The reasons for the increased death rate are not the usual things that kill Americans, like diabetes and heart disease. Rather, it’s suicide, alcohol and drug poisonings, and alcohol-related liver disease.

The least-educated are worst off: All-cause mortality among middle-aged Americans with a high-school degree or less increased by 134 deaths per 100,000 people between 1999 and 2013, but there was little change in mortality for people with some college. The death rate for the college-educated fell slightly.

Causes of Increased Mortality

White Americans in this age category are also experiencing worse self-reported health, the authors write, and one in three say they experience chronic joint pain.

The PNAS analysis represents a confluence of several public-health disasters that have slammed white Baby Boomers in recent years.

Deaths from drug overdoses among people aged 45 through 64 increased 11-fold between 1990 and 2010, and nearly 90 percent of people who try heroin for the first time these days are white. (Most found heroin through prescription painkillers, which treat the chronic pain this age group struggles with, but can also make it worse.)

In January, a CDC Vital Signs report found that alcohol poisoning kills more than 2,200 Americans a year, three-quarters of them adults aged 35 to 64. A 2012 Health Affairs study found that life expectancy for white, female high-school dropouts has fallen so much over the past 18 years that these women are now expected to die five years younger than their mothers did.

Obviously, no one can be blamed for his own addiction or depression. But the causes of death this study highlights are the kinds of things—drinking, doping, suicide—that people who feel good about their lives don’t tend to do.

So, what’s eating less-educated Boomers?

One persuasive explanation, and one the researchers put forth, is financial strain. Jobs in fields like manufacturing and construction, which were historically filled by people without college degrees, have been evaporating quickly over the past 15 years. As I’ve written previously, less-educated people are more likely to be unemployed and to make less, so they struggle to afford things like therapy, gym memberships, and recreation that isn’t drugs. Without jobs, they may lack the social networks and sense of purpose that have shown to reduce mortality.

Nearly half of Americans in their 40s and 50s don’t have enough money saved for retirement to live as they’re accustomed to, even if they work until they’re 65. All of this is crashing down on Boomers, who were raised on the promise of the American Dream.

As Deaton and his co-author, his wife and fellow Princeton economist Anne Case, put it, “After the productivity slowdown in the early 1970s, and with widening income inequality, many of the baby-boom generation are the first to find, in midlife, that they will not be better off than were their parents.”