This dataset presents the age-adjusted death rates for the 10 leading causes of death in the United States beginning in 1999. Data are based on information from all resident death certificates filed in the 50 states and the District of Columbia using demographic and medical characteristics. Age-adjusted death rates (per 100,000 population) are based on the 2000 U.S. standard population. Populations used for computing death rates after 2010 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for non-census years before 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Causes of death classified by the International Classification of Diseases, Tenth Revision (ICD–10) are ranked according to the number of deaths assigned to rankable causes. Cause of death statistics are based on the underlying cause of death. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm. Murphy SL, Xu JQ, Kochanek KD, Curtin SC, and Arias E. Deaths: Final data for 2015. National vital statistics reports; vol 66. no. 6. Hyattsville, MD: National Center for Health Statistics. 2017. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_06.pdf.

From 2018 to 2023, heart disease and cancer accounted for the highest share of deaths in the United States. In 2020 and 2021, COVID-19 became the third leading cause of death, accounting for around 12 percent of all deaths in 2021. However, by 2023, COVID-19 was responsible for only 1.6 percent of deaths, making it the tenth leading cause of death. This statistic shows the distribution of the 10 leading causes of death in the United States from 2018 to 2023.

Heart disease is currently the leading cause of death in the United States. In 2022, COVID-19 was the fourth leading cause of death in the United States, accounting for almost six percent of all deaths that year. The leading causes of death worldwide are similar to those in the United States. However, diarrheal diseases and neonatal conditions are major causes of death worldwide, but are not among the leading causes in the United States. Instead, accidents and chronic liver disease have a larger impact in the United States.

Racial differences

In the United States, there exist slight differences in leading causes of death depending on race and ethnicity. For example, assault, or homicide, accounts for around three percent of all deaths among the Black population but is not even among the leading causes of death for other races and ethnicities. However, heart disease and cancer are still the leading causes of death for all races and ethnicities.

Leading causes of death among men vs women

Similarly, there are also differences in the leading causes of death in the U.S. between men and women. For example, among men, intentional self-harm accounts for around two percent of all deaths but is not among the leading causes of death among women. On the other hand, influenza and pneumonia account for more deaths among women than men.

This dataset contains information on the number of deaths and age-adjusted death rates for the five leading causes of death in 1900, 1950, and 2000.

Age-adjusted death rates (deaths per 100,000) after 1998 are calculated based on the 2000 U.S. standard population. Populations used for computing death rates for 2011–2017 are postcensal estimates based on the 2010 census, estimated as of July 1, 2010. Rates for census years are based on populations enumerated in the corresponding censuses. Rates for noncensus years between 2000 and 2010 are revised using updated intercensal population estimates and may differ from rates previously published. Data on age-adjusted death rates prior to 1999 are taken from historical data (see References below).

SOURCES

CDC/NCHS, National Vital Statistics System, historical data, 1900-1998 (see https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm); CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov).

REFERENCES

1. National Center for Health Statistics, Data Warehouse. Comparability of cause-of-death between ICD revisions. 2008. Available from: http://www.cdc.gov/nchs/nvss/mortality/comparability_icd.htm.

2. National Center for Health Statistics. Vital statistics data available. Mortality multiple cause files. Hyattsville, MD: National Center for Health Statistics. Available from: https://www.cdc.gov/nchs/data_access/vitalstatsonline.htm.

3. Kochanek KD, Murphy SL, Xu JQ, Arias E. Deaths: Final data for 2017. National Vital Statistics Reports; vol 68 no 9. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_09-508.pdf.

4. Arias E, Xu JQ. United States life tables, 2017. National Vital Statistics Reports; vol 68 no 7. Hyattsville, MD: National Center for Health Statistics. 2019. Available from: https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf.

5. National Center for Health Statistics. Historical Data, 1900-1998. 2009. Available from: https://www.cdc.gov/nchs/nvss/mortality_historical_data.htm.

In 2022, heart disease was the leading cause of death among Hispanics in the United States, accounting for **** percent of deaths, followed by cancer and accidents, which accounted for **** and **** percent of all deaths, respectively. COVID-19, cerebrovascular diseases, and diabetes were also among the top 10 leading causes of death among Hispanics in the United States. Cancer among Hispanics Cancer (malignant neoplasms) is the second leading cause of death in the United States as of 2022. In 2021, there were ****** deaths among Hispanic males attributed to cancer, compared to ****** deaths among Hispanic females. The most common treatments for cancer include surgery, chemotherapy, and radiation. Hispanic healthcare Access to health care and health insurance remains a problem for many Hispanics in the United States. In 2022, around ** percent of Hispanic men reported having no personal doctor or health care provider. Furthermore, as of 2022, around ** percent of children without health insurance were Hispanic.

