A patient walks into University Hospitals in Newark, New Jersey, according to a Stateline analysis. New Jersey has seen one of the largest declines in the death rate since 2015. (Photo by Terrence McDonald/New Jersey Monitor)
Youth deaths could fall to historic lows in 2025 as homicides of youthful people caused by drug overdoses, gun homicides and traffic accidents continued to decline in 2025, according to modern federal statistics.
However, according to Stateline’s analysis of interim data, states did not share the success equally. And the low attrition may reflect the effects of past health care expansion efforts that are threatened by today’s moves by the Trump administration to limit Medicaid expansion and cut funding for rural hospitals.
Some states in the Northeast saw the greatest declines in deaths between 2015 and 2025, led by New Jersey (down 8.3%), Rhode Island (down 8%), New York (down 7.9%), Massachusetts (down 7.4%), and the District of Columbia (down 7.0%). Some experts place the importance of states on health care, traffic problems and gun violence.
New Jersey took the lead in declines because of its long-term commitment to expanding health care coverage to low-income people, said Stephen Crystal, director of the Center for Health Services Research at Rutgers University.
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Crystal said that even before the expansion of Medicaid under the federal Affordable Care Act, New Jersey and Massachusetts, among others, pooled funding with hospitals to provide care to more low-income residents.
“New Jersey has been doing this for a long time and you can see the results in lower death rates for the big killers,” he said.
The state has the distinction of having less than half the national rate of gun deaths, both suicides and homicides, and deaths from heart and kidney disease caused by high blood pressure. The road accident death rate is also much lower than the national rate.
He added that in the northeast of the country there is also a more confrontational approach to speeding and less tolerance for weapons.
“Here’s something that upsets a lot of New Jerseyans. State troopers have the guts to pull you over if you’re driving on Highway 90. That’s not the case in Wyoming,” Crystal said. “And if you go to the West where gun ownership is very high, gun suicides become huge.”
Nationally, most of the declines in 2024–2025 concerned youthful age groups. The factors most likely to kill them have declined after a spike in the early phase of the pandemic, including drug overdoses, traffic accidents, gun violence and suicide, according to the study. analysis The death count was conducted by Mary Pat Campbell, an actuary and life insurance analyst in New York State.
She said the northeastern states have an advantage in solving these problems based on wealth.
“There has been an increasing disaggregation of mortality factors by socioeconomic status,” Campbell said, noting that traffic accidents are less common in places like New Jersey, in part because so many people commute to work by public transportation.
“In New Jersey’s case, it’s really a group of high-income people who have a lower-than-average death rate, just like people on Long Island and wealthy parts of Westchester [in New York state]– she added.
Some states have seen no improvement since 2015 in interim statistics analyzed by Stateline, which could change as the federal Centers for Disease Control and Prevention makes modern age adjustments at the state level.
New Mexico’s age-adjusted death rate was 9% higher last year than it was 10 years ago, as drug overdose deaths continue to plague the state and are more than twice the national rate.
In June, Democratic New Mexico Gov. Michelle Lujan Grisham called for such a solution restitution from the federal government over allegations that U.S. Drug Enforcement Administration officials knowingly released supplies of fentanyl into the state during multiple presidential terms. In one case, a whistleblower alleged, agents were eyeing the trade of 1.8 million fentanyl pills in hopes of catching higher-ranking dealers and suppliers.
New Mexico also faces higher rates of deaths from alcohol-related liver disease and gun homicides. Neighboring Arizona, where the death rate is 5% higher than 10 years ago, also has a high rate of overdose deaths and a high rate of gun suicide.
Death rates in Iowa and Oklahoma also increased by 5% compared to 2015. Iowa has a higher than national rate of deaths from falls, typical of an aging rural population lacking daily supervision. Oklahoma has a similarly high rate of deaths from falls, as well as nearly four times the national rate of deaths from high blood pressure and hardening of the arteries – both problems that can be controlled with medications.
Iowa “recognizes fall-related deaths as a serious public health issue,” state Department of Health and Human Services spokeswoman Danielle Sample wrote in an emailed statement. This decline is related to older age groups and probably rural areas’ access to health care and preventive services, she added.
The state has a fall prevention system program which emphasizes exercises to maintain mobility and monitoring excess medications that can cause dizziness, destitute vision and unsafe home conditions.
Campbell told Stateline that almost two-thirds of the improvement in the nation’s death rate from 2024 to 2025 came from people aged 15 to 44.
The improvement was particularly enormous for youthful people ages 25 to 34, which includes younger Millennials and older Generation Z, which was hit tough early in the pandemic by homicides and drug overdose deaths, Campbell told Stateline. She said the accident rate, a category that includes drug overdoses, gun accidents and traffic accidents, dropped 6% in one year, and the homicide rate dropped 14%.
It’s tough to be sure how much the death rate has changed from 2024 to 2025 because the methodology has changed, Crystal noted, accusing the CDC of “grabbing a good news headline” by chronicling the seemingly historic decline prominently on the blog item.
For 2025, the CDC used a variety of methods to calculate the rates, including more adjustments to 2020 Census data serving as the basis for age adjustments, noting in the report that the results are subject to change and “should be interpreted with caution.”
When asked about the issue, the CDC said in a statement to Stateline that “because this is an interim report, we have not delved into changes in population denominators” and that it “plans a short report that will show the impact” of changes in death and birth rates in the modern statistics.
In any case, the Trump administration probably can’t take credit for the current decline in the death rate, which would reflect years-old policy changes that are slowly taking effect, Crystal said.
“This is not the time to see the impact of what Trump is doing now. It will take five years,” Crystal said.
Not a single youth killer has dropped: The gun suicide rate has increased 14% since 2015, according to a Stateline analysis. Suicide has affected youthful people from Generation Z to a greater extent than previous generations.
Rates for blacks and Latinos have increased over the past 10 years, while rates for other groups have declined, according to Stateline’s analysis.
“We are improving as a country. We should celebrate that. But many segments of the population are lagging behind,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington.
Mokdad credited medical advances with the reduction in heart disease that occurred despite increased obesity.
“The decline in cardiovascular disease was due to better blood pressure control,” Mokdad said. “Blood pressure medications were very expensive when they first came out. Now blood pressure medications are so cheap that you can buy a three-month supply of them for less than the price of a cup of coffee.”
Stateline reporter Tim Henderson can be reached at: thenderson@stateline.org.
This story was originally produced by state linewhich is part of States Newsroom, a nonprofit news network that includes Pennsylvania Capital-Star, and is supported by grants and a coalition of donors as a 501c(3) public charity.
