Recent trends in death rates among US women ages 15 to 54 reveal that rates among non-Hispanic whites are rising for many causes of death. These rising causes include accidental poisoning (linked to the epidemic of prescription opioids), suicide, and obesity- and smoking-related diseases. Specific changes in behavior might reduce some of these death rates, but the range of rising causes of death among white women suggests a need for a broader perspective on the social determinants of health. Unhealthy behaviors often arise and persist within certain social and economic contexts, and such behaviors resist improvement or are replaced by other unhealthy behaviors unless those contexts change.