Life expectancy at birth in the United States is now 76.1 years – the lowest it has been since 1996. The recent decline is due largely to COVID-19. A drop of 1.8 years in 2020, followed by a decrease of 0.9 year in 2021 added up to the biggest two-year decline since almost exactly a century ago.
Another primary cause of the downward trend, besides COVID, is the sharp rise in drug overdoses, most notably those involving synthetic opioids like fentanyl. (Click here to see the county with the worst drug problem in every state.)
To determine the city in every state with the most premature deaths, 24/7 Tempo reviewed data from the 2022 County Health Rankings & Roadmaps, a joint program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The study ranks metro areas according to the number of people who died before age 75 per 100,000 population (age-adjusted). (These are the states with the lowest life expectancies.)
Click here to see the premature death capital of every state
Click here to see a detailed methodology
In addition to overdose fatalities, hundreds of thousands of Americans die prematurely every year from accidents, curable disease, suicide, murder, and other preventable causes.
Unintentional injuries, which include poisoning, traffic fatalities, and falls, were the third leading cause in the country, according to CHR. In 2019 alone, the latest year for which data is available, unintentional injuries were the leading cause of death for all people under 45.
Many premature deaths occur as a consequence of long-term unhealthy behaviors. Over time these risk factors such as obesity and excessive drinking, for example, can lead to common causes of death including heart disease and cancer – the leading causes of death in the U.S., according to the CDC, accounting for a total of more than 1.2 million a year. (These are the states where people drink the most alcohol.)
Alabama: Gadsden
> Premature deaths: 596 per 100,000 people (state: 500 per 100,000 people)
> Life expectancy at birth: 72.54 years (state: 74.84 years)
> Drug overdose fatalities: 67 per 100,000 people (state: 2,572 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 493 per 100,000 people (state: 21,249 per 100,000 people)
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Alaska: Anchorage
> Premature deaths: 362 per 100,000 people (state: 364 per 100,000 people)
> Life expectancy at birth: 78.77 years (state: 78.62 years)
> Drug overdose fatalities: 246 per 100,000 people (state: 402 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,780 per 100,000 people (state: 3,673 per 100,000 people)
Arizona: Lake Havasu City-Kingman
> Premature deaths: 515 per 100,000 people (state: 360 per 100,000 people)
> Life expectancy at birth: 75.47 years (state: 79.06 years)
> Drug overdose fatalities: 146 per 100,000 people (state: 6,127 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,358 per 100,000 people (state: 32,367 per 100,000 people)
Arkansas: Pine Bluff
> Premature deaths: 596 per 100,000 people (state: 478 per 100,000 people)
> Life expectancy at birth: 72.88 years (state: 75.49 years)
> Drug overdose fatalities: 50 per 100,000 people (state: 1,378 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 483 per 100,000 people (state: 12,833 per 100,000 people)
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California: Redding
> Premature deaths: 453 per 100,000 people (state: 288 per 100,000 people)
> Life expectancy at birth: 75.79 years (state: 81.01 years)
> Drug overdose fatalities: 120 per 100,000 people (state: 20,454 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 942 per 100,000 people (state: 108,182 per 100,000 people)
Colorado: Pueblo
> Premature deaths: 497 per 100,000 people (state: 298 per 100,000 people)
> Life expectancy at birth: 75.12 years (state: 79.98 years)
> Drug overdose fatalities: 175 per 100,000 people (state: 3,566 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 976 per 100,000 people (state: 23,685 per 100,000 people)
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Connecticut: Norwich-New London
> Premature deaths: 332 per 100,000 people (state: 298 per 100,000 people)
> Life expectancy at birth: 79.45 years (state: 80.11 years)
> Drug overdose fatalities: 327 per 100,000 people (state: 3,654 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,173 per 100,000 people (state: 13,494 per 100,000 people)
Delaware: Dover
> Premature deaths: 409 per 100,000 people (state: 371 per 100,000 people)
> Life expectancy at birth: 77.11 years (state: 78.01 years)
> Drug overdose fatalities: 194 per 100,000 people (state: 1,280 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 692 per 100,000 people (state: 4,211 per 100,000 people)
Florida: Homosassa Springs
> Premature deaths: 543 per 100,000 people (state: 351 per 100,000 people)
> Life expectancy at birth: 74.52 years (state: 79.69 years)
> Drug overdose fatalities: 164 per 100,000 people (state: 17,197 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,022 per 100,000 people (state: 92,013 per 100,000 people)
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Georgia: Albany
> Premature deaths: 560 per 100,000 people (state: 400 per 100,000 people)
