A new study concludes a lack of steady, well-paying jobs for whites who don’t have college degrees has led to an increase in deaths by drugs, alcohol and suicide.

The mortality rate for whites ages 45 to 54 without a college degree increased by a half-percent each year from 1999 to 2013, NPR reports. Whites with college degrees have not seen the same loss of life expectancy, Princeton University researchers report in Brookings Papers on Economic Activity.

Researcher Ann Case told NPR, “The rates of suicide are much higher among men [than women]. And drug overdoses and alcohol-related liver death are higher among men, too. But the [mortality] trends are identical for men and women with a high school degree or less. So we think of this as people, either quickly with a gun or slowly with drugs and alcohol, are killing themselves. Under that body count there’s a lot of social dysfunction that we think ultimately we may be able to pin to poor job prospects over the life course.”