According to a recent study in the Washington Post, the death rate for poor white women in rural areas is spiking. This follows a report about rising suicide rates among middle-aged white men without college educations living in the same regions.

These are the people who used to appear in Dorothea Lange photographs. John Steinbeck wrote about them in The Grapes of Wrath. Merle Haggard sang about them for decades, and so did Hank Williams, Johnny Cash and more recently, Nick Cave. They are often called poor white trash, and are treated accordingly. But behind the term lies a tale. While these studies hint at it (“inadequate health care,” “obesity,” “smoking”), they don’t get to the source of the obliteration. I know because I’ve been writing about the people with the spiking death rates for a long time. I know how they live and I know what's destroying them. And now, I’d like to tell you about one of them.

Her name was Mandi Scott and she was killed by a Marine after the Gulf War in Twentynine Palms, Calif., on the eve of her 16th birthday. She came from a legacy of poverty and violence that stretched back for generations, all the way to the Donner party when an ancestor had the sense to make the correct turn at Hastings Cutoff. But from then on, there was trouble.

In Sonora, her great-grandmother Lorena married a bulldozer—“the finest in the county,” according to family lore. He drank a lot and stormed out after Lorena gave birth to Rose Marie, returning three days later and continuing to drink and beat his wife. Lorena drank too, and listened to “The Lone Ranger” on the radio.

One day she ran away. Every day, she sent Rose a letter. Rose would stand and wait, and when the mailman handed it to her, she would tear it open. “Dear Rose,” the letters said. “I miss you very much. Don’t worry about me, I am doing fine. Please look after your brother and sister and try not to get into fights with your Dad. I love you.”

One morning, Rose put on a plaid skirt and white blouse and pink saddle shoes and counted out nickels and dimes and bought a ticket for San Francisco. She went to Lorena’s hotel. Her mother stumbled to the door. There were empty wine bottles all over the room, but Rose wanted to stay. “Maybe some day,” Lorena said, and hugged Rose. Then Lorena called her husband James and he said everything would be fine, and the cops came and took Rose away.

Time passed and Rose grew up, and one day, she met Clarence. He took her to see Johnny Guitar because she liked westerns and then they got married. Clarence was gone most of the time, including when his first two sons were born and on the day, a daughter, Debie with one “b,” entered the world.

A year later, Lorena was beaten to death in her hotel room. Rose went to the funeral and stood by her mother in her casket. She couldn’t stop looking at all the bruises. “She looked like a famine victim” is what she told everyone later. “Like a famine victim.” She kissed Lorena on the forehead and left, thinking about the letters. “Don’t worry about me… I’m doing fine.”

Rose and Clarence got divorced, and Rose hooked up with Herb, a member of the Hells Angels. There were parties and drugs and fights, and then the beatings. Debie was growing up, and the Angels told her to carry little brown sacks to the dry cleaner’s and pick up other sacks in exchange. One day she took a peek and saw a lot of money inside. When Rose found out Herb was turning her daughter into a drug runner, she asked for a divorce. He punched her in the ribs and left.

Years later, when he was dying, he called Rose and took her out for a steak dinner and they reminisced over the good times and Herb shed a tear. While cutting his meat, he had a stroke and for the next few months, Rose took care of the man who had tried to kill her.

As for Debie, her brother served in Vietnam and was shot up, taken for dead, and thrown on top of a pile of corpses. Later, he contracted Agent Orange disease. Vietnam ran through the family. Debie married a vet who drank a lot. When the Dallas Cowboys lost the Superbowl, he hit her.

Eventually, Debie kidnapped her children, Mandi and her brother and sister, taking them to Twentynine Palms, a few hours east of Los Angeles, to start over. En route, they adopted a pitbull and named him Corky. The family had a toehold for a while, but drugs entered the picture again and things went south. One night Mandi was raped and stabbed 33 times, along with her friend Rosalie. Shortly after Mandi died, Debie began raising funds for the Mandi Scott Scholarship, $1,000 to help an average girl get out of town. That was all it would take, Debie figured, and it was a sum that was as much as her circle could muster.

The money came from matchbook collections and bar tips, lottery tickets that went unpurchased, all manner of spare change from all manner of local tribes: Samoans, Crips, Bloods, bikers, Marines—a rainbow coalition of Mandi’s friends who wanted to make sure that another girl was not felled before she could make her way in the world. The prize went to a friend of Mandi’s, a Latina, who wrote the best essay about what she would do with the prize. She became a juvenile counselor and returned to show other kids that there was a way out. No one knows what happened to her, but everyone remembers the fundraiser where a band called Velvet Hammer played and for a little while everyone danced and no fights broke out, and Corky, in shades and leathers, sat on the counter next to an urn with Mandi’s ashes.

To this day, Mandi's legacy is recounted. She liked to dance and taught all the younger kids how to do it. Once, at a party in the seventh grade, a schoolmate of Mandi's had tried to light a cigarette and accidentally set her eyebrows on fire. As I would later write in my book Twentynine Palms, "Mandi was the first to help: She put some butter on the burn to calm the pain, and then, to make sure that it never happened again, showed the girl how to smoke"—no doubt unaware that the rite of passage, smoking, would one day appear as a common cause of death in a survey of doomed citizens. A few months later, Mandi carried out another rescue. This time it was in the school parking lot; the girl's boyfriend had grabbed her during an argument and cocked his fist. "After Mandi died, her new friend had a baby girl," I wrote. "To Debie’s pride and sweet sorrow, she called her Amanda Lee, in honor of the teenager who had protected her against another black eye. One of the first things she told her little girl was how she got her name.”

Mandi’s friends are grown up now, and some have escaped a fate that has shadowed them for generations. But others are still stranded, foundering in a morass of dead-end jobs, a past they can’t shake and a future that is foreclosed. They are the women with the “spiking death rate,” and their boyfriends and husbands and sons are the men who are killing themselves. It is not Vietnam that runs through their lives, but the Gulf War, the wars in Iraq and Afghanistan, the wars they keep signing up for, not because there’s nothing else they can do, but because it’s a thing that they do, and have done, for a very long time.

Some may be showing up at the polls (and not necessarily voting in predicted ways), but others can barely get to the doctor’s office. You might find them behind the counter of a 7-Eleven, or in jail, or a desert bar. Should you have a conversation with such a soul, don’t be surprised if he lights up a Marlboro, takes a nice, long drag, and starts spinning out a story about being related to Jesse James. “I kid you not,” he might add, knowing that the world views him as inconsequential, and then he might down a shot and a beer, and after the next inhale, there may follow some prolonged and serious coughing and then, “I’m fine, no really.”

But he is not fine, not fine at all, although there is this one thing that makes him feel okay every now and then, and that is his connection with the iconic Jesse James. He was Scots Irish too, and they may even have descended from the same clan. Beyond that, he was famous. And nowadays, that’s all that really matters. So he tells this story to anyone who will listen, hoping it will lead to something else, anyplace, really, other than a survey that says his kind is dying.