Unintentional Deaths Are on the Rise: Here’s What That Could Mean for You

Updated: November 1, 2024

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In the United States, unintentional injury is the leading cause of death for individuals aged 1–44. The primary causes of these unintentional deaths include accidental poisonings — such as drug overdoses — motor vehicle accidents, accidental drowning and falls. In 2022, the number of unintentional deaths reached 227,039, a 36% increase from 2018. Some states, however, had higher rates of accidental deaths than others.

MoneyGeek analyzed data from the Center for Disease Control’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database from 2020 to 2022 to find the states where the most unintentional deaths occur and explore the types of accidental deaths that are on the rise.

KEY FINDINGS:

From 2020 to 2022, 370,783 unintentional deaths occurred in the United States, with a median of 6,024 deaths per state (7,270 average per state).
Montana ranks No. 1 for unintentional deaths in the U.S., with an average of 57.1 deaths per 100,000 residents.
Unintentional deaths from firearms in the U.S. decreased by 14% in the three years analyzed, with Mississippi having the highest rate of these deaths in the country.
More unintentional deaths caused by nature occur in Alaska than in any other state, with four deaths per 100,000 residents annually.
Unintentional deaths are on the rise in Mississippi and South Dakota, with Mississippi moving to the No. 2 spot from No. 4 and South Dakota climbing to No. 3 from No. 5 in the previous year's study.

How Unintentional Deaths Are Classified and Understood

According to the Centers for Disease Control and Prevention, unintentional injury is the leading cause of death in the United States for people ages 1–44.

The most common types of unintentional injury leading to death include drug overdose, motor vehicle traffic, drowning and falls. Additional deaths qualified as unintentional include deaths due to fire, firearms, being cut or pierced with sharp objects, nature, suffocation (including choking) and unintentional poisonings from household chemicals. Because drug overdoses make up the vast majority of unintentional deaths in the U.S., MoneyGeek excluded them from this study for the purpose of focusing on lesser known — but still common, in some cases — causes of unintentional death. You can find a complete list of the causes of unintentional death we examined in this study, along with definitions for each, in our Cause of Death Definitions section.

Public health experts believe these types of deaths can be prevented. Just as many diseases are preventable with good health care, many injuries can also be avoided. Making smart choices in our own individual behavior, being aware of hazards in the environment and ensuring access to good health care are ways that we can reduce our risk of death from unintentional injury.

Montana Has the Highest Unintentional Death Rate in the Country

To find the worst states for accidental deaths, MoneyGeek calculated the average rate of accidental death per 100,000 residents from 2020 to 2022. At No. 1 on our list of deadliest states, Montana — even with a 13% drop in unintentional deaths from 2021 to 2022 — saw an average of 57.1 unintentional deaths per 100,000 residents from 2020 to 2022.

Mississippi is close behind at No. 2, with a 0.4% decrease in unintentional deaths from 2021 to 2022 and an average of 56.2 unintentional deaths per 100,000 residents from 2020–22. To put this rate in perspective, the state with the fewest accidental deaths is New Jersey, with 22.9 deaths per 100,000 residents.

Geographically, the states with the highest rates of unintentional death are not specific to one region, ranging from the West (Montana) to the Northeast (Maine) and the South (West Virginia, Mississippi). Additionally, Delaware, Nebraska and Iowa experienced the most significant increases in unintentional deaths, each seeing a rise of more than 9% from 2021 to 2022.

15 States with the Highest Unintentional Death Rates

	State	Unintentional Deaths per 100,000 Residents (2020–22)	Percentage Change in Unintentional Deaths (2021–22)
1.	Montana	57.1	-12.6%
2.	Mississippi	56.2	-0.4%
3.	South Dakota	55.4	1.6%
4.	West Virginia	54.8	-6.3%
5.	New Mexico	54.8	-2.8%
6.	Wisconsin	54.7	7.3%
7.	Oklahoma	53.3	4.5%
8.	Maine	51.2	2.1%
9.	South Carolina	49.8	-0.2%
10.	Vermont	49.4	8.0%
11.	Tennessee	48.0	1.3%
12.	Wyoming	47.9	7.1%
13.	Arkansas	47.9	1.2%
14.	Oregon	46.0	-4.0%
15.	Arizona	45.5	1.9%

Mississippians and Alaskans Are More Likely to Experience Unusual Unintentional Deaths

Although traffic fatalities and falls are the most common reasons for unintentional deaths in our study, in some states, more unusual accidents are common. For example, Alaska, which ranks No. 21 overall on our list, is the state where the most unintentional deaths occur due to natural and environmental accidents and other transport-related deaths. Mississippi is the leading state for accidental deaths caused by fire, firearms, suffocation and motor vehicle traffic.

