A new analysis from The Schiller Kessler Group of national mortality data has found that preventable injury claimed 197,449 American lives in 2024, an average of 541 deaths every day, or more than 22 every hour, making it the third leading cause of death in the country behind only heart disease and cancer.

Of the 2,179,957 deaths recorded across the ten leading causes of mortality in 2024, heart disease remained the top killer at 683,491 deaths, or roughly 1,873 a day, followed by cancer at 619,876 deaths, or about 1,698 a day. Together, those two causes accounted for 59.8% of all top ten fatalities. Preventable injury followed in third place at 9.1% of the total, a toll that exceeded stroke deaths by 30,597, more than doubled diabetes deaths, and claimed 1.7 times more lives than Alzheimer’s disease. Unlike chronic disease, researchers note that preventable deaths could largely be avoided through evidence-based interventions, infrastructure improvements, and targeted public health policy.

Three broad categories, poisoning, falls, and motor vehicle crashes, accounted for 84% of all preventable deaths in 2024, with no other cause representing more than 4% of the total. Poisoning, driven by the ongoing overdose crisis, has held the top spot since 2013 and caused 75,761 deaths, or about 208 a day, making it roughly 1.8 times deadlier than motor vehicle crashes and 1.6 times deadlier than falls. Falls became the second leading cause in 2022 and remain just ahead of motor vehicle crashes in third. Notably, the leading cause shifts by age, with motor vehicle crashes topping the list for those aged 5 to 24, poisoning dominating from 24 to 65, and falls becoming the primary threat after 65.

State-level figures reveal how dramatically that national picture shifts by geography. The national age-adjusted preventable injury death rate stood at 58.55 per 100,000 people in 2024, yet 23 of 51 states and jurisdictions recorded rates above that average, and the most dangerous states posted figures more than double those of the safest.

Alaska ranked as the most dangerous state in the country, with an age-adjusted rate of 91.78 per 100,000, 56.8% above the national average and 2.4 times higher than the safest state, New Jersey, despite recording just 675 total preventable deaths, a reflection of the state’s geographic isolation, limited emergency medical infrastructure, and difficult environmental conditions. West Virginia ranked second at 87.78 per 100,000, nearly 50% above the national average, driven by rural poverty, limited healthcare access, and the ongoing overdose crisis, with every preventable death in the state representing an average of 14.1 years of potential life lost. New Mexico (79.31), Tennessee (75.14), Oklahoma (73.96), Maine (73.30), Vermont (71.23), Arizona (70.86), and Kentucky and Mississippi, tied at 70.46, rounded out the top ten, with the South accounting for half of those states and rural New England states like Maine and Vermont also standing out due to aging populations and limited trauma care access.

At the opposite end of the spectrum, New Jersey posted the nation’s lowest preventable death rate at 38.44 per 100,000, followed by New York (39.67), Hawaii (41.01), Nebraska (41.56), Virginia (43.36), and California (43.59), states researchers credit with stronger infrastructure, broader insurance coverage, and more effective trauma and emergency care systems. The 53.34 point gap between Alaska and New Jersey illustrates just how much geography can shape a person’s risk of dying from a preventable cause.

Climate is emerging as a growing factor as well. The natural and environmental death category recorded 3,078 fatalities in 2024, though researchers believe the true figure is likely higher since death certificates often attribute weather-related fatalities to underlying conditions like heart disease. The U.S. recorded more than 2,300 heat-related deaths in 2023 alone, a 117% increase over 1999 levels, and NOAA has confirmed 2024 as the hottest year on record, with researchers projecting the sharpest future increases in heat-related mortality among non-Hispanic Black and Hispanic populations and older adults.

“Where a person lives can determine whether they survive a preventable injury just as much as their own choices do,” said a spokesperson for the Florida wrongful death legal team at InjuredInFlorida.com. “These numbers show why every state needs its own approach to closing these gaps, and why families who lose a loved one to a preventable tragedy deserve to understand exactly what went wrong.”