2017 The University of Florida Award for Investigative Data Journalism, Large Newsroom finalist

Unnatural Causes

About the Project

Over the past year, The Post set out to explore a historic increase in early death among white Americans. Through our own analysis of federal health data, The Post revealed that the trend is concentrated in small towns and rural areas, and is most pronounced among women, who are succumbing increasingly to suicide and substance abuse — mainly prescription drugs and alcohol.

In this series, Post journalists illuminated the lives of pain and disadvantage that preceded many of these deaths, and documented a profound sense of social collapse in parts of the nation. They also shed light on complex, previously unexplored shifts in culture and medicine that are damaging American health, particularly for women: the normalization of binge drinking, the rampant use of psychiatric drugs and a huge increase not only in long-term opioid use, but also dangerous follow-on prescriptions. A specially-commissioned poll, conducted with the Kaiser Family Foundation, revealed the failure of doctors to talk to patients about how to get off the drugs they prescribe.

Writers Eli Saslow, Joel Achenbach, Kimberly Kindy and Amy Ellis Nutt approached people at funerals and other vulnerable moments, moving carefully to gain their trust. Photographer Bonnie Jo Mount produced shattering images of one California woman, Beverly Layman, 58, a week before she died. Getting close to the Oklahoma family of Anna Marrie Jones, who drank herself to death at 54, was harder: The men were often drunk, and the family pressed Mount to buy them more booze one night when the vodka ran out. She declined.

Data journalist Dan Keating worked with the federal Agency for Healthcare Research and Quality to plumb a massive federal database of emergency room visits. Keating wrote a custom search — the first ever by a media organization — to tease apart the causes of early mortality and identify its victims. That database was among more than a dozen Keating mined for information, and The Post offered the resulting analyses in several interactive digital presentations, allowing readers to break down mortality trends by age, gender, race and location.

More than 2 million readers engaged with the stories, photographs, videos and interactive graphics in this series, and shared them on social media. A lively debate raged in our comments section about white mortality and white privilege. And countless readers thanked The Post for covering this subject. Many had lost mothers, sisters and daughters to substance abuse and suicide, or came from rural areas plagued by a problem that, they said, had been too long misunderstood or ignored.