Every year, millions of people die in the United States from a wide range of causes. In 2020, while the U.S. (and the world) was ravaged by the COVID-19 pandemic, nearly 3.4 million U.S. resident deaths were registered – 528,000 more than in 2019. This represented the largest single-year increase since the first year of annual mortality data for the US became available.
When looking at state-level data, we find significant variance from state to state. We examined 19 years of CDC data (1999 through 2017, the latest available version of this data) to find out where people die at higher rates and lower rates in the United States.
Of course, comparing total death – while interesting – does not provide an accurate means of comparison. Therefore, the CDC provides age-adjusted rates that account for each state’s population.
Consider this: while the age-adjusted death rate for the entire U.S. in 2020 was 835.4 (again, after the largest single-year increase in history), 17 states had a higher average death rate during the 19-year period.
*this chart is interactive. Hover over the bubbles to reveal the death rate and year. Red lines indicate the 19-year average death rate.
So, in which states do more U.S. residents die at higher rates? When looking at map, it’s easy to see that they are mostly Southern and Midwestern states. In particular, Mississippi had the highest overall death rate at 988 deaths per 100,000, followed by West Virginia with 963 and Alabama with 962.
Of course, the age-adjusted death rate includes all registered deaths from all causes. This includes heart disease, cancers, respiratory diseases, influenza, and unintentional injuries.
According to the CDC, unintentional injuries have been the third leading cause of death during this 19-year period and are the leading cause of death for younger Americans, those aged 44 years old and younger. Unintentional poisoning (which has spiked in recent years due to the Opioid epidemic), motor vehicle collisions, drowning, and falls are the most common sources of unintentional (or accidental) deaths in the United States.
As consumer safety attorneys, we are very interested in deaths caused by incidents such as motor vehicle collisions or falls. While disease-related deaths may be reduced by early detection or improved access to healthcare, deaths caused by unintentional injury are 100 percent preventable.
Where then are people killed as a result by accidents at the highest rate? Accidental deaths make up the highest percentage of all deaths in Alaska, at nearly ten percent. Alaska is followed closely by New Mexico and Wyoming.
| State | Unintentional Injury Deaths | Total Deaths | Unintentional Injury Death Rate | Percent Of All Deaths |
|---|---|---|---|---|
| Alabama | 45,871 | 914,067 | 50.95 | 5.02 |
| Alaska | 6,744 | 67,789 | 56.88 | 9.95 |
| Arizona | 58,144 | 895,865 | 49.24 | 6.49 |
| Arkansas | 27,027 | 555,553 | 48.72 | 4.86 |
| California | 207,961 | 4,575,252 | 29.72 | 4.55 |
| Colorado | 41,025 | 599,361 | 45.16 | 6.84 |
| Connecticut | 26,424 | 562,638 | 36.18 | 4.70 |
| Delaware | 6,815 | 145,173 | 40.06 | 4.69 |
| District of Columbia | 4,286 | 99,121 | 36.79 | 4.32 |
| Florida | 168,236 | 3,334,759 | 44.02 | 5.04 |
| Georgia | 72,052 | 1,342,156 | 42.62 | 5.37 |
| Hawaii | 8,443 | 183,683 | 30.93 | 4.60 |
| Idaho | 12,815 | 214,181 | 45.31 | 5.98 |
| Illinois | 83,902 | 1,981,914 | 34.05 | 4.23 |
| Indiana | 50,579 | 1,097,283 | 41.03 | 4.61 |
| Iowa | 24,403 | 537,802 | 37.76 | 4.54 |
| Kansas | 23,898 | 475,935 | 42.57 | 5.02 |
| Kentucky | 46,709 | 800,867 | 57.18 | 5.83 |
| Louisiana | 44,306 | 801,761 | 51.79 | 5.53 |
| Maine | 11,578 | 246,518 | 42.63 | 4.70 |
| Maryland | 29,884 | 850,448 | 27.13 | 3.51 |
| Massachusetts | 41,163 | 1,045,879 | 30.49 | 3.94 |
| Michigan | 73,548 | 1,697,556 | 37.63 | 4.33 |
| Minnesota | 40,513 | 746,666 | 38.02 | 5.43 |
| Mississippi | 32,613 | 558,436 | 58.71 | 5.84 |
| Missouri | 56,188 | 1,070,201 | 48.36 | 5.25 |
| Montana | 10,683 | 168,680 | 54.86 | 6.33 |
| Nebraska | 13,636 | 294,874 | 37.15 | 4.62 |
| Nevada | 20,538 | 369,939 | 42.80 | 5.55 |
| New Hampshire | 10,289 | 200,504 | 39.75 | 5.13 |
| New Jersey | 51,795 | 1,366,422 | 29.83 | 3.79 |
| New Mexico | 24,155 | 300,286 | 64.57 | 8.04 |
| New York | 102,652 | 2,896,936 | 26.36 | 3.54 |
| North Carolina | 80,979 | 1,492,170 | 46.07 | 5.43 |
| North Dakota | 5,716 | 113,792 | 40.23 | 5.02 |
| Ohio | 97,622 | 2,110,957 | 43.08 | 4.62 |
| Oklahoma | 40,155 | 696,993 | 56.31 | 5.76 |
| Oregon | 30,710 | 612,587 | 40.00 | 5.01 |
| Pennsylvania | 112,829 | 2,449,539 | 43.52 | 4.61 |
| Rhode Island | 8,543 | 186,494 | 37.78 | 4.58 |
| South Carolina | 43,821 | 782,071 | 50.85 | 5.60 |
| South Dakota | 7,802 | 136,687 | 47.30 | 5.71 |
| Tennessee | 63,534 | 1,136,868 | 52.99 | 5.59 |
| Texas | 171,530 | 3,167,333 | 39.19 | 5.42 |
| Utah | 17,187 | 278,545 | 38.54 | 6.17 |
| Vermont | 5,609 | 101,450 | 43.68 | 5.53 |
| Virginia | 53,886 | 1,139,776 | 36.29 | 4.73 |
| Washington | 49,869 | 922,683 | 38.84 | 5.40 |
| West Virginia | 22,997 | 409,572 | 63.42 | 5.61 |
| Wisconsin | 50,243 | 910,313 | 43.59 | 5.52 |
| Wyoming | 5,913 | 82,234 | 56.91 | 7.19 |
We examined the data to find out in which states are people killed as a result of unintentional injuries most often and where they make up the highest percentage of deaths. We ranked them with a composite score that factors in the percentage of all deaths that are a result of unintentional injuries.