Rank, number of deaths, percentage of deaths, and age-specific mortality rates for the leading causes of death, by age group and sex, 2000 to most recent year.

MMWR Surveillance Summary 66 (No. SS-1):1-8 found that nonmetropolitan areas have significant numbers of potentially excess deaths from the five leading causes of death. These figures accompany this report by presenting information on potentially excess deaths in nonmetropolitan and metropolitan areas at the state level. They also add additional years of data and options for selecting different age ranges and benchmarks. Potentially excess deaths are defined in MMWR Surveillance Summary 66(No. SS-1):1-8 as deaths that exceed the numbers that would be expected if the death rates of states with the lowest rates (benchmarks) occurred across all states. They are calculated by subtracting expected deaths for specific benchmarks from observed deaths. Not all potentially excess deaths can be prevented; some areas might have characteristics that predispose them to higher rates of death. However, many potentially excess deaths might represent deaths that could be prevented through improved public health programs that support healthier behaviors and neighborhoods or better access to health care services. Mortality data for U.S. residents come from the National Vital Statistics System. Estimates based on fewer than 10 observed deaths are not shown and shaded yellow on the map. Underlying cause of death is based on the International Classification of Diseases, 10th Revision (ICD-10) Heart disease (I00-I09, I11, I13, and I20–I51) Cancer (C00–C97) Unintentional injury (V01–X59 and Y85–Y86) Chronic lower respiratory disease (J40–J47) Stroke (I60–I69) Locality (nonmetropolitan vs. metropolitan) is based on the Office of Management and Budget’s 2013 county-based classification scheme. Benchmarks are based on the three states with the lowest age and cause-specific mortality rates. Potentially excess deaths for each state are calculated by subtracting deaths at the benchmark rates (expected deaths) from observed deaths. Users can explore three benchmarks: “2010 Fixed” is a fixed benchmark based on the best performing States in 2010. “2005 Fixed” is a fixed benchmark based on the best performing States in 2005. “Floating” is based on the best performing States in each year so change from year to year. SOURCES CDC/NCHS, National Vital Statistics System, mortality data (see http://www.cdc.gov/nchs/deaths.htm); and CDC WONDER (see http://wonder.cdc.gov). REFERENCES Moy E, Garcia MC, Bastian B, Rossen LM, Ingram DD, Faul M, Massetti GM, Thomas CC, Hong Y, Yoon PW, Iademarco MF. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas – United States, 1999-2014. MMWR Surveillance Summary 2017; 66(No. SS-1):1-8. Garcia MC, Faul M, Massetti G, Thomas CC, Hong Y, Bauer UE, Iademarco MF. Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States. MMWR Surveillance Summary 2017; 66(No. SS-2):1–7.

The leading causes of death by sex and ethnicity in New York City in since 2007. Cause of death is derived from the NYC death certificate which is issued for every death that occurs in New York City. Report last ran: 09/24/2019 Rates based on small numbers (RSE > 30) as well as aggregate counts less than 5 have been suppressed in downloaded data Source: Bureau of Vital Statistics and New York City Department of Health and Mental Hygiene

In 2022, the most significant cause of death among men in the United States was heart disease, which contributed to **** percent of deaths. COVID-19 was the third leading cause of death among U.S. men in both 2020 and 2021, and the fourth leading cause in 2022. This statistic shows the distribution of the ** leading causes of death among men in the United States from 2020 to 2022.

Heart disease and cancer remained the leading causes of death in the United States from 2018 to 2023. However, there have been slight changes in the 10 leading causes of death in the U.S. from 2018 to 2023. Most notable is that COVID-19 became the third leading cause of death in 2020 and 2021, but by 2023 it was the tenth leading cause. This statistic shows the rates of the 10 leading causes of death in the United States from 2018 to 2023.

