Drug overdoses in Ohio and Pennsylvania. Suicides in Montana and Alaska. Alcohol deaths in New Mexico and South Dakota. The rise in these types of mortality is so dramatic that the mainstream media has recently adopted a new term for them: “deaths of despair.”

A recent report published by the Commonwealth Fund found that deaths of despair are surging across the country. Most strikingly, in eleven states drug overdose deaths tripled in just twelve years, owing mostly to the opioid epidemic.

After steadily rising for six decades, life expectancy is now declining in the United States. The main culprit, according to the authors of a study published in the Journal of the American Medical Association, is midlife mortality “caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases.” These deaths of despair are concentrated among the working class, which has seen its wages stagnate, its debt balloon, its living costs skyrocket, and its options narrow over the last half-century.