Maps show the typical cause of death in each region of America

Where you live determines how you die. 

That is the conclusion of a new study that lays bare the most common causes of death county-by-county across the United States, and how it has changed since 1980. 

The data collected by the University of Washington in Seattle offer an unprecedented detailed glimpse into the differing healthcare needs between regions. 

Violent deaths are more common in the West. 

Heart disease is more likely to claim lives in West Virginia and Kentucky. 

Diabetes is most commonly fatal in Arkansas, Louisiana, and Mississippi. 

Cancer kills more in Idaho, Wyoming and Colorado than anywhere else. 

Drug overdose deaths have shot up 200 percent since 1980 – with some areas seeing an increase as high as 1000 percent. The worst-affected counties are in Kentucky, West Virginia, Ohio, Indiana, western Pennsylvania, and east-central Missouri.

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In general, American lifespan is longer today than it was in 1980. However, some regions have seen a surge in death rates.

The disparity has left demographers and public health officials baffled, unable to explain it in a nutshell. 

But in a new study published this week, researchers at the University of Washington in Seattle warn we are not doing enough to tailor rehab and healthcare programs to each county’s specific needs. 

There were also disparities within regions.  

The counties with the highest and the lowest mortality rates from cirrhosis and other liver diseases were both in South Dakota.

Oglala Lakota County, SD, sees 193 deaths per 100,000 people. However, in Lincoln County, SD, there are around seven deaths per 100,000 people.

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WHERE HEART DISEASE IS MOST COMMON

Cardiovascular disease was the leading cause of death overall in the United States in 2014.

Though the rate has dropped by 50 percent since 1980, some regions have seen slower improvement.  

It was a particularly common cause of death along the Mississippi River.

Cardiovascular disease was a particularly common cause of death along the Mississippi River

The worst-affected counties in 2014 were Franklin, Louisiana; Caldwell, Louisiana; Gallatin, Kentucky; and some other counties in the surrounding area.

The researchers warned it is difficult to accurately design targeted healthcare strategies for each region’s needs because death certificates are so vague.  

Nearly all deaths in the United States are reported in death certificates.

However, the causes of death recorded may be vague or even implausible. 

For example, a physician may report that someone died of heart disease, when the underlying cause was, in fact, hypertensive heart disease. 

This is important because hypertensive heart disease specifically refers to a build up of blood pressure, and health care providers could target their work in that area. 

WORST AFFECTED BY DRUGS MENTAL DISORDERS

The study combines drug use and mental disorders into one category.

More than 2,000 US counties witnessed increases of 200 percent or more in deaths related to substance abuse and mental disorders since 1980.

The worst affected were counties in Kentucky, West Virginia, and Ohio, which saw alarming surges of more than 1,000 percent.

The greatest increases in substance-related deaths were in Clermont County, Ohio (2,206 percent), and Boone County, West Virginia (2,030 percent) 

Drug overdoses are far more prevalent in rural areas, the data showed.

The greatest increases in substance-related deaths were in Clermont County, Ohio (2,206 percent), and Boone County, West Virginia (2,030 percent).

The largest drops in this category were seen in Aleutians East Borough, Aleutians West Census Area, Alaska, and Miami-Dade County, Florida, declining by 51 percent and 45 percent, respectively.

‘The mortality trends in mental and substance use disorders, as well as with other causes of death covered in the study, point to the need for a well-considered response from local and state governments, as well as care providers, to help reduce the disparities we are seeing across the country,’ said Dr Christopher Murray, Director of IHME.

HARDEST HIT BY CHRONIC RESPIRATORY DISEASES

Chronic respiratory diseases, a group that includes COPD and asthma, saw the most dramatic increases in a band of counties spanning northern Texas to the Carolinas. 

Concurrently, a small number of counties along the Mexico border, in northwestern New Mexico, and in central Colorado, experienced decreases.  

Northern Texas, the Carolinas, and parts of New Mexico are hardest hit by respiratory disease

WHERE ACCIDENTS KILL MORE THAN ANYWHERE ELSE

Transport accidents killed the most in Todd County, South Dakota, in 2014.

