The incresing rate of deaths due to opioids, alcohol and suicides are part of a public health crisis described as “deaths of despair” in a new report published recently. Life expectancy in the United States has decreased for the second year in a row because of these factors, researchers wrote in BMJ. The drop was particularly steep among middle-age white Americans and people living in rural areas, USA Today reports. “Why white Americans are dying at higher rates from drugs, alcohol, and suicides is unclear, complex, and not explained by opioids alone,” the researchers wrote. They note that possibilities include the collapse of industries and the local economies they supported, the erosion of social cohesion and greater social isolation, economic hardship, and distress among white workers over losing the security their parents once enjoyed.

A new government report finds life expectancy in the United States decreased for the second consecutive year in 2016, in part due to an increase in fatal opioid overdoses. Until recently, life expectancy was rising in the United States, according to NPR. Life expectancy fell from 78.9 in 2014 to 78.7 in 2015 to 78.6 in 2016. “For any individual, that’s not a whole lot. But when you’re talking about it in terms of a population, you’re talking about a significant number of potential lives that aren’t being lived,” said Robert Anderson, Chief of the Mortality Statistics Branch at the National Center for Health Statistics. “I’m not prone to dramatic statements. But I think we should be really alarmed. The drug overdose problem is a public health problem, and it needs to be addressed. We need to get a handle on it.”