West Virginia, Nearby Southern States, Make Up America’s Death Belt

A cluster of contiguous states in the U.S. south suffer the highest mortality rates of any part of the nation, an analysis of Centers for Disease Control and Prevention (CDC) finds.

In 2022, more than 1% of West Virginians died of any cause. This is followed by Mississippi, Kentucky, Oklahoma, Tennessee, Arkansas, Alabama and Louisiana to round out the top eight — running without break from the Mid-Atlantic through nearly the entire bible belt, up to the Gulf of Mexico. Nearby South Carolina is ninth.

In 2022, West Virginia had a rate of about 1,144 deaths per 100,000 people, Mississippi had a rate of 1,109 per 100,000 people, Kentucky had a rate of 1080 per 100,000 people, and Oklahoma had a rate of 1,057 per 100,000 people.

This list of states has a lot of overlap with the least healthy states in the US. These states tend to have high heart disease rates, high cancer rates, and high rates of chronic diseases in general. These states also tend to be poorer, which is often associated with worse health outcomes. Four of these states—Mississippi, Oklahoma, Arkansas and Alabama—are also in the bottom 10 states for active physicians per capita. 

West Virginia also has the highest accidental death rate, according to an analysis of CDC data. These accidents include traffic injuries, drowning, accidental poisonings, falls, and fires.

Maternal mortality is a major issue for these states as well. Mississippi was the deadliest state for infants in 2022, with an infant mortality rate of 8.12 per 1,000 live births, according to CDC data. It also has one of the highest maternal mortality rates in the country, with 36.0 deaths per 100,000 live births, and this rate has gotten worse over time. 

Kentucky also has a high child death rate, and most counties in the state have seen more deaths than births. The under-40 death rate has also increased not due to COVID-19, but because of drug overdose deaths; drug overdoses are now the number one killer of people under 40 years old in the state. 

Oklahoma has a similar maternal mortality rate crisis to Mississippi, especially among Black mothers, who are nearly twice as likely to die during childbirth than white mothers. The state consistently ranks in the bottom 10 in the country for Black maternal mortality. As of March 2023, drug overdose rates in the state are also up by 22%.