The U.S. suicide rate hit a 50-year record in 2017, contributing to a lower life expectancy for Americans that’s part of a larger downward trend.

More than 47,000 people died by suicide in 2017, compared to roughly 45,000 in 2016, according to data from the Centers for Disease Control and Prevention.

The CDC released 2017 data on mortality in the U.S. Thursday and compared 2017’s death rates to those in 1999. The age-adjusted suicide rate increased 33 percent from 10.5 deaths to 14 deaths per 100,000 people from 1999 to 2017, the CDC found.

“We must address suicide as a public health issue, as we do with other leading causes of death such as cancer and HIV/AIDS,” Christine Moutier, chief medical officer for the American Foundation for Suicide Prevention, said in a statement Thursday.

“Suicide is preventable. As a nation, we must take action by making a major investment in suicide research, translating that research into treatment and early interventions for mental health, and further educating the public on the warning signs of suicide.”

Suicide rates for both men and women jumped in that 18-year span, but the women’s rate increased twice as fast as that of men, according to CDC data. The suicide rate for men increased 26 percent from 17.8 deaths per 100,000 people in 1999 to 22.4 deaths per 100,000 people in 2017. For women, the suicide rate increased 53 percent from four deaths per 100,000 people in 1999 to 6.1 deaths per 100,000 people in 2017.

The CDC did not speculate why the suicide rate was going up. The 2017 numbers also highlighted that people living in very rural counties are nearly twice as likely to die by suicide than those living in very urban counties.

Life expectancy for the U.S. population fell from 78.7 in 2016 to 78.6 in 2017, according to CDC data. That decline was impacted by higher suicide and drug overdose rates that hit middle-aged Americans especially hard, according to The Associated Press.

The CDC recorded 70,237 drug overdose deaths in 2017, according to data released Thursday. Unfortunately, that number represents a new record, reported The New York Times blog The Upshot. Many analysts traced the increase in overdose deaths to the growing amount of drugs that are laced with dangerous substances like the synthetic opioid fentanyl when the CDC released preliminary 2017 overdose statistics in August.

Other recent suicide studies showed concerning trends, including a jump in suicides among younger veterans noted by the Department of Veterans Affairs in late September.

Suicides are widely believed to be underreported because of the stigma surrounding suicide, according to the American Foundation for Suicide Prevention.

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