The columns in the table below are defined as follows:

State Leader: The state with the most cases of the cause of unintentional death in the corresponding “Cause of Unintentional Death” row.
State Deaths per 100,000 Residents: The rate of the Cause of Unintentional Death in the corresponding row for the State Leader of that Cause of Unintentional Death.
National Percent Change in Deaths ('20–'22): The percentage change in the number of the corresponding Cause of Unintentional Death nationally from 2020 to 2022.

Definitions for each of the causes of death listed below can be found in the Cause of Unintentional Death Definitions section.

Causes of Unintentional Death in the US

State Leader	Cause of Unintentional Death	State Deaths per 100,000 Residents	National Percent Change in Deaths ('20–'22)
Alaska	Natural/Environmental	4.2	48%
Alaska	Transport, Other	2.6	-13%
Alaska	Transport, Other Land	1.7	-7%
Mississippi	Motor Vehicle Traffic	27.0	9%
Mississippi	Suffocation	3.8	10%
Mississippi	Fire/Flame	3.0	18%
Mississippi	Firearm	0.7	-14%
Alabama	Unspecified Injury	5.0	-16%
Hawaii	Drowning	3.6	0%
Maryland	Hot Object/Substance	0.1	9%
Montana	Pedestrians Hit by Trains or Vehicles Off-Road	0.6	6%
New Mexico	Poisoning	5.0	18%
North Dakota	Machinery	0.6	22%
Utah	Cyclists Hit by Trains or Vehicles Off-Road	0.3	-5%
West Virginia	Struck by or Against	0.8	3%
West Virginia	Cut/Pierce	0.4	21%
Wisconsin	Fall	32.5	11%

Unintentional Deaths Are Preventable: Here’s What You Can Do

Unintentional injuries and deaths are on the rise. Many experts believe that poverty and increased alcohol consumption are two reasons for the increase. Some demographic groups have a higher risk of dying from unintentional injuries than others, with the highest risks found among those who are young, male or Black.

Working in high-risk industries, such as commercial truck driving and construction, also exposes people to more risk. Environmental factors, such as unsafe home or work environments and lack of access to good health insurance and medical care, are additional reasons that some people are more likely to be seriously injured than others.

While broader societal factors are an important predictor of unintentional injuries and deaths, there are also steps individuals can take to protect themselves and their loved ones, particularly as summer vacation approaches.

Taking Summer Safety Precautions

Summer is a time that most of us associate with outdoor activities, ranging from swimming and camping to fireworks celebrations. Yet, with these activities often comes the risk of accidents. Taking precautions in the following situations can help keep you and your family safe in the upcoming months.

High Temperatures

With hotter temperatures, heat-related illnesses are more common, so stay hydrated and take extra breaks if working or playing outdoors. Use sunscreen to protect your skin from burns.

Swimming

Drowning risks increase in the summer. Swimming lessons, watching young children closely around bodies of water, safety barriers and removing toys and other tempting objects from pools are all good ways to reduce the risk of drowning.

Boating

If you’re boating, don’t drink and drive. Be familiar with boat safety rules, and consider taking a boating safety course. All boat riders should wear life jackets: even swimmers can hit their heads or become disoriented when falling off a boat. If the weather changes suddenly, head back to shore.

Mosquitos

Mosquitoes can carry diseases such as Zika and West Nile virus. If spending time outdoors, consider bringing insect repellent containing DEET and wearing long-sleeved shirts and pants. After storms, empty outdoor containers with standing water, where mosquitoes can breed.

Fireworks

Fireworks cause thousands of preventable accidents and multiple deaths per year. For those who aren’t willing to leave fireworks to the professionals, keep children away from fireworks, never light them indoors and have a bucket of water handy in case of fires. Even smaller fireworks can cause severe burns and other injuries: for children, consider glow sticks instead of sparklers.

Biking or Walking

MoneyGeek’s pedestrian crash analysis showed that accidents often cause severe injuries, even at low speeds. Cyclists and pedestrians should wear bright or reflective clothing, avoid cell phone use and always be on the lookout for cars pulling out of driveways or in and out of parking.

Driving

Drivers should take extra precautions during the summer. Avoid drinking and driving, watch for pedestrians, motorcyclists and cyclists, be careful of weather conditions leading to rainy or slick roads and always stay alert and drive defensively.

Financially Protecting Your Loved Ones With Life Insurance

Having a solid life insurance policy can ensure that your family and other dependents are financially protected in the event of unintentional death.

Many people are offered accidental death and dismemberment (AD&D) insurance through their employers; this can be a good option if you have a high-risk job, such as a commercial driver or construction worker. However, note that AD&D insurance only pays out due to accidents, and the insurance definitions for accidents are very specific. Those looking for the best life insurance companies for AD&D coverage should look at policy features such as the amount of coverage and the types of accidents covered.

