The reduction in underage drinking and drunken driving accidents among young people is widely viewed as one of the greatest public health achievements in the United States. But data suggest that among people who are middle age, another problem involving excess drinking has been quietly brewing.

The problem is contributing to the alarming trend of white Americans dying younger than they used to. The rise was driven by drug overdoses and suicides, but also by alcohol poisoning, chronic liver disease and cirrhosis. It has been observed only in the U.S. Anne Case and Angus Deaton, who are spouses and Princeton University economists, have found that the trend began among people ages 45 to 54 in 1999 and continued through 2013, resulting in an increase of 134 deaths per 100,000 people.