New York County, New York, had the lowest rate of accident-related deaths.

The national mortality rate from traffic accidents decreased by 45 percent between 1980 and 2014. 

Generally, lower death rates were found in urban areas, and higher rates were seen in rural counties.

Transport accidents killed the most in Todd County, South Dakota, in 2014.

SELF-HARM WORST ON RESERVATIONS

The highest mortality rates were observed in counties in Alaska, in Native American reservations in North Dakota and South Dakota, and in states in the southwest.

Lower rates were found in the upper Midwest, New England, southwestern Texas, and southern California.

The mortality rate from self-harm and interpersonal violence declined by 22.1 percent overall between 1980 and 2014.

The highest mortality rates were observed in counties in Alaska, in Native American reservations in North Dakota and South Dakota, and in states in the southwest

However, it was not the same everywhere. 

Substantial declines were seen in counties in southern California, Texas, and states along the Atlantic coast from Florida to Virginia.

But there was a surge in counties in Utah, Oklahoma and Kansas, along the Canadian border in North Dakota and Michigan, and parts of the Midwest and New England.

ALZHEIMER’S AND OTHER NEUROLOGICAL DISEASES

Deaths from neurological disorders, such as Alzheimer’s disease and other forms of dementia, increased in the majority of counties over the 35-year span of the study.

Neurological disorders caused 3,971,426 deaths between 1980 and 2014.

Large increases were seen in counties from eastern Texas and Oklahoma to Alabama

Especially large increases were seen in counties stretching from eastern Texas and Oklahoma to Alabama. 

Notable declines in mortality were found in counties in the west stretching from central Idaho and western Montana to central Colorado.

DIABETES 

Counties throughout much of the south and mid-Atlantic had mortality rates thatwere higher than average.

Mortality rates were particularly high in counties in Arkansas, Louisiana, and Mississippi along the Mississippi River and in counties in North Dakota and South Dakota with Native American reservations.

The mortality rate from this cause increased by 21 percent overall between 1980 and 2014. 

Mortality rates from diabetes were particularly high in counties along the Mississippi River

Similarly, 91.5 percent of counties had an increase in mortality rates from these diseases.

However, pockets of counties in Maryland, central Colorado, and north and western Alaska as well as individual counties throughout the rest of the country experienced declines in mortality during the same period.

DIARRHEA INFECTIOUS DISEASES

Counties in southern states from Louisiana and Arkansas to Georgia, Tennessee, and Kentucky were worst-affected by this cause of death

Mortality rates from this cause were highest in counties in southern states from Louisiana and Arkansas to Georgia, Tennessee, and Kentucky.

Rates were lower than average in southern Florida, New England, the upper Midwest, central Colorado, and the Pacific Northwest. 

Nationally, the mortality rate from this cause declined by 22.1 percent between 1980 and 2014. 

But 28.3 percent of counties experienced increases in this mortality rate during the same period. 

Especially large increases were seen in counties in Louisiana, Arkansas, Mississippi, Alabama, southern Illinois, and eastern Kentucky.

CANCER 

Very high mortality rates were observed in counties along the southern half of the Mississippi River, in eastern Kentucky and western West Virginia, and in western Alaska

The study charted the rate of deaths by neoplasms – abnormal growths of tissue in the body. In other words: cancer.

Very high mortality rates were observed in counties along the southern half of the Mississippi River, in eastern Kentucky and western West Virginia, and in western Alaska.

Rates were much lower in states stretching from Idaho and Wyoming in the north to western Texas in the south.

Looking at the rates since 1980, increases in mortality from neoplasms were found in south-central counties.

The largest increases were observed in eastern Kentucky. 

In contrast, the largest decreases in mortality from neoplasms were found primarily in counties in central Colorado, southern Florida, Alaska, parts of New England, and coastal counties in California.

CIRRHOSIS OTHER LIVER DISEASES

Select counties in Montana, Florida, and North and South Dakota have the highest mortality rates from cirrhosis. 

But sharp increases were seen in southwestern Oregon and northwestern Texas since 1980.

Counties in Montana, Florida, and North and South Dakota have the highest mortality rates from cirrhosis