A study shows why mortality rates in the United States are higher among less-educated white people.

In the U.S., middle-aged white men with lower levels of education are dying at an unprecedented rate. In fact, their mortality rate is higher than the Hispanic and black populations of the same age and educational level. Mortality among white men with lower levels of education is also much higher now than it was in the last century. This is an exclusively North American phenomenon, which is not occurring in other developed countries.

These are the conclusions of an important study that was presented in Washington by Nobel winner Angus Deaton and Anne Case, an eminent economist at Princeton University, who is also Deaton’s wife.

In 2015, the two economists caused a commotion with a study that reported, for the first time, a tragic increase in deaths among white Americans without a college degree. In 1999, their mortality rate was 30 percent lower than the African-American population with the same characteristics. However, in 2015, mortality among the white population was 30 percent higher than that of the African-American population. These changes in the U.S. reverse decades of progress. Over the last century, and still today, worldwide mortality has fallen 2 percent per year, in every country and in every demographic category. But white Americans with little academic training are the exception. What has happened? In this group, suicide and death by drug overdose and alcoholism increased drastically. Cancer and heart disease also increased, as well as obesity. Since 2000, death from these causes among white, non-Hispanic men between 50 and 54 years old doubled. And, in 2015, white men died at a rate twice as high as white women with the same characteristics, and four times higher than men who went to college.

A common explanation for this tragedy is that unemployment harshly affected this group of workers; the economic crises, globalization and manufacturing automation are making low skilled jobs disappear.

Deaton and Case have no doubt that unemployment, and the consequent fall in incomes, are important factors. However, according to them, these factors are not enough of an explanation. They say that the high mortality rate among white men in the United States has “deeper causes.” How can it be explained that Hispanic and black men who also lost their jobs and incomes have higher longevity? And why do European workers, who were victims of the Great Recession of 2008 and austerity policies, not exhibit these lethal tendencies that affect white American workers? And there’s more: in Europe, the longevity of those who have less education and lower income has continued to rise—at a faster pace—than among those with higher education.

According to the two economists, the deeper causes of this phenomenon are related to what they call “cumulative disadvantage.” These are debilitating conditions and dysfunctional habits that this group has been accumulating throughout their lives as a reaction to great economic and social changes. Very often, it started when white males left high school and started work early, at a time when jobs were abundant and salaries very attractive. But this “professional bonanza” came to an end, and other changes in society—the role of women, more divorces and family fragmentation, geographical mobility—made life difficult for white men and made them more vulnerable. Deaton and Case describe this as “death by hopelessness.” They don’t see a better future for themselves or their families.

This hopelessness causes great suffering. In the United States, half the population of unemployed men takes medicine for pain and two-thirds takes opioids. The abuse of these drugs has become a dangerous epidemic. In 2015, more North Americans died of drug overdose than by firearms and traffic accidents. The vast majority of victims? White men.

Two final questions: why do white men of Hispanic origin, with poor education and who are in bad economic situations, die less? Because they have more hope for the future. They do not expect a better economic situation, as they never had it. For them, the future can only be better, and for their children even more so.

Second: What is the political reaction of white North American men with high mortality rates? They vote for Donald Trump. More than 60 percent did.