The unexpected increase in premature deaths in the white community over the last couple of decades is an increasingly hot topic, and every time it comes up, people note that white people (even working class rural white Americans) still live longer than blacks. Why should people focus so much energy on a segment of the population that is still comparatively privileged?

Well, I’ll give you a few reasons for that.

Number one, and it’s not just women:

Among African Americans, Hispanics and even the oldest white Americans, death rates have continued to fall. But for white women in what should be the prime of their lives, death rates have spiked upward. In one of the hardest-hit groups — rural white women in their late 40s — the death rate has risen by 30 percent.

The issue here isn’t overall rates of life expectancy but the fact that whites alone are moving in the wrong direction.

Number two, the numbers are staggering:

Compared with a scenario in which mortality rates for whites continued to fall steadily after 1998, roughly 650,000 people have died prematurely since 1999 — around 450,000 men and nearly 200,000 women.

That number nearly equals the death toll of the American Civil War.

That’s remarkable, don’t you think? It’s almost as if we had a Civil War and no one noticed until some academics began digging into the cross tabs of the CDC’s 2014 annual report on American health.

Number three, overall, the victims are not from some privileged background:

Some regions are hit especially hard, such as the belt of poverty and pain that runs across the northern tier of the South, incorporating much of West Virginia, Kentucky, Tennessee and Arkansas. But significant increases in white mortality also showed up in the small-town and rural Midwest — such as Johnson County, Iowa, home of the University of Iowa — and in parts of the American West, such as Nye County, Nev., and Siskiyou County, Calif…

…[Princeton University economist Anne] Case said that the whites who are dying are not America’s elites.

“They may be privileged by the color of their skin,” she said, “but that is the only way in their lives they’ve ever been privileged.”

And, number four, this phenomenon probably goes a long way towards describing the crackup of the Republican Party, and so it has major political ramifications. For one thing, areas with the highest die-off of whites correlate with areas where Donald Trump has done well in the primaries.

Predominantly white, working-class areas with high death rates have proved to be fertile ground for Trump. Political observers speculate that the voter anger driving his campaign emerges from the many distresses felt in these economically challenged — and increasingly morbid — places.

The wave of lethal agents rolling across the country is broad in its effects, but it appears to be cresting in places that are particularly vulnerable — such as a town where the trains no longer stop, or a small city that saw its biggest manufacturer move overseas, or in a household broken by divorce or substance abuse or tragedy.

Or in the mind and body of someone who is doing poorly, and just barely hanging on.

It’s easy to see the correlation between areas that vote Republican and areas where whites are dying in droves. The orange areas are where mortality is increasing and the blue areas are where it is decreasing.

Republicans don’t need to look much further to get a clue as to why their base of supporters is in full revolt against their party’s Establishment elites. The GOP has been oblivious as their base’s communities have been decimated by an opioid epidemic, rising levels of alcoholism and suicide, and a loss of life comparable to the deadliest war in our nation’s history. Fighting Obamacare (which has done wonders for the treatment of mental illness and addiction) is doing nothing for these communities. Tax cuts for the rich and deregulatory schemes for Wall Street won’t help them one iota. Unisex bathrooms and gay marriage aren’t what’s ailing them.

Democrats get frustrated that these folks keep turning to the GOP for help when it should be manifestly obvious by now that the Republicans have nothing to offer them. There ought to be a political opportunity now to step in with sensible plans to make a real difference in their lives, but it’s really up to the people who represent these communities to come to the Democrats in the spirit of cooperation. They ought to know their constituents and their needs better than anyone, but it’s difficult to force politicians to take help that they won’t even request.

There are a lot of progressive solutions that could be pursued. Democrats have already been leading the way on efforts at smoking cessation. The First Lady has tried to lead people into healthier eating habits, including efforts to give people access to better quality food. The Senate just passed a bill to help address the enormous needs we have to get treatment for opioid-dependent people, but the Republicans refuse to add any meaningful funding to it. I already mentioned how Obamacare makes it easier to get addiction treatment. The president has done a lot in consumer protection, including major credit card reform, vastly increased scrutiny of predatory lenders, and a much-needed overhaul of the college lending system. Bernie Sanders is pushing for free tuition at college universities.

These are starting points, but there are limits to how much a party can do to help the opposing party’s base of supporters if they can’t get any cooperation. A president is a representative of all the people, though, even when they are a Democrat. If, as expected, the next president is a Democrat, it’d be nice if some Republican lawmakers were willing to work with them to find solutions that can reverse this troubling trend.

Because the fascism of Trump is a much less appealing alternative, for all of us.

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