expect people to immediately plunge into despair after their plant closes. Was it at all obvious in the 1970s that plant closures would continue for generations and never reverse? A lot of displaced workers were promised retraining or job placement, and politicians have perennially sold us on reindustrialization. I think a totally plausible mechanism is: plant closes -> community/social fabric deteriorates (i.e., hope fades over the years) -> despair sets in.
Having grown up in Baltimore, lived in Pittsburgh and lost people to pills/suicide/despair, the idea that deindustrialization played NO role in "Deaths of Despair" is slightly goofy.
What you are looking at is the conversion of Jim Crow from a racially based system to a class based system. The central principal of Jim Crow was to impoverish a class, black people, and then criminalize everything they could try to do to ameliorate that impoverishment, allowing the state to kill or incarcerate and force labor from the criminalized class.
The historical classes subjected to this adapted cultural ameliorations, primarily a very robust and resilient culture of black women, that mitigate against "deaths of despair."
Falling out of the historically protected class of "white people" into the newly criminal class of "poor people" without the ameliorations of American black culture, white men have no place to fall but on their own hand guns, which their fetish with the old Jim Crow has encouraged them to own.
Policy is being driven by war-mongering Neocons who think they are going to take down Russia and China and put a social credit score noose around the necks of the remaining working class, about whom they care not a whit. IMHO.
Did de-industrialization play a role in the emergence of the hourglass economy?
The evidence of a 'China shock in 2001' is everywhere but in the stats.
China's admission to the WTO made no appreciable difference to the rate of decline of American manufacturing.
The last time the US was trade competitive was in 1982.
I suspect that some ink-stained wretch came up with that phrase, and it may indicate an emotional, rather than an economic shock. We were in the ring with someone bigger and smarter than us!