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Advances in medicine and technology have led to decades of rising life expectancy in the U.S. However, according to the Centers for Disease Control and Prevention, life expectancy at birth in the U.S. was 78.6 years in 2017, down from 78.7 years in 2016.

Though it may seem small, this notable decline marks the third consecutive year that life expectancy at birth has fallen and represents an alarming national trend. While common physical health conditions like heart disease and cancer still claim the majority of lives in the U.S. each year, accidental deaths from overdoses and intentional deaths by suicide are largely responsible for rising mortality rates nationwide.

Despite representing a smaller percentage of total deaths compared to other major health conditions, death rates due to suicide and accidents have skyrocketed over the past two decades. In 2017, the suicide death rate per 100,000 people was 14.5, an increase of 33 percent from the rate of 10.8 in 1999. Over the same time period, the death rate due to accidents increased from 37.2 per 100,000 to 52.2. Accidents are defined as unintentional injuries, which include alcohol and drug overdoses.

According to the CDC, 70,327 deaths in 2017 were the result of drug overdoses, with about two-thirds related to opioids. This represents a 9.6 percent increase in the age-adjusted death rate from 2016. Notably, the states with the highest rates of drug overdose deaths are West Virginia (57.8 per 100,000), Ohio (46.3 per 100,000), Pennsylvania (44.3 per 100,000), the District of Columbia (44.0 per 100,000), and Kentucky (37.2 per 100,000).

Overall, mortality rates also vary significantly by state. There is a clear geographical cluster of high mortality rates for states along the Ohio and Mississippi Rivers. More specifically, eight states in the Southeast, including West Virginia, Mississippi, Alabama, and Tennessee have age-adjusted mortality rates exceeding 1,000 per 100,000 people. By contrast, the lowest mortality rates are in California and Hawaii at 734.1 and 688.2 respectively.

There is a significant relationship between high mortality rates and low median incomes among U.S. states. For example, Mississippi, Louisiana, Arkansas, and West Virginia have median household incomes below $50,000 as well as mortality rates in excess of 1,000 per 100,000. California and Hawaii, which have median household incomes around $70,000, have mortality rates under 750 per 100,000.

The other major geographic trend related to mortality rates is a clear cluster of high suicide rates in Alaska and the Rocky Mountain region, which has been labeled “the suicide belt.” In 2017, the suicide rate was highest in Montana, at a rate of 29.7 deaths per 100,000 people, and lowest in Washington D.C., at 6.7 deaths per 100,000.

In general, suicide rates are significantly lower on the East Coast and in California. Research from the CDC shows that suicide is particularly prevalent among young people and became the second-leading cause of death for Americans aged 10-34 in 2016. The same CDC report indicates that in 2017, the suicide rate in rural counties was 1.8 times higher than the suicide rate in urban counties, a differential that had also increased since 1999.

To find out how major causes of death vary around the country, researchers from EffortlessInsurance.com calculated the most over-indexed cause of death in each state, using 2017 data from the CDC WONDER Online Database. For the top 15 leading causes of death nationally, they compared each state’s age-adjusted mortality rate to the national mortality rate for that cause. Whichever cause exceeded its respective national mortality rate by the greatest amount, was identified as the most over-indexed cause of death in that state. The most over-indexed cause of death represents a disproportionately high death rate within the state relative to the national rate. Here is the full state-by-state analysis.

The Most Over-Indexed Cause of Death in Every State

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1. Alabama

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 20.8 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,036
  • State percentage of total deaths for the cause: 1.95%

Photo Credit: Alamy Stock Photo

2. Alaska

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 27.5 deaths per 100,000 people
  • State total number of deaths per year for the cause: 200
  • State percentage of total deaths for the cause: 4.53%

Photo Credit: Alamy Stock Photo

3. Arizona

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 19.1 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,327
  • State percentage of total deaths for the cause: 2.30%

Photo Credit: Alamy Stock Photo

4. Arkansas

  • Most over-indexed cause of death: Chronic lower respiratory diseases
  • State age-adjusted death rate for the cause: 80.6 deaths per 100,000 people
  • State total number of deaths per year for the cause: 2,517
  • State percentage of total deaths for the cause: 7.72%