> Life expectancy at birth: 73.55 years (state: 77.31 years)
> Drug overdose fatalities: 51 per 100,000 people (state: 4,728 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 603 per 100,000 people (state: 36,347 per 100,000 people)
Hawaii: Urban Honolulu
> Premature deaths: 287 per 100,000 people (state: 289 per 100,000 people)
> Life expectancy at birth: 82.38 years (state: 82.26 years)
> Drug overdose fatalities: 537 per 100,000 people (state: 729 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 2,938 per 100,000 people (state: 4,410 per 100,000 people)
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Idaho: Pocatello
> Premature deaths: 388 per 100,000 people (state: 311 per 100,000 people)
> Life expectancy at birth: 77.04 years (state: 79.19 years)
> Drug overdose fatalities: 60 per 100,000 people (state: 802 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 439 per 100,000 people (state: 6,820 per 100,000 people)
Illinois: Danville
> Premature deaths: 512 per 100,000 people (state: 352 per 100,000 people)
> Life expectancy at birth: 74.55 years (state: 78.62 years)
> Drug overdose fatalities: 61 per 100,000 people (state: 9,061 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 388 per 100,000 people (state: 44,389 per 100,000 people)
Indiana: Muncie
> Premature deaths: 528 per 100,000 people (state: 420 per 100,000 people)
> Life expectancy at birth: 74.18 years (state: 76.51 years)
> Drug overdose fatalities: 144 per 100,000 people (state: 5,649 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 592 per 100,000 people (state: 28,315 per 100,000 people)
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Iowa: Sioux City
> Premature deaths: 400 per 100,000 people (state: 340 per 100,000 people)
> Life expectancy at birth: 77.01 years (state: 78.74 years)
> Drug overdose fatalities: 27 per 100,000 people (state: 1,071 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 417 per 100,000 people (state: 10,982 per 100,000 people)
Kansas: Wichita
> Premature deaths: 422 per 100,000 people (state: 373 per 100,000 people)
> Life expectancy at birth: 76.56 years (state: 77.81 years)
> Drug overdose fatalities: 382 per 100,000 people (state: 1,238 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 2,776 per 100,000 people (state: 11,410 per 100,000 people)
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Kentucky: Elizabethtown-Fort Knox
> Premature deaths: 458 per 100,000 people (state: 491 per 100,000 people)
> Life expectancy at birth: 75.80 years (state: 75.08 years)
> Drug overdose fatalities: 91 per 100,000 people (state: 4,778 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 656 per 100,000 people (state: 22,424 per 100,000 people)
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Louisiana: Alexandria
> Premature deaths: 574 per 100,000 people (state: 485 per 100,000 people)
> Life expectancy at birth: 73.47 years (state: 75.22 years)
> Drug overdose fatalities: 143 per 100,000 people (state: 4,303 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 784 per 100,000 people (state: 22,341 per 100,000 people)
Maine: Lewiston-Auburn
> Premature deaths: 408 per 100,000 people (state: 344 per 100,000 people)
> Life expectancy at birth: 76.81 years (state: 78.56 years)
> Drug overdose fatalities: 109 per 100,000 people (state: 1,212 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 517 per 100,000 people (state: 6,566 per 100,000 people)
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Maryland: Hagerstown-Martinsburg
> Premature deaths: 464 per 100,000 people (state: 358 per 100,000 people)
> Life expectancy at birth: 75.45 years (state: 78.58 years)
> Drug overdose fatalities: 542 per 100,000 people (state: 7,464 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,852 per 100,000 people (state: 26,687 per 100,000 people)
Massachusetts: Pittsfield
> Premature deaths: 378 per 100,000 people (state: 288 per 100,000 people)
> Life expectancy at birth: 78.02 years (state: 80.19 years)
> Drug overdose fatalities: 170 per 100,000 people (state: 6,753 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 645 per 100,000 people (state: 24,245 per 100,000 people)
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Michigan: Flint
> Premature deaths: 495 per 100,000 people (state: 385 per 100,000 people)
> Life expectancy at birth: 74.82 years (state: 77.48 years)
> Drug overdose fatalities: 580 per 100,000 people (state: 7,735 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 2,149 per 100,000 people (state: 40,427 per 100,000 people)
Minnesota: Duluth
> Premature deaths: 346 per 100,000 people (state: 280 per 100,000 people)
> Life expectancy at birth: 78.37 years (state: 80.40 years)
> Drug overdose fatalities: 169 per 100,000 people (state: 2,478 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,252 per 100,000 people (state: 19,454 per 100,000 people)
Mississippi: Hattiesburg
> Premature deaths: 512 per 100,000 people (state: 543 per 100,000 people)
> Life expectancy at birth: 75.09 years (state: 73.89 years)
> Drug overdose fatalities: 69 per 100,000 people (state: 1,290 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 679 per 100,000 people (state: 13,808 per 100,000 people)
