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CNN —  

The five US states with the highest death rates have an average rate 49% higher than that of the five states with the lowest death rates, according to a new report from the US Centers for Disease Control and Prevention’s National Center for Health Statistics.

The five states with the highest death rates overall were:

  • Alabama
  • Kentucky
  • Mississippi
  • Oklahoma
  • West Virginia

The five states with the lowest death rates were:

  • California
  • Connecticut
  • Hawaii
  • Minnesota
  • New York

The new report, published on Thursday, is based on 2017 mortality data from the National Vital Statistics System database. That data get collected and compiled by the National Center for Health Statistics from death certificates in all 50 states and the District of Columbia. All age groups – from under 1, to 85 and older – were included in the data.

What’s killing us?

In 2017, the five leading causes of death were the same for both states with the highest and lowest death rates: heart disease, cancer, chronic lower respiratory diseases, unintentional injuries and stroke.

Death rates from those leading causes of death were higher in the states with the highest death rates than the states with the lowest death rates.

For instance, the researchers found that the death rates for chronic lower respiratory diseases were doubled in the states with the highest death rates, compared with those with the lowest death rates.

Similarly, death rates for unintentional injuries were found to be nearly double in states with the highest death rates, compared with those with the lowest rates.

Yet some of the highest-rate states fared better on certain other leading causes of death than some states with the lowest death rates, said Dr. Jiaquan Xu, a researcher with the National Center for Health Statistics and author of the new report.

“Alzheimer’s disease for California, one of the five lowest-rate states, was higher than the rates for Kentucky and West Virginia, two of the five lowest-rate states,” Xu said.

“California had a higher death rate from diabetes than Alabama. Hawaii had the highest death rate from influenza and pneumonia in the nation,” he said. “The findings in this report are important information for the health community to learn about inequalities in mortality between the two groups of the states and help them in their important work using such information.”

’We know that ZIP code matters’

The state-by-state differences in death rates came as no surprise to Dr. Georges Benjamin, executive director of the American Public Health Association in Washington, DC, who was not involved in the new CDC report.

“We know that ZIP code matters,” Benjamin said.

“We know very clearly that things such as educational attainment, access and utilization of things like tobacco, physical inactivity, nutrition, the location of if they have access to things like grocery stores, all those things matter at the county level and at the local level,” he said. “When you roll those up at the state level, they also matter.”

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For states that have the highest death rates, Benjamin said that there is hope for improvement.

“We know that states that have looked at these kinds of rankings and get into the data and understand why they rank or do so poorly can make changes,” Benjamin said.

“They can improve the social determinants that determine health, they can improve health care quality, they can improve access to health care. So there’s a range of things that states can do to change these numbers,” he said. “It’s not inevitable.”