The rate of deaths from drug overdoses, alcohol and suicide—so-called “deaths of despair”—were about the same in 2018 compared with the year before, a new study finds.

In 2018, more than 150,000 Americans died from alcohol, drugs and suicide combined, according to the study from the nonprofit health policy groups Trust for America’s Health and the Well Being Trust. The death rate—46.4 deaths per 100,000—was level with the 2017 rate, the study found. It is the first time since 1999 that there has not been an annual increase.

The study found that deaths of despair did increase in some minority communities between 2017 and 2018, CNN reports.

Earlier this month, the Well Being Trust released a report that predicted as many as 75,000 Americans could die because of deaths of despair due to the coronavirus pandemic.