Photo Credit: Alamy Stock Photo

5. California

  • Most over-indexed cause of death: Essential hypertension and hypertensive renal disease
  • State age-adjusted death rate for the cause: 15.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 5,596
  • State percentage of total deaths for the cause: 2.09%

Photo Credit: Alamy Stock Photo

6. Colorado

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 21 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,181
  • State percentage of total deaths for the cause: 3.10%

Photo Credit: Alamy Stock Photo

7. Connecticut

  • Most over-indexed cause of death: Pneumonitis due to solids and liquids
  • State age-adjusted death rate for the cause: 9.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 392
  • State percentage of total deaths for the cause: 1.25%

Photo Credit: Alamy Stock Photo

8. Delaware

  • Most over-indexed cause of death: Nephritis, nephrotic syndrome and nephrosis
  • State age-adjusted death rate for the cause: 19.5 deaths per 100,000 people
  • State total number of deaths per year for the cause: 205
  • State percentage of total deaths for the cause: 2.23%

Photo Credit: Alamy Stock Photo

9. District of Columbia

  • Most over-indexed cause of death: Accidents (unintentional injuries)
  • State age-adjusted death rate for the cause: 70.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 427
  • State percentage of total deaths for the cause: 8.60%

Photo Credit: Alamy Stock Photo

10. Florida

  • Most over-indexed cause of death: Accidents (unintentional injuries)
  • State age-adjusted death rate for the cause: 58.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 13,059
  • State percentage of total deaths for the cause: 6.41%

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11. Georgia

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 18.1 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,611
  • State percentage of total deaths for the cause: 1.94%

Photo Credit: Alamy Stock Photo

12. Hawaii

  • Most over-indexed cause of death: Influenza and pneumonia
  • State age-adjusted death rate for the cause: 35.8 deaths per 100,000 people
  • State total number of deaths per year for the cause: 637
  • State percentage of total deaths for the cause: 5.59%

Photo Credit: Alamy Stock Photo

13. Idaho

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 23.7 deaths per 100,000 people
  • State total number of deaths per year for the cause: 392
  • State percentage of total deaths for the cause: 2.80%

Photo Credit: Alamy Stock Photo

14. Illinois

  • Most over-indexed cause of death: Nephritis, nephrotic syndrome and nephrosis
  • State age-adjusted death rate for the cause: 20 deaths per 100,000 people
  • State total number of deaths per year for the cause: 2,565
  • State percentage of total deaths for the cause: 2.34%

Photo Credit: Alamy Stock Photo

15. Indiana

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 19.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,277
  • State percentage of total deaths for the cause: 1.95%

Photo Credit: Alamy Stock Photo

16. Iowa

  • Most over-indexed cause of death: Chronic lower respiratory diseases
  • State age-adjusted death rate for the cause: 55.7 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,939
  • State percentage of total deaths for the cause: 6.35%

Photo Credit: Alamy Stock Photo

17. Kansas

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 19.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 553
  • State percentage of total deaths for the cause: 2.04%

Photo Credit: Alamy Stock Photo

18. Kentucky

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 22 deaths per 100,000 people
  • State total number of deaths per year for the cause: 979
  • State percentage of total deaths for the cause: 2.03%

Photo Credit: Alamy Stock Photo

19. Louisiana

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 24.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,080
  • State percentage of total deaths for the cause: 2.36%

Photo Credit: Alamy Stock Photo

20. Maine

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 19.5 deaths per 100,000 people
  • State total number of deaths per year for the cause: 274
  • State percentage of total deaths for the cause: 1.87%

Photo Credit: Alamy Stock Photo

21. Maryland

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 14.9 deaths per 100,000 people
  • State total number of deaths per year for the cause: 882
  • State percentage of total deaths for the cause: 1.77%

Photo Credit: Alamy Stock Photo

22. Massachusetts

  • Most over-indexed cause of death: Pneumonitis due to solids and liquids
  • State age-adjusted death rate for the cause: 7.7 deaths per 100,000 people
  • State total number of deaths per year for the cause: 581
  • State percentage of total deaths for the cause: 0.99%

