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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.


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