The nation’s death rate may have fallen to a historic low last year as many of the killers of young people such as drug overdoses, gun homicides and traffic accidents continued receding in 2025, according to new federal statistics.
States have not shared equally in the success, though, according to a Stateline analysis of provisional data by state. And the low ebb may reflect the effects of past health care expansion efforts that are threatened by today’s Trump administration moves to curtail Medicaid expansion and cut funding for rural hospitals.
Some states in the Northeast have seen death rates drop by the most between 2015 and 2025 — led by New Jersey (down 8.3%), Rhode Island (down 8%), New York (down 7.9%), Massachusetts (down 7.4%) and the District of Columbia (down 7.0%). Some experts credit states’ attention to health care, traffic issues and gun violence.
New Jersey has taken the lead in decreases because of a long-term commitment to expanding health care to people with low incomes, said Stephen Crystal, director of Rutgers University’s Center for Health Services Research.
Even before Medicaid expansion under the federal Affordable Care Act, New Jersey and Massachusetts, among other states, were pooling funds with hospitals to cover more low-income residents, Crystal said.
“New Jersey has been doing this for a long time, and you’re seeing the effects in the lower mortality rates for the big killers,” he said.
The state stands out for having less than half the national rate of firearm deaths, both suicide and homicide, as well as deaths from heart and kidney diseases caused by high blood pressure. The rate of traffic accident deaths is also well below the national rate.
There’s also a more confrontational attitude toward speeding and less tolerance for guns in the Northeast, he said.
“Here’s something that annoys a lot of New Jerseyans. The state troopers have the cojones to pull you over if you’re doing 90 on the turnpike. This is not the case in Wyoming,” Crystal said. “Also if you go out West where gun possession is very high, then the firearm suicide deaths become enormous.”
Nationally most of the decrease between 2024 and 2025 came from young age groups. The things most likely to kill them dropped after spiking during the early pandemic, including drug overdoses, traffic accidents, gun violence and suicide, according to an analysis of death counts by Mary Pat Campbell, an actuary and life insurance analyst in New York state.
Northeastern states have an advantage in tackling those problems based on wealth, she said.
“There has been an increasing separation of mortality outcomes by socioeconomic status,” Campbell said, noting that traffic accidents are rarer in places like New Jersey partly because so many people commute on public transportation.
“For New Jersey, a lot of it really is that there are a bunch of high-income people who have lower-than-average mortality, just like people on Long Island and the rich parts of Westchester [in New York state],” she added.
Some states have not improved since 2015 in the provisional statistics analyzed by Stateline, which may change as the federal Centers for Disease Control and Prevention makes new age adjustments at the state level.
New Mexico had an age-adjusted death rate 9% higher last year than 10 years ago, as drug overdose deaths continue to plague the state at more than twice the national rate.
In June, New Mexico Democratic Gov. Michelle Lujan Grisham called for restitution from the federal government over allegations that U.S. Drug Enforcement Administration officials knowingly let fentanyl shipments into the state during multiple presidential administrations. In one case, a whistleblower alleged, agents stood by while 1.8 million fentanyl pills were trafficked in hopes of catching higher-ranking dealers and suppliers down the line.
New Mexico also struggles with higher death rates from alcoholic liver disease and gun homicide. Neighboring Arizona, where the death rate is 5% higher than 10 years ago, also stands out for a high overdose death rate and a high gun suicide rate.
Iowa and Oklahoma death rates are also up 5% from 2015. Iowa stands out for a higher-than-national rate of fall-related deaths, typical of an aging rural population with little day-to-day supervision. Oklahoma has a similarly high rate of fall-related deaths, as well as almost four times the national rate of deaths from high blood pressure and hardening of the arteries — both problems that can be controlled with medication.
Iowa “recognizes fall-related deaths as a significant public health concern,” wrote a spokesperson for the state Department of Health and Human Services, Danielle Sample, in an e-mail statement. Those falls are associated with older age groups and possibly rural access to health care and preventive services, she said.
The state has a falls prevention program that stresses exercise to maintain mobility and monitoring excessive medication that could cause dizziness, poor vision and unsafe home conditions.
Almost two-thirds of the national death rate improvement for 2024 to 2025 came from people between the ages of 15 to 44, Campbell told Stateline.
Improvements were especially large for young people 25 to 34, a group including younger Millennials and older Gen Z, a demographic hard hit by homicides and drug overdose deaths early in the pandemic, Campbell told Stateline. The rate for accidents, a category that includes drug overdoses, gun accidents and traffic accidents, dropped 6% in one year, and the homicide rate dropped 14%, she said.
It’s hard to be sure how much death rates really changed between 2024 and 2025 because the methodology changed, Crystal noted, accusing the CDC of “grabbing for a good news headline” by reporting the apparently historic decrease prominently in a blog item.
For 2025, the CDC used different methods to calculate rates, including more adjustments to 2020 census data used as a basis for age adjustment, noting in the report that the results could change and “should be interpreted with caution.”
Asked about the issue, the CDC said in a statement to Stateline that “as this is a provisional report, we did not go in depth about the change in population denominators” and that it is “planning a brief report that will show the impact” of the changes on death rates and birth rate in new statistics.
In any case, the Trump administration likely can’t claim credit for current decreases in death rates, which would reflect policy changes from years ago that slowly take effect, Crystal said.
“This is not the time to see the effect of what Trump is doing now. It’s going to take five years,” Crystal said.
One killer of young people has not dropped: The rate of gun suicide has increased 14% since 2015, according to the Stateline analysis. Suicide has affected Gen Z young people more than previous generations.
Over the past 10 years, rates for Black and Hispanic people have increased while rates for other groups have gone down, according to the Stateline analysis.
“As a country we are improving. We should celebrate that. But many segments of the population are left behind,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington.
Mokdad credited some medical advances for decreases in heart disease that came in spite of increased obesity.
“That decline in cardiovascular disease was due to better controlled blood pressure,” Mokdad said. “Blood pressure medication, when it came out, was very expensive. Now blood pressure medication is so cheap you can get a three-month supply for less than the price of a cup of coffee.”
This story originally appeared on New Jersey Monitor.
