shocking increase in midlife mortality among non-Hispanic Americans, exploring patterns and contributing factors to the troubling trend. Case and Deaton find that while midlife mortality rates continue to fall among all education classes in most of the rich world, middle-aged non-Hispanic whites in the U.S. with a high school diploma or less have experienced increasing midlife mortality since the late 1990s. This is due to both rises in the number of "deaths of despair"-death by drugs, alcohol and suicide-and to a slowdown in progress against mortality from heart disease and cancer, the two largest killers in middle age. The combined effect means that mortality rates of whites with no more than a high school degree, which were around 30 percent lower than mortality rates of blacks in 1999, grew to be 30 percent higher than blacks by 2015. Case and Deaton find that deaths of despair are rising in parallel for both men and women without a high school degree, and these deaths of despair have increased in all parts of the country and at every level of urbanization. The states with the highest mortality rates from drugs, alcohol and suicide, among white non-Hispanics aged 45-54, are geographically scattered. In 2000, the epidemic was centered in the southwest. By the mid-2000s it had spread to Appalachia, Florida, and the west coast. Today, it's country-wide.
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