For most people, term life insurance or whole life insurance are better options than accidental death and dismemberment (AD&D) insurance. Although these types of life insurance tend to be more expensive, they also cover more causes of death.

However, even with term and whole life insurance policies, keep in mind that not all types of death are covered by life insurance. For example, insurance companies may deny beneficiaries' claims if the applicant lied or omitted crucial health information about pre-existing conditions. Risky activities, such as scuba diving or mountain climbing, are also often not covered. Otherwise, life insurance policies cover natural causes such as disease, accidents and even murder (provided it’s not murder by the beneficiary).

Expert Insights

MoneyGeek spoke with experts on unintentional injuries and deaths to better understand why some people are at higher risks than others and what our society could do to improve safety for everyone.

Methodology

MoneyGeek analyzed CDC WONDER data from 2020 to 2022 to explore which causes of unintentional death are the most common overall and which are becoming more common over time. We excluded homicides, suicides and drug overdose deaths from our analysis. To rank states, we combined all causes of unintentional death analyzed in the study and calculated an average annual rate of unintentional death in each state based on the population of each state.

Full Dataset

The data points presented are defined as follows:

Unintentional Death Rate: Average number of unintentional deaths per 100,000 residents from 2020 to 2022.
Percentage Change in Unintentional Deaths (2021–22): Change calculated based on the change in total unintentional deaths by state from 2021 to 2022.
Total Number of Unintentional Deaths (2020–22): The total number of deaths classified as unintentional that took place in the indicated state from 2020 to 2022.
Most Common Cause of Unintentional Death: The unintentional cause of death that caused the most deaths from 2020–2022. For the years analyzed, the most common cause of unintentional death was either Falls or Motor Vehicle Traffic in every state. These causes of death are defined as follows:
— Falls: Includes deaths resulting from falls from stairs, steps, ladders, scaffolds, beds or chairs.
— Motor Vehicle Traffic: Includes all deaths resulting from motor-vehicle-traffic injuries involving automobiles, vans, trucks, motorcycles and other motorized cycles on public roadways.

Rank	State	Unintentional Death Rate	Percentage Change in Unintentional Deaths (2021–22)	Total Number of Unintentional Deaths (2020–22)	Most Common Cause of Unintentional Death
1	Montana	57.1	-12.6%	1,889	Fall
2	Mississippi	56.2	-0.4%	4,979	Motor Vehicle Traffic
3	South Dakota	55.4	1.6%	1,494	Fall
4	West Virginia	54.8	-6.3%	2,929	Fall
5	New Mexico	54.8	-2.8%	3,472	Motor Vehicle Traffic
6	Wisconsin	54.7	7.3%	9,644	Fall
7	Oklahoma	53.3	4.5%	6,389	Fall
8	Maine	51.2	2.1%	2,102	Fall
9	South Carolina	49.8	-0.2%	7,814	Motor Vehicle Traffic
10	Vermont	49.4	8.0%	946	Fall
11	Tennessee	48.0	1.3%	10,034	Motor Vehicle Traffic
12	Wyoming	47.9	7.1%	835	Motor Vehicle Traffic
13	Arkansas	47.9	1.2%	4,356	Motor Vehicle Traffic
14	Oregon	46.0	-4.0%	5,854	Fall
15	Arizona	45.5	1.9%	10,041	Motor Vehicle Traffic
16	Missouri	45.3	4.7%	8,388	Motor Vehicle Traffic
17	Louisiana	45.2	-4.4%	6,270	Motor Vehicle Traffic
18	Florida	45.2	-3.5%	29,706	Fall
19	Kansas	44.7	-1.8%	3,930	Fall
20	Kentucky	44.6	-3.2%	6,024	Motor Vehicle Traffic
21	Alaska	44.0	-4.9%	966	Motor Vehicle Traffic
22	Minnesota	43.8	3.7%	7,486	Fall
23	North Carolina	43.6	0.6%	13,891	Motor Vehicle Traffic
24	Colorado	43.0	5.4%	7,515	Fall
25	Iowa	42.8	9.8%	4,086	Fall
26	Idaho	42.7	-2.6%	2,417	Fall
27	North Dakota	42.1	-9.0%	976	Fall
28	Alabama	42.0	-2.1%	6,310	Motor Vehicle Traffic
29	Ohio	39.5	0.2%	13,911	Fall
30	Pennsylvania	39.1	-0.3%	15,144	Fall
31	Rhode Island	38.8	2.5%	1,260	Fall
32	Michigan	38.8	-1.1%	11,645	Fall
33	New Hampshire	38.5	9.0%	1,597	Fall
34	Indiana	37.8	-4.7%	7,710	Motor Vehicle Traffic
35	Nebraska	37.8	10.5%	2,216	Motor Vehicle Traffic
36	Washington	37.2	0.0%	8,633	Fall
37	Georgia	36.2	-0.4%	11,731	Motor Vehicle Traffic
38	Nevada	35.6	2.4%	3,366	Motor Vehicle Traffic
39	Texas	33.0	0.7%	29,387	Motor Vehicle Traffic
40	Connecticut	32.7	4.5%	3,531	Fall
41	Virginia	32.4	1.2%	8,407	Fall
42	Maryland	32.4	0.2%	5,958	Fall
43	Delaware	32.0	13.5%	964	Motor Vehicle Traffic
44	Illinois	31.4	-4.0%	11,893	Fall
45	Massachusetts	30.4	6.1%	6,349	Fall
46	Utah	30.4	0.3%	3,030	Fall
47	Hawaii	28.9	6.5%	1,239	Fall
48	District of Columbia	26.9	-5.6%	553	Fall
49	California	26.6	3.0%	31,273	Motor Vehicle Traffic
50	New York	23.7	5.6%	13,975	Fall
51	New Jersey	22.9	-2.4%	6,268	Motor Vehicle Traffic