The leading causes of death in the United States have changed significantly from the year 1900 to the present. Leading causes of death in 1900, such as tuberculosis, gastrointestinal infections, and diphtheria have seen huge decreases in death rates and are no longer among the leading causes of death in the United States. However, other diseases such as heart disease and cancer have seen increased death rates. Vaccinations One major factor contributing to the decrease in death rates for many diseases since the year 1900 is the introduction of vaccinations. The decrease seen in the rates of death due to pneumonia and influenza is a prime example of this. In 1900, pneumonia and influenza were the leading causes of death, with around *** deaths per 100,000 population. However, in 2023 pneumonia and influenza were not even among the ten leading causes of death. Cancer One disease that has seen a large increase in death rates since 1900 is cancer. Cancer currently accounts for almost ** percent of all deaths in the United States, with death rates among men higher than those for women. The deadliest form of cancer for both men and women is cancer of the lung and bronchus. Some of the most common avoidable risk factors for cancer include smoking, drinking alcohol, sun exposure, and obesity.

This dataset tracks the updates made on the dataset "NCHS - Top Five Leading Causes of Death: United States, 1990, 1950, 2000" as a repository for previous versions of the data and metadata.

As of 2022, the third leading cause of death among teenagers aged 15 to 19 years in the United States was intentional self-harm or suicide, contributing around 17 percent of deaths among age group. The leading cause of death at that time was unintentional injuries, contributing to around 37.4 percent of deaths, while 21.8 percent of all deaths in this age group were due to assault or homicide. Cancer and heart disease, the overall leading causes of death in the United States, are also among the leading causes of death among U.S. teenagers. Adolescent suicide in the United States In 2021, around 22 percent of students in grades 9 to 12 reported that they had seriously considered attempting suicide in the past year. Female students were around twice as likely to report seriously considering suicide compared to male students. In 2022, Montana had the highest rate of suicides among U.S. teenagers with around 39 deaths per 100,000 teenagers, followed by South Dakota with a rate of 33 per 100,000. The states with the lowest death rates among adolescents are New York and New Jersey. Mental health treatment Suicidal thoughts are a clear symptom of mental health issues. Mental health issues are not rare among children and adolescents, and treatment for such issues has become increasingly accepted and accessible. In 2021, around 15 percent of boys and girls aged 5 to 17 years had received some form of mental health treatment in the past year. At that time, around 35 percent of youths aged 12 to 17 years in the United States who were receiving specialty mental health services were doing so because they had thought about killing themselves or had already tried to kill themselves.

This dataset contains counts of deaths for California as a whole based on information entered on death certificates. Final counts are derived from static data and include out-of-state deaths to California residents, whereas provisional counts are derived from incomplete and dynamic data. Provisional counts are based on the records available when the data was retrieved and may not represent all deaths that occurred during the time period. Deaths involving injuries from external or environmental forces, such as accidents, homicide and suicide, often require additional investigation that tends to delay certification of the cause and manner of death. This can result in significant under-reporting of these deaths in provisional data.

The final data tables include both deaths that occurred in California regardless of the place of residence (by occurrence) and deaths to California residents (by residence), whereas the provisional data table only includes deaths that occurred in California regardless of the place of residence (by occurrence). The data are reported as totals, as well as stratified by age, gender, race-ethnicity, and death place type. Deaths due to all causes (ALL) and selected underlying cause of death categories are provided. See temporal coverage for more information on which combinations are available for which years.

The cause of death categories are based solely on the underlying cause of death as coded by the International Classification of Diseases. The underlying cause of death is defined by the World Health Organization (WHO) as "the disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury." It is a single value assigned to each death based on the details as entered on the death certificate. When more than one cause is listed, the order in which they are listed can affect which cause is coded as the underlying cause. This means that similar events could be coded with different underlying causes of death depending on variations in how they were entered. Consequently, while underlying cause of death provides a convenient comparison between cause of death categories, it may not capture the full impact of each cause of death as it does not always take into account all conditions contributing to the death.

This dataset contains counts of deaths for California counties based on information entered on death certificates. Final counts are derived from static data and include out-of-state deaths to California residents, whereas provisional counts are derived from incomplete and dynamic data. Provisional counts are based on the records available when the data was retrieved and may not represent all deaths that occurred during the time period. Deaths involving injuries from external or environmental forces, such as accidents, homicide and suicide, often require additional investigation that tends to delay certification of the cause and manner of death. This can result in significant under-reporting of these deaths in provisional data.

