A new medical study shows that after decades of increasing life expectancy across the country, people are living shorter lives. And that trend is in part driven by premature deaths among people in the Ohio Valley due to the opioid epidemic, suicide and alcohol abuse. The article published Tuesday in the Journal of the American Medical Association focuses specifically on people 25 to 64-years-old whose premature deaths impact what is called the midlife mortality rate. Among that group, the report calculates about 33,000 excess deaths between 2010 and 2017. A third of those deaths occurred in West Virginia, Ohio, Kentucky and Indiana. The New England region has the second-highest rates of midlife mortality and includes New Hampshire, Maine and Vermont. Life expectancy in the United States has increased for most of the past 60 years, but the rate began to slow across the country after 2014. Life expectancy across the country peaked in 2016 at roughly 79 years. The report’s authors say that in spite of spending significantly more on health care than other high-income countries, the United States fares poorly in rates of chronic conditions such as diabetes and high blood pressure. Understanding the underlying conditions contributing to the decline is key to reversing the trend, according to the report.