Photo Credit: Alamy Stock Photo

23. Michigan

  • Most over-indexed cause of death: Diseases of heart
  • State age-adjusted death rate for the cause: 236.5 deaths per 100,000 people
  • State total number of deaths per year for the cause: 25,187
  • State percentage of total deaths for the cause: 25.81%

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24. Minnesota

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 14.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 783
  • State percentage of total deaths for the cause: 1.76%

Photo Credit: Alamy Stock Photo

25. Mississippi

  • Most over-indexed cause of death: Essential hypertension and hypertensive renal disease
  • State age-adjusted death rate for the cause: 19.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 551
  • State percentage of total deaths for the cause: 1.71%

Photo Credit: Alamy Stock Photo

26. Missouri

  • Most over-indexed cause of death: Nephritis, nephrotic syndrome and nephrosis
  • State age-adjusted death rate for the cause: 23.5 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,515
  • State percentage of total deaths for the cause: 2.45%

Photo Credit: Alamy Stock Photo

27. Montana

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 29.7 deaths per 100,000 people
  • State total number of deaths per year for the cause: 311
  • State percentage of total deaths for the cause: 3.05%

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28. Nebraska

  • Most over-indexed cause of death: Chronic lower respiratory diseases
  • State age-adjusted death rate for the cause: 62.9 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,224
  • State percentage of total deaths for the cause: 7.25%

Photo Credit: Alamy Stock Photo

29. Nevada

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 21.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 627
  • State percentage of total deaths for the cause: 2.54%

Photo Credit: Alamy Stock Photo

30. New Hampshire

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 19.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 265
  • State percentage of total deaths for the cause: 2.12%

Photo Credit: Alamy Stock Photo

31. New Jersey

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 20 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,898
  • State percentage of total deaths for the cause: 2.54%

Photo Credit: Alamy Stock Photo

32. New Mexico

  • Most over-indexed cause of death: Chronic liver disease and cirrhosis
  • State age-adjusted death rate for the cause: 29.3 deaths per 100,000 people
  • State total number of deaths per year for the cause: 605
  • State percentage of total deaths for the cause: 3.24%

Photo Credit: Alamy Stock Photo

33. New York

  • Most over-indexed cause of death: Influenza and pneumonia
  • State age-adjusted death rate for the cause: 21.1 deaths per 100,000 people
  • State total number of deaths per year for the cause: 4,517
  • State percentage of total deaths for the cause: 2.91%

Photo Credit: Alamy Stock Photo

34. North Carolina

  • Most over-indexed cause of death: Nephritis, nephrotic syndrome and nephrosis
  • State age-adjusted death rate for the cause: 20.3 deaths per 100,000 people
  • State total number of deaths per year for the cause: 2,040
  • State percentage of total deaths for the cause: 2.19%

Photo Credit: Alamy Stock Photo

35. North Dakota

  • Most over-indexed cause of death: Pneumonitis due to solids and liquids
  • State age-adjusted death rate for the cause: 10.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 86
  • State percentage of total deaths for the cause: 1.34%

Photo Credit: Alamy Stock Photo

36. Ohio

  • Most over-indexed cause of death: Accidents (unintentional injuries)
  • State age-adjusted death rate for the cause: 76.5 deaths per 100,000 people
  • State total number of deaths per year for the cause: 8,971
  • State percentage of total deaths for the cause: 7.26%

Photo Credit: Alamy Stock Photo

37. Oklahoma

  • Most over-indexed cause of death: Chronic lower respiratory diseases
  • State age-adjusted death rate for the cause: 79.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 3,035
  • State percentage of total deaths for the cause: 7.50%

Photo Credit: Alamy Stock Photo

38. Oregon

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 19.6 deaths per 100,000 people
  • State total number of deaths per year for the cause: 825
  • State percentage of total deaths for the cause: 2.25%