The final data tables include both deaths that occurred in each California county regardless of the place of residence (by occurrence) and deaths to residents of each California county (by residence), whereas the provisional data table only includes deaths that occurred in each county regardless of the place of residence (by occurrence). The data are reported as totals, as well as stratified by age, gender, race-ethnicity, and death place type. Deaths due to all causes (ALL) and selected underlying cause of death categories are provided. See temporal coverage for more information on which combinations are available for which years.

The cause of death categories are based solely on the underlying cause of death as coded by the International Classification of Diseases. The underlying cause of death is defined by the World Health Organization (WHO) as "the disease or injury which initiated the train of events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury." It is a single value assigned to each death based on the details as entered on the death certificate. When more than one cause is listed, the order in which they are listed can affect which cause is coded as the underlying cause. This means that similar events could be coded with different underlying causes of death depending on variations in how they were entered. Consequently, while underlying cause of death provides a convenient comparison between cause of death categories, it may not capture the full impact of each cause of death as it does not always take into account all conditions contributing to the death.

In 2019, the leading causes of death worldwide were ischemic heart disease, stroke, and chronic obstructive pulmonary disease (COPD). That year, ischemic heart disease and stroke accounted for a combined ** percent of all deaths worldwide. Although the leading causes of death worldwide vary by region and country, heart disease is a consistent leading cause of death regardless of income, development, size, or location. Heart disease In 2019, around **** million people worldwide died from ischemic heart disease. In comparison, around **** million people died from lung cancer that year, while *** million died from diabetes. The countries with the highest rates of death due to heart attack and other ischemic heart diseases are Lithuania, Russia, and Slovakia. Although some risk factors for heart disease, such as age and genetics, are unmodifiable, the likelihood of developing heart disease can be greatly reduced through a healthy lifestyle. The biggest modifiable risk factors for heart disease include smoking, an unhealthy diet, being overweight, and a lack of exercise. In 2019, it was estimated that around *** million deaths worldwide due to ischemic heart disease could be attributed to smoking. The leading causes of death in the United States Just as it is the leading cause of death worldwide, heart disease is also the leading cause of death in the United States. In 2023, heart disease accounted for ** percent of all deaths in the United States. Cancer was the second leading cause of death in the U.S. that year, followed by accidents. As of 2023, the odds that a person in the United States will die from heart disease is * in *. However, rates of death due to heart disease have actually declined in the U.S. over the past couple decades. From 2000 to 2022, there was a *** percent decline in heart disease deaths. On the other hand, deaths from Alzheimer’s disease saw an increase of *** percent over this period. Alzheimer’s disease is currently the sixth leading cause of death in the United States, accounting for **** deaths per 100,000 population in 2023.

Note: DPH is updating and streamlining the COVID-19 cases, deaths, and testing data. As of 6/27/2022, the data will be published in four tables instead of twelve.

The COVID-19 Cases, Deaths, and Tests by Day dataset contains cases and test data by date of sample submission. The death data are by date of death. This dataset is updated daily and contains information back to the beginning of the pandemic. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Cases-Deaths-and-Tests-by-Day/g9vi-2ahj.

The COVID-19 State Metrics dataset contains over 93 columns of data. This dataset is updated daily and currently contains information starting June 21, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-State-Level-Data/qmgw-5kp6 .

The COVID-19 County Metrics dataset contains 25 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-County-Level-Data/ujiq-dy22 .

The COVID-19 Town Metrics dataset contains 16 columns of data. This dataset is updated daily and currently contains information starting June 16, 2022 to the present. The data can be found at https://data.ct.gov/Health-and-Human-Services/COVID-19-Town-Level-Data/icxw-cada . To protect confidentiality, if a town has fewer than 5 cases or positive NAAT tests over the past 7 days, those data will be suppressed.

COVID-19 cases and associated deaths that have been reported among Connecticut residents, broken down by race and ethnicity. All data in this report are preliminary; data for previous dates will be updated as new reports are received and data errors are corrected. Deaths reported to the either the Office of the Chief Medical Examiner (OCME) or Department of Public Health (DPH) are included in the COVID-19 update.

