"I am deeply concerned about what's happening in every community in America, and that includes white communities, where we are seeing an increase in alcoholism, addiction, earlier deaths. People with a high school education or less are not even living as long as their parents lived. This is a remarkable and horrifying fact."
In the Democratic primary debate on February 11, presidential hopeful Hillary Clinton spoke about the persistent generational poverty and addiction ravaging blue-collar white communities, piggy-backing on a Nobel-Prize-winning economist's groundbreaking research.
The study gives those of us who are advocates and have dedicated our professional lives to treating people with addictions and mental health a more precise idea of who's more likely to overdose on drugs and alcohol or commit suicide - and surprisingly, they're white, middle-aged, working-class men.
Angus Deaton, a Nobel laureate, and his wife, Anne Case, found these kinds of deaths rising among white men over the last 15 years, while falling among white women, African-Americans and Hispanics of both genders, and white men with more education.
Unfortunately, we don't know for sure why, although many have ventured guesses, including Professor Deaton. He favors fairly straightforward explanations: Doctors prescribing more prescription painkillers to this group for the aches and pains of age; and then the daunting problem of coming to terms with their diminished prospects for economic security in our unbalanced economy.
Conservatives, on the other hand, blame the welfare state for undermining these Americans' sturdy beliefs in work and responsibility; liberals blame the increasing stratification of wealth that gives an ever-smaller group of Americans an ever-larger slice of the pie.
We believe the latter; one of us is a psychiatrist who treats these people and knows personally that vanishing good paying secure blue-collar jobs means whites with a high-school education are doomed to low-paying service jobs, often part-time or temporary. Where once they could support their whole family on union factory wages. As they age, their knees and backs worsen through the years, and soon a doctor is writing them a prescription for pain-killers that often turns into a heroin addiction (or they drink and become alcoholic.)
Add to this perhaps a divorce and the loss of a social network due to unemployment, and you have a serious mental-health problem brewing.
But what is really important about the lively discussion this research has engendered is that the public is finally talking about root causes of addiction, just as they have come to see that the problems of crime and poverty have more complicated causes than simply the traditional explanation - a moral failing.
There must be social and economic reasons for this anomaly the two professors uncovered, even if we're not entirely sure what they are yet. As a society, we can only treat the results of these problems, not the causes, if we don't eventually understand and address them.
That's what's hopeful to us about this otherwise bad news - it's a call to action. The more we know know about its cause, the more likely we are to deal effectively with problems like addiction and suicide.
We see these hopeful changes, for instance, in the presidential primary campaigns. Candidates are finally discussing addiction in terms of cures and prevention, not punishments for a weak character, as so often was the case in the past.
We see it in President Obama's resolve to ameliorate the prescription drug problem that so often turns to heroin as addicted people seek cheaper, easier-to-find alternatives, becoming a full-blown epidemic.
And we see it in Congress, where several bipartisan bills are under discussion to ameliorate our drug-abuse crisis.
Two of them are especially relevant here: The Comprehensive Addiction and Recovery Act, which seeks to reduce the number of inappropriate prescriptions of opiates and educate doctors and patients about the dangers of addiction and that effective treatments are available.
CARA, as it's known, is based on the fact that no single agency or group alone can successfully fight addiction. It provides more money for prevention, treatment and recovery and encourages consumer education, alternatives to jail and monitoring drug prescriptions. It melds methods for long-term recovery with prevention and education.
The Excellence in Mental Health Act, already law, also will provide more access to higher quality and more comprehensive treatment, especially for the blue collar, white, middle-aged men the new study highlights.
These laws and others recognize that addiction isn't cured with 30 days in detox; it requires careful, patient, intensive follow-up to make sure the person doesn't relapse. Without this, detox is almost meaningless.
And now, thanks to the study, we understand how the enemy - substance abuse - can reach out and hurt even the groups we thought were least susceptible and where it's likelier to strike.
As advocates for mental health and addiction treatment, we can't fix the unfairness in our economy and the loss of connection to family and friends that create social problems like addiction and crime. But we can understand better how - and whom - these trends affect most, and adjust our treatment and prevention strategies accordingly.
And we must. The alternative is to condemn this group of middle-aged blue-collar men - and every other person with an addiction - to a living hell that, for many, as it did for the people in Professor Deaton's study, will end in an early death.
We all have a part to play. If you know a middle aged white man that you're worried about tell him you're worried about him, tell him he doesn't have to tough it out alone, tell him there are effective treatments that help him, tell him you care, and get him in to see a mental health or addiction clinician for help.