Declines in Adult Death Rates Lag in the U.S. South

January 2018

Americans are now living longer but declines in adult death rates have not been evenly distributed across states. Between 1980 and 2015, states with the highest death rates among adults ages 55 and older became increasingly concentrated in the South. By contrast, states in the Northeast, Upper Midwest, and Pacific Coast tended to see the greatest improvement. Death rates in the South diverged from the rest of the country first among men and later among women.

Adult death rates in many southern states are 30 percent or 40 percent higher than in states with the lowest death rates. The growing geographic disparity means that adults (ages 55+) in the worst-off southern states can expect to die three to four years earlier, on average, than their counterparts in states with the lowest death rates.

Highest Adult Death Rates Now Concentrated in South

In 2015, the five states with the highest adult death rates were all located in the South, including Alabama, Kentucky, Mississippi, Oklahoma, and West Virginia (see figure below). Among women ages 55 and older, the death rate was highest in West Virginia. Among men, the rate was highest in Mississippi.

Adult death rates for women and men were lowest in Arizona, California, Florida, Hawaii, and parts of the Northeast and Midwest.

Death Rates for Older F in 2015

Per 100,000 F Ages 55 and Older

Note: Death rates are for adults ages 55 and older in each state, and adjusted so that age differences across states and over time are eliminated to allow for comparison. Map categories are based on quintiles, which divide the states into five categories with a roughly equal number of states in each category. State rankings are shown in parentheses. Additional notes and data sources »

Women’s Death Rates Drop More Slowly in South; Gap With Other States Widening

Women’s death rates have declined in recent years, but progress in the South has been much slower than in other parts of the country. The figure below shows trends in death rates for women ages 55 and older across 10 states, from 1980 to 2015. Trends are shown for the five states with the highest female death rates in 2015 and the five states with the lowest rates.

Death Rates for Older Women, 1979 to 2015

Per 100,000 Women Ages 55 and Older, 50 States and the District of Columbia

Note: Death rates are for adults ages 55 and older in each state, and adjusted so that age differences across states and over time are eliminated to allow for comparison. States are divided into quintiles, with a roughly equal number of states in each category. Additional notes and data sources »

Men’s Death Rates Have Fallen Nationwide, But South Not Keeping Pace

Declines in death rates among men were similar to those for women, but the declines have been steeper, and the divergence in death rates between the South and the rest of the country started sooner.

Death Rates for Older Men, 1979 to 2015

Per 100,000 Men Ages 55 and Older, 50 States and the District of Columbia

Note: Death rates are for adults ages 55 and older in each state, and adjusted so that age differences across states and over time are eliminated to allow for comparison. States are divided into quintiles, with a roughly equal number of states in each category. Additional notes and data sources »

Diverging Trends in Adult Deaths Shift State Rankings; Southern States Now Rank Last

In 2015, all of the states with the highest female death rates (ages 55+) were located in the South. In 1980, by comparison, the five states with the highest female death rates included Louisiana, New Jersey, New York, Ohio, and Pennsylvania.

State Rankings of Death Rates for Older Women

Rankings at five-year intervals from 1980 to 2015, 50 States and the District of Columbia.

A "Lowest" ranking indicates a low death rate and a "Highest" ranking indicates a high death rate.

Note: Death rates are for adults ages 55 and older in each state, and adjusted so that age differences across states and over time are eliminated to allow for comparison. States are divided into quintiles, with a roughly equal number of states in each category. Additional notes and data sources »

State rankings for men shifted in a similar fashion. In 1980, men’s death rates were highest in Kentucky, Pennsylvania, Ohio, South Carolina, and Vermont. But by 2015, the five states with the highest death rates for men were all located in the South.

State Rankings of Death Rates for Older Men

Rankings at five-year intervals from 1980 to 2015, 50 States and the District of Columbia.

A "Lowest" ranking indicates a low death rate and a "Highest" ranking indicates a high death rate.

Note: Death rates are for adults ages 55 and older in each state, and adjusted so that age differences across states and over time are eliminated to allow for comparison. States are divided into quintiles, with a roughly equal number of states in each category.

Notes and Sources

Death rates are for adults ages 55 and older in each state, and adjusted so that age differences across states and over time are eliminated to allow for comparison.

For more information: Andrew Fenelon, "Geographic Divergence in Mortality in the United States," Population and Development Review 39, no. 4 (2013): 611-34.

Data source: United States Department of Health and Human Services, Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Compressed Mortality File (CMF) on CDC WONDER Online Database, accessed at https://wonder.cdc.gov/, on July 14, 2017.

Project Credits

Population Reference Bureau: Mark Mather and Paola Scommegna

University of Maryland: Andrew Fenelon

University of Michigan: Vicki Freedman and Amanda Sonnega

District Analytics: Alec Friedhoff

Photo: © Wesley Hitt/Getty Images

This project was funded by the University of Michigan Center on the Demography of Aging, through a grant from National Institute on Aging.