The following data show the number of COVID-19 cases and associated deaths per 100,000 population by race and ethnicity. Crude rates represent the total cases or deaths per 100,000 people. Age-adjusted rates consider the age of the person at diagnosis or death when estimating the rate and use a standardized population to provide a fair comparison between population groups with different age distributions. Age-adjustment is important in Connecticut as the median age of among the non-Hispanic white population is 47 years, whereas it is 34 years among non-Hispanic blacks, and 29 years among Hispanics. Because most non-Hispanic white residents who died were over 75 years of age, the age-adjusted rates are lower than the unadjusted rates. In contrast, Hispanic residents who died tend to be younger than 75 years of age which results in higher age-adjusted rates.

The population data used to calculate rates is based on the CT DPH population statistics for 2019, which is available online here: https://portal.ct.gov/DPH/Health-Information-Systems--Reporting/Population/Population-Statistics. Prior to 5/10/2021, the population estimates from 2018 were used.

Rates are standardized to the 2000 US Millions Standard population (data available here: https://seer.cancer.gov/stdpopulations/). Standardization was done using 19 age groups (0, 1-4, 5-9, 10-14, ..., 80-84, 85 years and older). More information about direct standardization for age adjustment is available here: https://www.cdc.gov/nchs/data/statnt/statnt06rv.pdf

Categories are mutually exclusive. The category “multiracial” includes people who answered ‘yes’ to more than one race category. Counts may not add up to total case counts as data on race and ethnicity may be missing. Age adjusted rates calculated only for groups with more than 20 deaths. Abbreviation: NH=Non-Hispanic.

Data on Connecticut deaths were obtained from the Connecticut Deaths Registry maintained by the DPH Office of Vital Records. Cause of death was determined by a death certifier (e.g., physician, APRN, medical examiner) using their best clinical judgment. Additionally, all COVID-19 deaths, including suspected or related, are required to be reported to OCME. On April 4, 2020, CT DPH and OCME released a joint memo to providers and facilities within Connecticut providing guidelines for certifying deaths due to COVID-19 that were consistent with the CDC’s guidelines and a reminder of the required reporting to OCME.25,26 As of July 1, 2021, OCME had reviewed every case reported and performed additional investigation on about one-third of reported deaths to better ascertain if COVID-19 did or did not cause or contribute to the death. Some of these investigations resulted in the OCME performing postmortem swabs for PCR testing on individuals whose deaths were suspected to be due to COVID-19, but antemortem diagnosis was unable to be made.31 The OCME issued or re-issued about 10% of COVID-19 death certificates and, when appropriate, removed COVID-19 from the death certificate. For standardization and tabulation of mortality statistics, written cause of death statements made by the certifiers on death certificates are sent to the National Center for Health Statistics (NCHS) at the CDC which assigns cause of death codes according to the International Causes of Disease 10th Revision (ICD-10) classification system.25,26 COVID-19 deaths in this report are defined as those for which the death certificate has an ICD-10 code of U07.1 as either a primary (underlying) or a contributing cause of death. More information on COVID-19 mortality can be found at the following link: https://portal.ct.gov/DPH/Health-Information-Systems--Reporting/Mortality/Mortality-Statistics

Data are subject to future revision as reporting changes.

Starting in July 2020, this dataset will be updated every weekday.

Additional notes: A delay in the data pull schedule occurred on 06/23/2020. Data from 06/22/2020 was processed on 06/23/2020 at 3:30 PM. The normal data cycle resumed with the data for 06/23/2020.

A network outage on 05/19/2020 resulted in a change in the data pull schedule. Data from 5/19/2020 was processed on 05/20/2020 at 12:00 PM. Data from 5/20/2020 was processed on 5/20/2020 8:30 PM. The normal data cycle resumed on 05/20/2020 with the 8:30 PM data pull. As a result of the network outage, the timestamp on the datasets on the Open Data Portal differ from the timestamp in DPH's daily PDF reports.

Starting 5/10/2021, the date field will represent the date this data was updated on data.ct.gov. Previously the date the data was pulled by DPH was listed, which typically coincided with the date before the data was published on data.ct.gov. This change was made to standardize the COVID-19 data sets on data.ct.gov.

The Office for Health Improvement and Disparities (OHID) has updated the mortality profile.

The profile brings together a selection of mortality indicators, including from other OHID data tools such as the https://fingertips.phe.org.uk/profile/public-health-outcomes-framework/data" class="govuk-link">Public Health Outcomes Framework, making it easier to assess outcomes across a range of causes of death.

