White women between 25 and 55 have been dying at accelerating rates over the past decade, a spike in mortality not seen since the AIDS epidemic in the early 1980s. According to recent studies of death certificates, the trend is worse for women in the center of the United States, worse still in rural areas, and worst of all for those in the lower middle class. Drug and alcohol overdose rates for working-age white women have quadrupled. Suicides are up by as much as 50 percent.
What killed Jones was cirrhosis of the liver brought on by heavy drinking. The exact culprit was vodka, whatever brand was on sale, poured into a pint glass eight ounces at a time. But, as Anna’s family gathered at the gravesite for a final memorial, they wondered instead about the root causes, which were harder to diagnose and more difficult to solve.
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