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Life expectancy for white Americans has been declining since 1999 and the deaths are caused largely by drugs, alcohol and suicide. Lack of college degree put a limit on employment prospects and its negative impact accumulated over the years led to "deaths of despair," a study suggested.

Princeton University professors Anne Case and Angus Deaton saw the trend of lower life expectancy since 1999 among white Americans compared to blacks, Hispanics and Europeans. Two years since they reported it in 2015, they find no difference. Both sexes are affected and the common factor is the level of education.

The two economists found that having a college degree often meant better health and happiness than those who did not finish college. They suggested that less-educated white Americans experienced difficulties early in their adult years as they started working and establishing careers. "Deaths of despair" occur as a result of the compounded impact of limited economic opportunities over time which caused distress and social dysfunction.

Case explained that a "sea of despair" afflicting the country is marked by an increase in physical pain. Whereas a high school diploma was good enough for finding a job that offers benefits and prospects of promotion in the past, it no longer holds an advantage in the present. The disadvantaged attempts to cope with it by turning to drugs, alcohol and even food; hence, the obesity epidemic could be a sign of distress.

Although geography was not a significant factor, the researchers observed that the death rates of white people remained the same in suburban areas in big cities. The rates went down in the largest cities but they have gone up in all other sites.

A dissection of the findings which put an emphasis on the differences in mortality rates of urban and rural areas, and further classification under each was done by the Washington Post. It underscored the rising health problems more noticeable among white women in rural areas, the Sacramento Bee reported.