Source: NSC press release

The National Safety Council released its annual list of states with the lowest and highest rates of unintentional injury-related deaths[i], which include poisonings – largely from drug overdoses – car crashes and falls. For the second straight year, Maryland has the lowest rate of unintentional injury death, with 26.9 deaths per every 100,000 people – far below the national rate of 40.6. West Virginia has the highest rate for the third time in four years. The state’s rate of 77.2 deaths per every 100,000 people is largely fueled by overdoses from opioid prescription painkillers.

Unintentional injury deaths have overtaken strokes as the fourth leading cause of death in the U.S., and they are the primary focus of National Safety Month, observed each June.

“Someone dies every four minutes in the United States due to an unintentional injury,” said Deborah A.P. Hersman, president and CEO of the National Safety Council. “The top states are the best-in-class at addressing these preventable deaths, but they've also created a blueprint so other states may address the issues that threaten longevity.”

There are various factors that determine a state’s rate of unintentional injury deaths, including demographics and population density. However, some states with low rates have taken actions that can help reduce their numbers of preventable deaths. Some of these actions include strengthening Prescription Drug Monitoring Programs to track opioid painkiller prescribing and passing stronger laws around teen and distracted driving.  

States with the highest rates:

1. West Virginia (77.2)
2. New Mexico (64.3)
3. Montana (61.0)
4. Oklahoma (59.7)
5. Kentucky (59.7)
6. Mississippi (57.9)
7. Wyoming (55.9)
8. Alabama (55.4)
9. Tennessee (54.5)
10. Alaska (53.2)

States with the lowest rates:

1. Maryland (26.9)
2. New York (28.4)
3. California (28.7)
4. District of Columbia (29.9)
5. New Jersey (30.4)
6. Illinois (32.4)
7. Massachusetts (33.7)
8. Virginia (34.7)
9. Texas (36.7)
10. Nebraska (36.8)

Data on unintentional injury death reveal more than just the leading risks by state. The data also help identify the most significant threats to Americans’ safety at various times in their lives. Car crashes are the leading cause of death from ages 5 to 24. Poisonings, largely from opioid painkillers, account for most unintentional injury deaths among adults ages 25-64. For adults ages 65 and older, falls are the leading cause of preventable death.
For more about the leading causes of unintentional injury death, visit

About the National Safety Council

Founded in 1913 and chartered by Congress, the National Safety Council,, is a nonprofit organization whose mission is to save lives by preventing injuries and deaths at work, in homes and communities, and on the road through leadership, research, education and advocacy. NSC advances this mission by partnering with businesses, government agencies, elected officials and the public in areas where we can make the most impact – distracted driving, teen driving, workplace safety, prescription drug overdoses and Safe Communities.