a 2017 paper by the same scholars, updating and expanding the original. This figure compares the death rate of US whites from drugs, alcohol, and suicide, age 50-54, to that of people the same age in other wealthy nations. You can see that since 1990 the US has gone from about average to far and away in the lead. This international comparison is hard on certain explanations that have been advanced on both the right and the left. Leftists blame inequality, but inequality is just as big an issue in Australia and the UK as it is in the US, and in fact it is rising everywhere in the world. Some explanations favored on the right, such as declining church attendance and generous disability benefits, ought to be bigger factors in Europe than here. I personally think both inequality and declining religiosity may be contributing, but there is something unique about white Americans that makes the problem worse for them.
Still confused about support for Donald Trump? Look at those figures again. Trump got elected by promising to fight for ordinary white Americans. As long as he can keep posing as their champion, he will keep winning, because millions of white Americans believe that they desperately need a champion. They scan the political scene and see that Democrats seem more interested in helping asylum seekers at the border than dying white people; that they want white people whose death rate is rising to pay reparations to black people whose death rate is falling; that they would rather have cheap phones than fight for American factory jobs. The Republican mainstream has been crippled because desperate white folks aren't interested in free trade or lectures about hard work, they want help, now; meanwhile many better off suburbanites who used to vote Republican can't stomach Trump's racism and lowbrow vulgarity and so are likely to vote Democrat, leaving Trump's supporters firmly in control of the party.
The issue of 2020, the only issue, is who can do the most to help ordinary folks who feel like they are losing out, and are dying from their misery over it.