INDIANAPOLIS (AP) – A new federal report says Indiana’s suicide rate increased more than 30 percent from 1999 to 2016.

The Indianapolis Star reports that the Centers for Disease Control and Prevention officials say suicide, drug overdoses and Alzheimer’s disease are three causes of death on the rise.

Officials say suicide is the 10th leading cause of death in the U.S. The report says nearly 45,000 people died by suicide in 2016. The study found that a significant number of people who died by suicide didn’t have a known mental health condition.

CDC Principal Deputy Director Dr. Anne Schuchat says the study’s findings suggest more must be done to prevent suicide and work should extend beyond those diagnosed with a mental illness.

The report says 24 other states saw similar increases during that time period.