Each year, tens of thousands of people tragically die in traffic accidents. By latest count almost 37,000 people died last year in automotive accidents. Many of those people were pedestrians who were hit by cars. Others were passengers or drivers. Among children age 8 and older, motor vehicles accidents are the leading cause of death.

Still, some strides have been made to reduce vehicle deaths.  Because of airbags, seat belts, and improved automotive technology, cars are generally safer today than in prior decades. Moreover, some municipalities are redesigning their roads to make them safer for both drivers and pedestrians.

So where are the roads most dangerous in America? The staff at Personal Injury Lawyers San Diego.org decided to analyze the latest data available from the National Highway Traffic Safety Administration (NHTSA) on the rate of traffic fatalities in states and cities across America.

Among states, we found that Mississippi has the highest rate of traffic fatalities in the country, while New York has the lowest. Montana has the highest rate of alcohol-related traffic fatalities in the country. When it comes to wearing seat belts, Hawaii leads the nation with a 97.8% compliance rate. New Hampshire is last in the nation when it comes to seat belt safety as only 76.4% buckle up in the “live free or die” state.


The NHTSA is a governmental organization tasked with creating and enforcing automobile standards. As part of its mission to “Save lives, prevent injuries, reduce vehicle-related crashes” the agency releases traffic fatality data on an annual basis. On a state level, the most recent data available is from 2018, which we have analyzed in this report.

To begin, let’s look at the states that are most dangerous when it comes to motor vehicle-related deaths. The chart below shows the number of traffic fatalities per 100,000 living in each state.

States with the Most and Least Traffic Fatalities

By a considerable margin, Mississippi is the most dangerous state when it comes to automotive fatalities. In Mississippi there are 22.1 auto-related deaths per every 100,000 people living there. In Mississippi, the probability of dying in a motor vehicle accident is nearly 5 times as high as in New York, the state with the lowest death rate.

According to the CDC, rural roads tend to be much more dangerous which helps explain why states like Mississippi and South Carolina top the rankings. On the other hand, states where a lot of the population live in an urban center like New York tend to have safer streets on average.

However, the rural-urban divide only explains part of the divide when it comes to deaths in car crashes. Another factor is that there is considerable variation in how likely the population is to embrace life-saving safety measures like wearing a seatbelt.

States Ranked by Population Wearing Seatlbelts

Part of the reason a place like Mississippi have high traffic fatality rates is non-compliance with wearing seatbelts. In Hawaii, the state with the highest seat belt rate, 97.8% of people wear their seatbelts. In contrast, Mississippi has the 4th lowest seat belt rate at just 80.2%.  Of note, New Hampshire is the only state in the country that does not require wearing seatbelts and therefore ranks last on this metric.

Seatbelts is just one safety measure that can be embraced or rejected by the population. Another measure to consider is the prevalence of drunk driving. The following chart shows the rate of motor vehicle deaths that involved a positive blood alcohol concentration (BAC) by state:

The States with the Most Least Deaths from Drunk Driving Fatalities

When it comes to drunk driving deaths, Montana has the highest rate in the country, followed by Wyoming and South Carolina. On the other hand, drunk driving deaths are much more rare in New Jersey, New York and Minnesota.


Automobiles can be lethal. They are extremely heavy and are capable of moving at extraordinary speeds. A moment of distraction from a driver or a poorly designed intersection can easily result in death. In the United States, traffic fatalities are much more common than in others. Mississippi, South Carolina and Alabama lead with the highest fatality rates. These states also tend to have lower rates of seat belt wearing and higher rates of drunk driving, indicating that many of these deaths are completely preventable.