According to a new report, life expectancy rates in the United States have dropped for the third consecutive year.

The report was published in the Journal of the American Medical Association and cites the escalation of suicide, drug overdoses, liver disease, and dozens of other causes as contributing factors, per the Washington Post:

Despite spending more on health care than any other country, the United States has seen increasing mortality and falling life expectancy for people age 25 to 64, who should be in the prime of their lives. In contrast, other wealthy nations have generally experienced continued progress in extending longevity. Although earlier research emphasized rising mortality among non-Hispanic whites in the United States, the broad trend detailed in this study cuts across gender, racial and ethnic lines. By age group, the highest relative jump in death rates from 2010 to 2017 — 29 percent — has been among people age 25 to 34.

Basically, if you’re an American citizen, the age-old adage of “more money, more problems” is more real than ever.

“It’s supposed to be going down, as it is in other countries,” Steven H. Woolf, the lead author of the report and director emeritus of the Center on Society and Health at Virginia Commonwealth University, said. “The fact that that number is climbing, there’s something terribly wrong.”

Outside researchers have praised the report for its in-depth analysis of “the reversal of historical patterns in longevity.” Here are some other noteworthy findings:

• Over the past decade, life-threatening illnesses and conditions among young and middle-aged adults have greatly contributed to our mortality rate’s decline.
• Roughly a third of the estimated 33,000 “excess deaths” that have occurred since 2010 were in just four states: Ohio, Pennsylvania, Kentucky, and Indiana; while New Hampshire has the dubious distinction of having the biggest percentage increase in death rates among working-age people this decade with an astounding 23 percent. These results are important because with the upcoming presidential election on the horizon, the political implications are notable: Ohio and Pennsylvania are pivotal swing states and New Hampshire is the first primary state.
• The all-cause death rate (deaths per 100,000 people) increased 6 percent from 2010 to 2017 among working-age people in the United States.
• Men have higher all-cause mortality than women and die in greater absolute numbers, but women are falling victim to diseases once far more prevalent among men. Risk of suicide and alcohol-related liver disease among women are two noteworthy examples.
• Midlife mortality rates began to climb among whites in 2010, Latinos in 2011, and the black community in 2014.
• Between 1999 and 2017, the risk of death from drug overdoses increased 486 percent for midlife women. During that same period, risk for men increased 351 percent.

All in all, the findings are disturbing and paint a bleak picture of health and mortality throughout the United States.

“Some of it may be due to obesity, some of it may be due to drug addiction, some of it may be due to distracted driving from cell phones,” Woolf said. Though it’s evident that the data “suggests that the cause has to be systemic, that there’s some root cause that’s causing adverse health across many different dimensions for working-age adults.”

For those interested, the full “Life Expectancy and Mortality Rates in the United States, 1959-2017” report is available here.