The nation’s death rate might have reached a historic low last year as major causes of death among young people, such as drug overdoses, gun homicides, and traffic accidents, continued to decline in 2025, according to new federal statistics. However, not all states have shared equally in this success. The low death rate may be the result of past healthcare expansions, which are now under threat from the Trump administration’s efforts to cut Medicaid expansion and reduce funding for rural hospitals. An analysis of state data by Stateline highlights these disparities.
Northeastern states, including New Jersey and Rhode Island, saw the most significant drops between 2015 and 2025. New Jersey led with an 8.3% decrease, thanks to its long-term commitment to expanding healthcare for low-income individuals. Stephen Crystal from Rutgers University attributes New Jersey’s success to its efforts in addressing health care, traffic safety, and gun violence.
Before the federal Affordable Care Act’s Medicaid expansion, New Jersey and Massachusetts pooled funds with hospitals to cover more low-income residents. Stephen Crystal noted, “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.” The state also reports firearm death rates significantly below the national average, along with reduced deaths from heart and kidney diseases.
Nationally, the largest decrease between 2024 and 2025 came from younger age groups, as noted in an analysis by actuary Mary Pat Campbell. Causes of death like drug overdoses and gun violence dropped after spiking during the pandemic. Socioeconomic advantages in Northeastern states also play a role, with wealthier regions seeing lower mortality rates.
Despite overall improvements, states like New Mexico have not fared as well, with a 9% higher death rate than a decade ago. The state struggles with high drug overdose rates and has seen no improvement in gun homicide rates. In response, Gov. Michelle Lujan Grisham has demanded federal restitution over allegations of DEA complicity in fentanyl distribution.
Other states like Iowa and Oklahoma have seen a 5% increase in death rates since 2015, largely due to fall-related deaths among aging rural populations and issues with high blood pressure. Ali Mokdad from the University of Washington attributes some mortality declines to medical advances, especially in heart disease treatment.
While the CDC’s new methodology for calculating death rates has been questioned, it is clear that socioeconomic factors and state policies significantly impact mortality outcomes. Gun suicide rates are one area that has not improved, with a 14% increase since 2015, disproportionately affecting Gen Z and minority groups.
For further details, explore the full analysis by Mary Pat Campbell or read more on Stateline.
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