There were 40,100 traffic fatalities and another 4.57 million crash-related injuries serious enough to require medical attention in the United States last year, according to the National Safety Council. While that rate was down very slightly from the previous year, the Centers for Disease Control and Prevention reports that motor-vehicle crashes remain a leading cause of death nationwide.

24/7 Wall St. has compiled statistics from the National Highway Traffic Safety Administration revealing which American cities record the most traffic deaths each year.

Among the factors that contribute to car accidents, fatal and otherwise, are speeding, alcohol or drug use, fatigue, uncorrected poor eyesight, and distracted driving (which these days often involves texting or other cell phone use, a factor police officers say is underreported in accident records).

Other potential causes, not under the driver’s control, include bad weather, poor road conditions (badly maintained surfaces, obstructed visibility), vehicle issues (bad brakes, faulty turn signals), and even demographics: Young males or groups of young people riding in the same car are particularly susceptible to mishap.

Click here for the U.S. cities with the most traffic deaths per year.

Sex and economic status impact the statistics, as well. According to the Insurance Institute for Highway Safety’s Highway Loss Data Institute, many more men than women die in auto accidents each year: 71% of motor vehicle fatalities in 2016 were male. The Institute ascribes this imbalance to the fact that men drive many more miles annually than women and are more likely to engage in risky behavior, including speeding, not wearing seatbelts, and driving while alcohol-impaired. And according to the World Health Organization’s “Global Status Report on Road Safety,” low- and middle-income countries worldwide have approximately twice as many annual road traffic fatalities per capita as high-income countries.

While cities on this list span the nation, it seems major urban areas on the East Coast might actually be the safest places to drive. Only one city in the region was among the 10 most dangerous locales, and only six appear on our list of 52 in all. The part of the country with the most fatalities? The South, including Texas, has the dubious claim of representing almost half of the cities our list.

To identify the cities that have the most traffic accidents per year, 24/7 Wall St. reviewed the number of fatal car accidents in each city from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System (FARS) for 2016. Population was obtained from the American Community Survey 2012-2016 5-year averages.