One of the more reliable trends in industrialized nations is the decline in mortality rates — as medical science advances and better treatments for diseases are discovered, people live longer. In the United States, average life expectancy for men has gradually risen more than seven years over the past half-century and a remarkable 20 years since 1941.

That's what makes the findings of a new study so disturbing: Middle-aged, white, working-class Americans are bucking that trend and experiencing a significant rise in death rates. Drug addiction, suicide and mental health issues appear to be behind the rising toll of white Americans, age 45-54, with no more than a high school education.


Those findings, published this week in the Proceedings of the National Academy of Sciences, run completely counter to conventional wisdom and the experience in other wealthy nations. But the numbers don't lie: Between 1999 and 2013, more white Americans in this statistical category died from such causes as suicide; prescription drug and heroin overdoses; and alcohol abuse and liver disease.

The same thing isn't happening with middle-aged black or Hispanic Americans. (Although blacks still experience higher mortality rates than their white counterparts, the gap is closing). Nor is it happening for middle-aged Americans with a college education. That suggests strongly that the trend is related to economic circumstances.

Researchers say further study is needed to better understand what might be driving the numbers, but it isn't difficult to make an informed speculation. Income inequality — an issue that has become such a catch phrase in the presidential election — may hit this group harder than any other. The high school education that may have proved sufficient to make a comfortable living for the previous generation is not working for people at the tail end of the baby boom.

In 1965, the difference between median salaries for adults ages 25 to 32 with a college education versus adults with a high school education was relatively modest at slightly more than 20 percent. In 2013, it's closing in on 100 percent — $45,500 for those with a bachelor's degree versus $28,000 for those with a high school diploma, according to the Pew Research Center.

White Americans who used to be able to support a family are now struggling even in dual income households, and there's a corresponding loss in stature and self-esteem. They are turning to prescription opioids in greater numbers than minorities, but heroin use is also rising, in large part, because it's cheaper and ultimately easier to get than prescription drugs once a person is drug addicted.

Rarely have health statistics better reflected such a diminution of the American dream. If the problem with the U.S. economy is the growing separation between the "haves" and "have-nots," the working class has taken the biggest hit, and it's a leading reason why about half the country is classified as either low income or in poverty.

This not only underscores the need for greater investment in affordable post-secondary education and job training but in government policies that can help families survive this gap — progressive taxation, government-supported health care and other social safety net programs and a higher minimum wage to mention just a few (all of which have been embraced by European nations that haven't experienced this disturbing rise in mortality rates). But it also strongly suggests that white middle-aged Americans could use better access to mental health services — an estimated 44 percent of all Americans either don't have insurance coverage for such care or are unaware if they do, according to the American Psychological Association.

In the Baltimore area, Sparrows Point provides a perfect illustration of what's going on. Once, it was home to a thriving steel mill that employed thousands of unskilled workers. All that is gone. Its former employees were left with tiny severance packages and its retirees greatly reduced pension benefits. Now, the site is the focus of an environmental cleanup and revitalization effort that, even if successful, is unlikely to offset such a massive job loss. That people who might otherwise be working there still would find such circumstances discouraging should come as no shock.

The transition to a 21st economy is literally killing some people, and the United States can ill afford to ignore this disturbing development. It's a worthy subject for the next presidential debate — assuming the candidates are willing to put aside their egos and grapple with a difficult, multi-faceted issue instead of the usual talking points.