Photo Credit: Alamy Stock Photo

39. Pennsylvania

  • Most over-indexed cause of death: Accidents (unintentional injuries)
  • State age-adjusted death rate for the cause: 71.6 deaths per 100,000 people
  • State total number of deaths per year for the cause: 9,527
  • State percentage of total deaths for the cause: 7.02%

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40. Rhode Island

  • Most over-indexed cause of death: Accidents (unintentional injuries)
  • State age-adjusted death rate for the cause: 63.3 deaths per 100,000 people
  • State total number of deaths per year for the cause: 718
  • State percentage of total deaths for the cause: 7.07%

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41. South Carolina

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 17.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 884
  • State percentage of total deaths for the cause: 1.79%

Photo Credit: Alamy Stock Photo

42. South Dakota

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 22.6 deaths per 100,000 people
  • State total number of deaths per year for the cause: 191
  • State percentage of total deaths for the cause: 2.39%

Photo Credit: Alamy Stock Photo

43. Tennessee

  • Most over-indexed cause of death: Influenza and pneumonia
  • State age-adjusted death rate for the cause: 25.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,656
  • State percentage of total deaths for the cause: 2.36%

Photo Credit: Alamy Stock Photo

44. Texas

  • Most over-indexed cause of death: Septicemia
  • State age-adjusted death rate for the cause: 18.8 deaths per 100,000 people
  • State total number of deaths per year for the cause: 4,268
  • State percentage of total deaths for the cause: 2.15%

Photo Credit: Alamy Stock Photo

45. Utah

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 23 deaths per 100,000 people
  • State total number of deaths per year for the cause: 663
  • State percentage of total deaths for the cause: 3.68%

Photo Credit: Alamy Stock Photo

46. Vermont

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 18 deaths per 100,000 people
  • State total number of deaths per year for the cause: 112
  • State percentage of total deaths for the cause: 1.86%

Photo Credit: Alamy Stock Photo

47. Virginia

  • Most over-indexed cause of death: Nephritis, nephrotic syndrome and nephrosis
  • State age-adjusted death rate for the cause: 20.2 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,618
  • State percentage of total deaths for the cause: 2.36%

Photo Credit: Alamy Stock Photo

48. Washington

  • Most over-indexed cause of death: Pneumonitis due to solids and liquids
  • State age-adjusted death rate for the cause: 8.4 deaths per 100,000 people
  • State total number of deaths per year for the cause: 574
  • State percentage of total deaths for the cause: 1.01%

Photo Credit: Alamy Stock Photo

49. West Virginia

  • Most over-indexed cause of death: Accidents (unintentional injuries)
  • State age-adjusted death rate for the cause: 102 deaths per 100,000 people
  • State total number of deaths per year for the cause: 1,892
  • State percentage of total deaths for the cause: 8.13%

Photo Credit: Alamy Stock Photo

50. Wisconsin

  • Most over-indexed cause of death: Accidents (unintentional injuries)
  • State age-adjusted death rate for the cause: 62.7 deaths per 100,000 people
  • State total number of deaths per year for the cause: 3,746
  • State percentage of total deaths for the cause: 7.11%

Photo Credit: Alamy Stock Photo

51. Wyoming

  • Most over-indexed cause of death: Intentional self-harm (suicide)
  • State age-adjusted death rate for the cause: 27.6 deaths per 100,000 people
  • State total number of deaths per year for the cause: 157
  • State percentage of total deaths for the cause: 3.29%

Methodology

The underlying cause of death data is from the U.S. Centers for Disease Control and Prevention WONDER Online Database. The age-adjusted death rates shown are for 2017, using the 2017 population as the age-adjustment baseline. For the purpose of this analysis, only the top 15 leading causes of death nationally were considered.

For each state, the most over-indexed cause of death was determined by comparing the state level age-adjusted death rate for each cause to its respective national level age-adjusted rate. The cause of death that had the largest percent difference from the national rate was reported as the most over-indexed cause of death—representing a disproportionately high death rate within the state relative to the national rate.

Median household income statistics are from the U.S. Census Bureau Current Population Survey, Annual Social and Economic Supplements.