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White people in the United States are dying at alarmingly early ages. After decades of lengthening life expectancies, white lifespans are now going the other way. An increasingly unequal economy — alongside steadily declining opportunities for workers without a college degree — may be the cause, two rock-star Princeton economists conclude in their just-released latest research.

The two economists, Anne Case and Angus Deaton, a year ago revealed that whites without a college degree are reporting worse health and are dying younger than they did 15 years ago. In their new follow-up study, published by the Brookings Institution, Case and Deaton take a deep look at what’s driving this trend.

Economic insecurity, the husband-and-wife team note, certainly plays a major role. Lower wages have a major impact on health and happiness. But economic insecurity alone, they conclude, provides an insufficient explanation, since black and Latino households with similar household incomes are living longer, not shorter lives.

So what can help us understand the rising white death rate? Case and Deaton point to the rise of “deaths of despair” — drug overdoses, suicides, and alcohol-related deaths. These deaths, they believe, reflect a “long-standing process of cumulative disadvantage for those with less than a college degree.”

You don’t need to be a Nobel-prize winning economist to understand this “cumulative disadvantage” thesis, but Deaton (who is one) and Case make the explanation plain. Many working class whites who didn’t go to college have lost hope. Their children cannot — for the first time — expect to do better than their parents economically, a direct reproach to the American Dream.

This dynamic is, in effect, trauma, deeply felt by millions of families.

Like many economic and social trends, the deeper trends at play are often viewed as individual rather than structural problems. Anyone whose family has struggled with addiction, with financial insecurity, with mental health problems can attest to the trauma these cause. The cumulative impact of these dynamics are tough to see without studies like this one.

While inequality has always existed in this country, and has always existed along racial lines, deteriorating social and economic status for many working class white families is new. Many authors have reported on this dynamic, Arlie Hochschild’s Stranger in the Own Land and J.D. Vance’s Hillbilly Elegy are just a couple in this growing genre.

Why aren’t Black and Latino families, who are also struggling in the unequal economy, seeing similar health declines? Case and Deaton deviate from economic analysis and point to historian Carol Anderson who succinctly points out that for whites, “If you’ve always been privileged, equality begins to look like oppression.”

Solutions to the problem will not come quickly. Policies that raise wages for those at the bottom will take years to have an impact and even longer to change health outcomes. Worse yet, the policies of the current administration are going in the wrong direction. Case and Deaton suggest reforms in the regulation of opioids would help in the near-term.

The collective decline of the working class has been in motion for decades with middle class wages peaking in the 1970s. Reversing this trend will require a similar timeline. While many feel the problem in their pocketbooks, it is in their doctor’s office where the collective trauma is increasingly being felt.