A sharp rise in death rates among white middle-aged Americans has claimed nearly as many lives in the past 15 years as the spread of Aids in the US, researchers have said.
The alarming trend, overlooked until now, has hit less-educated 45- to 54-year-olds the hardest, with no other groups in the US as affected and no similar declines seen in other rich countries.
Though not fully understood, the increased deaths are largely thought to be a result of more suicides and the misuse of drugs and alcohol, driven by easier access to powerful prescription painkillers, cheaper high quality heroin and greater financial stresses.
The turnaround reverses decades of falling mortality rates achieved through better medical care and lifestyle choices that continue to improve public health in other groups in the US and in other nations around the world.