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Missouri: Joplin
> Premature deaths: 470 per 100,000 people (state: 426 per 100,000 people)
> Life expectancy at birth: 75.66 years (state: 76.64 years)
> Drug overdose fatalities: 80 per 100,000 people (state: 5,068 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 677 per 100,000 people (state: 29,326 per 100,000 people)
Montana: Great Falls
> Premature deaths: 416 per 100,000 people (state: 353 per 100,000 people)
> Life expectancy at birth: 77.09 years (state: 78.37 years)
> Drug overdose fatalities: 39 per 100,000 people (state: 430 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 416 per 100,000 people (state: 5,001 per 100,000 people)
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Nebraska: Grand Island
> Premature deaths: 361 per 100,000 people (state: 328 per 100,000 people)
> Life expectancy at birth: 77.91 years (state: 79.02 years)
> Drug overdose fatalities: 12 per 100,000 people (state: 513 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 226 per 100,000 people (state: 5,920 per 100,000 people)
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Nevada: Carson City
> Premature deaths: 505 per 100,000 people (state: 379 per 100,000 people)
> Life expectancy at birth: 74.41 years (state: 78.11 years)
> Drug overdose fatalities: 42 per 100,000 people (state: 2,167 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 297 per 100,000 people (state: 12,159 per 100,000 people)
New Hampshire: Manchester-Nashua
> Premature deaths: 311 per 100,000 people (state: 307 per 100,000 people)
> Life expectancy at birth: 79.42 years (state: 79.59 years)
> Drug overdose fatalities: 441 per 100,000 people (state: 1,252 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,834 per 100,000 people (state: 6,006 per 100,000 people)
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New Jersey: Vineland-Bridgeton
> Premature deaths: 509 per 100,000 people (state: 319 per 100,000 people)
> Life expectancy at birth: 74.60 years (state: 79.49 years)
> Drug overdose fatalities: 264 per 100,000 people (state: 8,545 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 799 per 100,000 people (state: 28,188 per 100,000 people)
New Mexico: Farmington
> Premature deaths: 547 per 100,000 people (state: 437 per 100,000 people)
> Life expectancy at birth: 74.04 years (state: 76.88 years)
> Drug overdose fatalities: 87 per 100,000 people (state: 1,920 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 844 per 100,000 people (state: 11,815 per 100,000 people)
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New York: Elmira
> Premature deaths: 431 per 100,000 people (state: 307 per 100,000 people)
> Life expectancy at birth: 76.35 years (state: 80.26 years)
> Drug overdose fatalities: 81 per 100,000 people (state: 12,279 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 372 per 100,000 people (state: 52,179 per 100,000 people)
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North Carolina: Rocky Mount
> Premature deaths: 531 per 100,000 people (state: 384 per 100,000 people)
> Life expectancy at birth: 73.99 years (state: 77.68 years)
> Drug overdose fatalities: 118 per 100,000 people (state: 7,671 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 738 per 100,000 people (state: 42,426 per 100,000 people)
North Dakota: Grand Forks
> Premature deaths: 353 per 100,000 people (state: 343 per 100,000 people)
> Life expectancy at birth: 78.46 years (state: 78.77 years)
> Drug overdose fatalities: 30 per 100,000 people (state: 266 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 314 per 100,000 people (state: 2,749 per 100,000 people)
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Ohio: Springfield
> Premature deaths: 543 per 100,000 people (state: 420 per 100,000 people)
> Life expectancy at birth: 73.90 years (state: 76.52 years)
> Drug overdose fatalities: 192 per 100,000 people (state: 13,435 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 849 per 100,000 people (state: 55,929 per 100,000 people)
Oklahoma: Enid
> Premature deaths: 495 per 100,000 people (state: 477 per 100,000 people)
> Life expectancy at birth: 74.99 years (state: 75.54 years)
> Drug overdose fatalities: 25 per 100,000 people (state: 2,123 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 289 per 100,000 people (state: 18,846 per 100,000 people)
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Oregon: Grants Pass
> Premature deaths: 432 per 100,000 people (state: 311 per 100,000 people)
> Life expectancy at birth: 76.42 years (state: 79.70 years)
> Drug overdose fatalities: 62 per 100,000 people (state: 1,965 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 518 per 100,000 people (state: 16,114 per 100,000 people)
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Pennsylvania: Johnstown
> Premature deaths: 449 per 100,000 people (state: 366 per 100,000 people)
> Life expectancy at birth: 75.81 years (state: 78.02 years)
> Drug overdose fatalities: 195 per 100,000 people (state: 13,960 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 878 per 100,000 people (state: 59,315 per 100,000 people)
Rhode Island: Providence-Warwick
> Premature deaths: 331 per 100,000 people (state: 314 per 100,000 people)