Cause of Unintentional Death Definitions

Definitions for all types of unintentional causes of death explored in this study are as follows:

Cause of Death	Definition
Cut/Pierce	This category includes deaths caused by cutting and piercing instruments, including knives, swords and daggers; power lawnmowers and hand tools, household appliances and other unspecified sharp objects.
Drowning	Deaths from drowning and submersion with and without watercraft. Most of these deaths occur in seas, rivers, pools, bathtubs and bodies of water with no watercraft involved.
Falls	Deaths resulting from falls from stairs, steps, ladders, scaffolds, beds or chairs.
Fire/Flame	Deaths caused by fire, flames and smoke inhalation. Structural fires in residences are the primary cause.
Hot Objects/Substances	Deaths caused by hot liquids and steam, caustics and corrosives.
Firearms	Unintentional deaths due to firearms (not homicide).
Machinery	Deaths associated with machinery used in various industrial and occupational activities, including agriculture, construction and mining.
Motor Vehicle Traffic	All deaths resulting from motor-vehicle–traffic injuries involving automobiles, vans, trucks, motorcycles and other motorized cycles on public roadways.
Pedal Cyclist, Other	This category looks at deaths among pedal cyclists NOT involving motor vehicles, but those hit by a train, a car that wasn't traveling on a road (driveway or parking lot), another cyclist or other mechanism.
Pedestrian, Other	Pedestrians hit by trains, motor vehicles that are not on a road (driveway, parking lot) or other means of public transportation.
Transport, Other	Deaths due to injuries involving motorized or non-motorized modes of transportation not on land, including drowning and other types of injuries associated with watercraft accidents, injuries due to aircraft accidents and injuries due to ski lift or suspended cable car accidents.
Transport, Other Land	Land-transport motor vehicle deaths due to collisions or accidents not occurring on public roadways. It further includes deaths among riders of animals or animal-drawn vehicles due to loss of control or collisions with pedestrians, pedal cyclists, stationary objects and railway trains/vehicles; and deaths among occupants of railway trains/vehicles or streetcars due to collisions with motor vehicles or rolling stock.
Natural/Environmental Factors	Deaths due to excessive heat or cold, hunger, excessive exposure outdoors, storms, bites and stings from bugs.
Poisoning	Unintentional poisoning can include alcohol, disinfectants, cleansers, paints, lubricants, insecticides, herbicides, fungicides and fumigants.
Struck By/Against	This category includes injuries resulting from being struck by or striking against objects or persons, including by falling objects and playing sports.
Suffocation	Deaths by inhalation of food or other objects (choking), including bedding.
Unspecified Injury	The mechanism of death is not reported by the coroner or medical examiner.

About Rachel Newcomb, PhD

Dr. Rachel Newcomb is an award-winning writer and the chair of anthropology at Rollins College. She has over two decades of research experience both internationally and domestically. She has published multiple books and articles on USA Today, HuffPost, The Economist and The Washington Post. She also contributes finance articles to MoneyGeek.

Dr. Newcomb earned her doctorate in anthropology from Princeton University.

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Centers for Disease Control and Prevention. "Injuries and Violence Are Leading Causes of Death." Accessed July 3, 2024.
National Library of Medicine. "Shifting patterns of disparities in unintentional injury mortality rates in the United States, 1999-2016." Accessed July 3, 2024.
National Safe Boating Council. "Boat on Course." Accessed July 3, 2024.