Vaccine distribution is well underway across the United States. Still, the novel coronavirus continues to spread and claim American lives. In the past week alone, there were an average of 597 new deaths attributed to the virus every day.

Since the first COVID-19-related death was reported in the United States on Feb. 29, 2020, there have been a total of 580,983 COVID-19 deaths nationwide, equal to about 178 for every 100,000 Americans.

Of course, deaths attributable to the virus are not evenly spread across the country. While there are still counties and county equivalents that have not reported a single COVID-19 death, nearly every state has at least one county where the number of deaths attributable to the virus per capita exceeds the national rate — sometimes by orders of magnitude. There are 14 states home to at least one county where COVID-19 deaths per capita are at least three times higher than they are nationwide. In one county in Virginia, there have been a total of 798 coronavirus deaths for every 100,000 people.

Counties and county equivalents where COVID-19 deaths are highly concentrated are often home to larger populations of individuals at increased risk of severe illness if they are infected. One such group is retirement-age Americans. Americans 65 and older are at least 90 times more likely to die from the virus, if infected, than those in the 18 to 29 age range. The vast majority of the places on this list are home to a larger concentration of 65 and older residents than the state as a whole.

In addition to more vulnerable populations, the places on this list also tend to have a higher than average per capita COVID-19 cases. In 38 states, the county or county equivalent with the most COVID-19 deaths per 100,000 also has a higher number of confirmed cases per 100,000 than the state as a whole.

All COVID-19 data used in this story are current as of May 19, 2021.