For the January 2022 update, 2 new indicators have been added to the profile:

• mortality rate for deaths involving COVID-19, all ages
• mortality rate for deaths involving COVID-19, under 75s

COVID-19 was the leading cause of death in England in 2020, but the pandemic had a much greater impact on mortality in some areas than others. These indicators have been included alongside other indicators for leading causes of death in the mortality profile to provide a more complete picture of mortality for local areas in 2020.

If you would like to send us feedback on the tool please contact profilefeedback@phe.gov.uk.

In the United States, the leading causes of death among women are heart disease and cancer. Heart disease and cancer are similarly the leading causes of death among U.S. men. In 2022, heart disease accounted for **** percent of all deaths among women in the United States, while cancer accounted for **** percent of deaths. COVID-19 was the third leading cause of death among both men and women in 2020 and 2021, and the fourth leading cause in 2022. Cancer among women in the U.S. The most common types of cancer among U.S. women are breast, lung and bronchus, and colon and rectum. In 2025, there were around ******* new breast cancer cases among women, compared to ******* new cases of lung and bronchus cancer. Although breast cancer is the most common form of cancer among women in the United States, lung and bronchus cancer causes the highest number of cancer deaths. In 2025, around ****** women were expected to die from lung and bronchus cancer, compared to ****** from breast cancer. Breast cancer Although breast cancer is the second most deadly form of cancer among women, rates of death have decreased over the past few decades. This decrease is possibly due to early detection, progress in therapy, and increasing awareness of risk factors. In 2023, the death rate due to breast cancer was **** per 100,000 population, compared to a rate of **** per 100,000 in the year 1990. The state with the highest rate of deaths due to breast cancer is Oklahoma, while South Dakota had the lowest rates.

BackgroundWhile the high prevalence of preterm births and its impact on infant mortality in the US have been widely acknowledged, recent data suggest that even full-term births in the US face substantially higher mortality risks compared to European countries with low infant mortality rates. In this paper, we use the most recent birth records in the US to more closely analyze the primary causes underlying mortality rates among full-term births.Methods and findingsLinked birth and death records for the period 2010–2012 were used to identify the state- and cause-specific burden of infant mortality among full-term infants (born at 37–42 weeks of gestation). Multivariable logistic models were used to assess the extent to which state-level differences in full-term infant mortality (FTIM) were attributable to observed differences in maternal and birth characteristics. Random effects models were used to assess the relative contribution of state-level variation to FTIM. Hypothetical mortality outcomes were computed under the assumption that all states could achieve the survival rates of the best-performing states. A total of 10,175,481 infants born full-term in the US between January 1, 2010, and December 31, 2012, were analyzed. FTIM rate (FTIMR) was 2.2 per 1,000 live births overall, and ranged between 1.29 (Connecticut, 95% CI 1.08, 1.53) and 3.77 (Mississippi, 95% CI 3.39, 4.19) at the state level. Zero states reached the rates reported in the 6 low-mortality European countries analyzed (FTIMR < 1.25), and 13 states had FTIMR > 2.75. Sudden unexpected death in infancy (SUDI) accounted for 43% of FTIM; congenital malformations and perinatal conditions accounted for 31% and 11.3% of FTIM, respectively. The largest mortality differentials between states with good and states with poor FTIMR were found for SUDI, with particularly large risk differentials for deaths due to sudden infant death syndrome (SIDS) (odds ratio [OR] 2.52, 95% CI 1.86, 3.42) and suffocation (OR 4.40, 95% CI 3.71, 5.21). Even though these mortality differences were partially explained by state-level differences in maternal education, race, and maternal health, substantial state-level variation in infant mortality remained in fully adjusted models (SIDS OR 1.45, suffocation OR 2.92). The extent to which these state differentials are due to differential antenatal care standards as well as differential access to health services could not be determined due to data limitations. Overall, our estimates suggest that infant mortality could be reduced by 4,003 deaths (95% CI 2,284, 5,587) annually if all states were to achieve the mortality levels of the best-performing state in each cause-of-death category. Key limitations of the analysis are that information on termination rates at the state level was not available, and that causes of deaths may have been coded differentially across states.ConclusionsMore than 7,000 full-term infants die in the US each year. The results presented in this paper suggest that a substantial share of these deaths may be preventable. Potential improvements seem particularly large for SUDI, where very low rates have been achieved in a few states while average mortality rates remain high in most other areas. Given the high mortality burden due to SIDS and suffocation, policy efforts to promote compliance with recommended sleeping arrangements could be an effective first step in this direction.