> Life expectancy at birth: 78.98 years (state: 79.37 years)
> Drug overdose fatalities: 1,792 per 100,000 people (state: 1,021 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 6,875 per 100,000 people (state: 4,334 per 100,000 people)
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South Carolina: Florence
> Premature deaths: 596 per 100,000 people (state: 434 per 100,000 people)
> Life expectancy at birth: 72.60 years (state: 76.44 years)
> Drug overdose fatalities: 129 per 100,000 people (state: 3,991 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 973 per 100,000 people (state: 23,960 per 100,000 people)
South Dakota: Rapid City
> Premature deaths: 351 per 100,000 people (state: 353 per 100,000 people)
> Life expectancy at birth: 78.42 years (state: 78.19 years)
> Drug overdose fatalities: 27 per 100,000 people (state: 226 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 609 per 100,000 people (state: 3,709 per 100,000 people)
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Tennessee: Jackson
> Premature deaths: 536 per 100,000 people (state: 478 per 100,000 people)
> Life expectancy at birth: 74.28 years (state: 75.33 years)
> Drug overdose fatalities: 79 per 100,000 people (state: 6,946 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 786 per 100,000 people (state: 33,732 per 100,000 people)
Texas: Texarkana
> Premature deaths: 540 per 100,000 people (state: 362 per 100,000 people)
> Life expectancy at birth: 74.16 years (state: 78.39 years)
> Drug overdose fatalities: 35 per 100,000 people (state: 10,313 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 553 per 100,000 people (state: 85,669 per 100,000 people)
Utah: Salt Lake City
> Premature deaths: 304 per 100,000 people (state: 291 per 100,000 people)
> Life expectancy at birth: 79.27 years (state: 79.72 years)
> Drug overdose fatalities: 830 per 100,000 people (state: 1,817 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 4,317 per 100,000 people (state: 10,605 per 100,000 people)
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Vermont: Burlington-South Burlington
> Premature deaths: 263 per 100,000 people (state: 309 per 100,000 people)
> Life expectancy at birth: 81.02 years (state: 79.67 years)
> Drug overdose fatalities: 104 per 100,000 people (state: 476 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 801 per 100,000 people (state: 2,827 per 100,000 people)
Virginia: Roanoke
> Premature deaths: 428 per 100,000 people (state: 335 per 100,000 people)
> Life expectancy at birth: 76.48 years (state: 79.07 years)
> Drug overdose fatalities: 341 per 100,000 people (state: 5,235 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 1,632 per 100,000 people (state: 28,895 per 100,000 people)
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Washington: Yakima
> Premature deaths: 422 per 100,000 people (state: 296 per 100,000 people)
> Life expectancy at birth: 76.95 years (state: 80.21 years)
> Drug overdose fatalities: 160 per 100,000 people (state: 4,156 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 987 per 100,000 people (state: 25,947 per 100,000 people)
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West Virginia: Beckley
> Premature deaths: 644 per 100,000 people (state: 528 per 100,000 people)
> Life expectancy at birth: 71.94 years (state: 74.26 years)
> Drug overdose fatalities: 302 per 100,000 people (state: 3,056 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 962 per 100,000 people (state: 12,039 per 100,000 people)
Wisconsin: Racine
> Premature deaths: 376 per 100,000 people (state: 324 per 100,000 people)
> Life expectancy at birth: 77.46 years (state: 78.87 years)
> Drug overdose fatalities: 128 per 100,000 people (state: 3,811 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 708 per 100,000 people (state: 25,889 per 100,000 people)
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Wyoming: Casper
> Premature deaths: 411 per 100,000 people (state: 368 per 100,000 people)
> Life expectancy at birth: 76.57 years (state: 78.08 years)
> Drug overdose fatalities: 42 per 100,000 people (state: 244 per 100,000 people)
> All deaths due to injury, car accidents, gun-related suicides and homicides: 402 per 100,000 people (state: 2,771 per 100,000 people)
Methodology
To determine the city in every state with the most premature deaths, 24/7 Tempo reviewed data from the 2022 County Health Rankings & Roadmaps, a joint program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The study ranks metro areas by premature deaths – i.e., the number of people who died before age 75 per 100,000 population (age-adjusted).
While the CHR report is from 2022, the latest years for which data is available are 2018-2020.
Data on life expectancies at birth – the average number of years a person can expect to live – also came from the 2022 CHR and is for the 2018-2020 period.
Information on drug overdose, firearm, and injury deaths also came from the 2022 CHR, though the data is for the 2018-2020 and the 2016-2020 periods. Firearm fatalities include suicides and homicides. Deaths due to injury include accidental and intentional.
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