President Trump's path to the White House was paved in large measure by white working-class voters. But he isn't exactly returning the favor to these Americans, who are dying in shockingly high numbers in middle age.

The epidemic of "deaths of despair" — those caused by drugs, alcohol and suicide — was once centered in rural Appalachia but is now nationwide, according to a new follow-up to the 2015 study that grabbed headlines around the world.

The lives of Trump's most loyal supporters, however, are not going to get much better by cutting coverage for preexisting conditions and treatment for opioid abuse, as proposed under Trump's health care fix, or by slashing social programs to pad defense spending, as envisioned in Trump's budget outline.

In fact, it's more likely that death rates will rise even faster if the president gets his way.

"The policies that you see seem almost perfectly designed to hurt the very people who voted for him," study co-author Angus Deaton, a Princeton economist who won the Nobel Prize in 2015, told the Associated Press.

Democrats in Congress have also pointed out this contradiction, to little avail. Voters might want to ask Republican members of Congress who are supporting Trump and who are back in their districts this week and next.

If Trump really wants to be the champion of forgotten Americans, he would focus far more on reversing the loss of good middle-income jobs — highlighted by the updated study as an underlying cause of the spiking death rate, triggering economic and social problems that build up over time.

The updated study, released by the Brookings Institution, confirms that "deaths of despair" rose most dramatically between 1999 and 2015 for white Americans with a high school degree or less. For men, the rate rose by 130 percent to 196 per 100,000 and for women by 380 percent to 115 per 100,000. The increase is so steep that the overall death rates for whites without college degrees have overtaken minority groups for the first time. The mortality rate for whites without college degrees is much higher for those born in 1975 than for those born in 1935, and it has been rising by a half-percent each year.

This devastating trend is markedly different than other wealthier nations, including Australia, Canada and countries in Europe. It certainly isn't going to make America great again.

FROM AN EDITORIAL IN THE SACRAMENTO BEE