Using rates is much more accurate when comparing states of different sizes. For instance, California had the most unintentional injury deaths over that time frame. However, due to the massive population of the state, it had the third lowest unintentional injury death rate. Conversely, Alaska had the fifth-fewest unintentional injury deaths, but the sixth-highest rate.
Below, we list the ten worst and ten best states for accidental deaths.
New Mexico takes the top spot, home to both the highest unintentional injury fatality rate in the United States (65.57 unintentional deaths per 100,000 people) and the second-highest share of all deaths.
The rugged and often remote terrain of Alaska is likely a factor in the state having the highest percentage of deaths (9.995) coming from accidents. Combined with the sixth-highest unintentional death rate of 56.88, it’s our second-worst state for accidental deaths.
The only state besides New Mexico to have both metrics in the top five, Wyoming is number three overall. Here, 7.19 percent of deaths occur as a result of accidents at a rate of 56.91.
Mississippi had the third-highest unintentional injury death rate at 58.71, along with the ninth-highest percentage of deaths coming from accidents, 5.84 percent.
The state of Kentucky was home to the fourth-highest U/I death rate (57.18) making up the tenth-highest percentage of all deaths (5.83). Kentucky was just behind Mississippi in both metrics. During the 19-year period, 46,709 people lost their lives in unintentional accidents.
In a state famous for having no speed limits (although Montana reinstated them in 1999), Montana is the sixth worst state for unintentional injuries. 6.33 percent of all deaths come from unintentional injuries at a rate of 54.86 per 100,000.
Perhaps the state hit worst by the Opioid epidemic, West Virginia had the second-highest unintentional injury death rate in the United States (63.51). However, due to a high number to total deaths, this was only the 13th highest share of all deaths (5.61 percent).
According to the New York Times, Arizona has the third most residents living more than 30 minutes from emergency medical services. Perhaps that is why 6.49 percent of all deaths are the result of accidents, the fifth highest share in the country. Interestingly, the U/I rate comes in at only the 13th-highest (49.24).
At number nine, Oklahoma was seventh in U/I injury rate (56.51) and eleventh in share of deaths (5.76).
Perhaps due to the outdoorsy reputation of Colorado and its impact on residents’ overall health, the state had the fourth-highest percentage of deaths resulting from unintentional injury (6.84) but only the 19th-highest U/I death rate (45.16).
The safest state in terms of dying from accidental injury is Maryland. Maryland had the second-lowest rate of death (27.13) and the lowest percentage of all deaths caused by accidental injury (3.51). Tied with New York for the lowest composite score, the tie was broken by the total number of accidental injury deaths, where Maryland had far fewer than New York.
Despite being one of the most populous states in the Union, New York had the lowest rate of unintentional injury deaths ( 26.36) and the second lowest share of all deaths with 3.54 percent.
Just behind New York is neighboring New Jersey at number three. Jersey had the fourth-lowest U/I death rate (29.83) and the third-lowest percentage deaths being caused by accidental injury (3.79).
Another state along the east coast of the United States, Massachusetts is the fourth-safest. With a share of all deaths at 3.94 percent and a U/I death rate of 30.91, MA was fourth and fifth respectively in each category.
Despite the gun violence issues that plague Chicago, Illinois is among the states where residents are least likely to die from unintentional injuries. The state had the seventh-lowest unintentional death rate (34.05) and the fifth-lowest percentage of deaths caused by accidental injuries.
By far the most populous state (and by extension home to the most licensed drivers), California – perhaps surprisingly to some – is also among the safest states by this measure. Despite having the most unintentional resident deaths during the 19-year time period, it actually had the third-lowest rate (29.72) and the ninth-lowest share of deaths resulting from accidents.
The U.S. Capital and owning the smallest footprint, D.C. (while not a state) is the seventh safest. The District had the tenth-lowest accidental injury death rate, causing only 4.32 percent of deaths – the sixth-lowest.
The Aloha state’s inclusion on the safest state list is likely not surprising given it’s relaxed reputation. Hawaii had the sixth lowest rate of U/I at 30.93. At the same time, the 8,443 unintentional deaths made up 4.60 percent of all deaths, the eleventh-lowest share.
Another of the more populated states appearing on the safe list, Michigan had the seventh-lowest share of deaths coming from accidents (4.33 percent)and the eleventh-lowest death rate (37.63).
Taking up the last spot in the top ten, Iowa had the thirteenth-lowest accidental death rate, but those deaths made up only 4.54 percent of all fatalities – good for the eighth-lowest share.
All data from this analysis comes from the Centers of Disease Control (CDC). State rankings were determined by a composite score based on unintentional death rate and the percentage of all fatalities that come from accidental deaths.
