Life expectancy at birth in the United States is now 76.1 years – the lowest it has been since 1996. The recent decline is due largely to COVID-19. A drop of 1.8 years in 2020, followed by a decrease of 0.9 year in 2021 added up to the biggest two-year decline since almost exactly a century ago.

Another primary cause of the downward trend, besides COVID, is the sharp rise in drug overdoses, most notably those involving synthetic opioids like fentanyl. (Click here to see the county with the worst drug problem in every state.)

To determine the city in every state with the most premature deaths, 24/7 Tempo reviewed data from the 2022 County Health Rankings & Roadmaps, a joint program of the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. The study ranks metro areas according to the number of people who died before age 75 per 100,000 population (age-adjusted). (These are the states with the lowest life expectancies.)

Click here to see the premature death capital of every state
Click here to see a detailed methodology

In addition to overdose fatalities, hundreds of thousands of Americans die prematurely every year from accidents, curable disease, suicide, murder, and other preventable causes.

Unintentional injuries, which include poisoning, traffic fatalities, and falls, were the third leading cause in the country, according to CHR. In 2019 alone, the latest year for which data is available, unintentional injuries were the leading cause of death for all people under 45.

Many premature deaths occur as a consequence of long-term unhealthy behaviors. Over time these risk factors such as obesity and excessive drinking, for example, can lead to common causes of death including heart disease and cancer – the leading causes of death in the U.S., according to the CDC, accounting for a total of  more than 1.2 million a year. (These are the states where people drink the most alcohol.)