The United States is the third-most populous country on Earth behind China and India, and, like them, it is growing. According to the U.S. Census Bureau, there is one birth in the U.S. every nine seconds and one death every 10 seconds. (Net population growth has also been boosted by immigration.) Even births outpace deaths on a national basis, however, there are 24 states where the reverse is true. (These are the states with the shortest life expectancies.)
To identify the 24 states where deaths out-numbered births in 2021, the most recent year for which data is available, 24/7 Tempo reviewed births, birth rates, deaths, and death rates by state and territory from the CDC’s National Center for Health Statistics. The births dataset counts live births occurring within the United States to U.S. residents in 2021. Birth rates are calculated for every 1,000 women 15 to 44 years old. Mortality data for 2021 also came from the National Center for Health Statistics. Population statistics for each state in 2021 came from the U.S. Census Bureau’s 2021 1-year American Community Survey.
The South has been the fastest-growing section of the country for many years because of intersectional migration as well as immigration from other countries. However, seven of the 10 states where deaths currently outnumber births the most are in the South. Three of the four with the highest death-to-birth ratio, however, are in the Midwest or Northeast — Michigan, Ohio, and Pennsylvania. (Here are the states with the highest birth rates.)
24. Louisiana
> Estimated births in 2021: 57,437 – 24th highest
> Estimated deaths in 2021: 57,533 – 24th highest
> Birth rate: 62.7 births per 1,000 women – 6th highest
> Age-adjusted death rate: 1094.6 per 100,000 people – 8th highest
> Total population: 4,624,047 – 10th highest
23. Wyoming
> Estimated births in 2021: 6,237 – 2nd lowest
> Estimated deaths in 2021: 6,582 – 2nd lowest
> Birth rate: 57.5 births per 1,000 women – 24th highest
> Age-adjusted death rate: 954.7 per 100,000 people – 16th highest
> Total population: 578,803 – 24th highest
22. Rhode Island
> Estimated births in 2021: 10,464 – 5th lowest
> Estimated deaths in 2021: 11,243 – 6th lowest
> Birth rate: 48.3 births per 1,000 women – 2nd lowest
> Age-adjusted death rate: 781.3 per 100,000 people – 8th lowest
> Total population: 1,095,610 – 21st highest
21. Delaware
> Estimated births in 2021: 10,482 – 6th lowest
> Estimated deaths in 2021: 11,296 – 7th lowest
> Birth rate: 56.5 births per 1,000 women – 25th lowest
> Age-adjusted death rate: 867.0 per 100,000 people – 24th lowest
> Total population: 1,003,384 – 22nd highest
20. Montana
> Estimated births in 2021: 11,231 – 7th lowest
> Estimated deaths in 2021: 12,707 – 8th lowest
> Birth rate: 54.8 births per 1,000 women – 17th lowest
> Age-adjusted death rate: 909.9 per 100,000 people – 22nd highest
> Total population: 1,104,271 – 20th highest
19. Vermont
> Estimated births in 2021: 5,384 – the lowest
> Estimated deaths in 2021: 6,877 – 3rd lowest
> Birth rate: 44.9 births per 1,000 women – the lowest
> Age-adjusted death rate: 791.2 per 100,000 people – 10th lowest
> Total population: 645,570 – 23rd highest
18. New Hampshire
> Estimated births in 2021: 12,625 – 10th lowest
> Estimated deaths in 2021: 14,198 – 10th lowest
> Birth rate: 49.9 births per 1,000 women – 6th lowest
> Age-adjusted death rate: 782.9 per 100,000 people – 9th lowest
> Total population: 1,388,992 – 18th highest
17. Oklahoma
> Estimated births in 2021: 48,410 – 24th lowest
> Estimated deaths in 2021: 50,945 – 25th lowest
> Birth rate: 61.5 births per 1,000 women – 8th highest
> Age-adjusted death rate: 1121.1 per 100,000 people – 6th highest
> Total population: 3,986,639 – 13th highest
16. Arizona
> Estimated births in 2021: 77,916 – 16th highest
> Estimated deaths in 2021: 81,442 – 14th highest
> Birth rate: 55.5 births per 1,000 women – 20th lowest
> Age-adjusted death rate: 908.5 per 100,000 people – 23rd highest
> Total population: 7,276,316 – 5th highest
15. New Mexico
> Estimated births in 2021: 21,391 – 13th lowest
> Estimated deaths in 2021: 25,300 – 15th lowest
> Birth rate: 52.9 births per 1,000 women – 10th lowest
> Age-adjusted death rate: 995.5 per 100,000 people – 13th highest
> Total population: 2,115,877 – 16th highest
14. Oregon
> Estimated births in 2021: 40,914 – 22nd lowest
> Estimated deaths in 2021: 44,989 – 23rd lowest
> Birth rate: 48.9 births per 1,000 women – 3rd lowest
> Age-adjusted death rate: 861.0 per 100,000 people – 22nd lowest
> Total population: 4,246,155 – 12th highest
13. Arkansas
> Estimated births in 2021: 35,965 – 20th lowest
> Estimated deaths in 2021: 40,070 – 21st lowest
> Birth rate: 61.7 births per 1,000 women – 7th highest
> Age-adjusted death rate: 1097.8 per 100,000 people – 7th highest
> Total population: 3,025,891 – 14th highest
12. Missouri
> Estimated births in 2021: 69,453 – 17th highest
> Estimated deaths in 2021: 73,847 – 16th highest
> Birth rate: 58.4 births per 1,000 women – 20th highest
> Age-adjusted death rate: 971.9 per 100,000 people – 14th highest
> Total population: 6,168,187 – 7th highest
11. Maine
> Estimated births in 2021: 12,006 – 9th lowest
> Estimated deaths in 2021: 17,269 – 11th lowest
> Birth rate: 49.9 births per 1,000 women – 6th lowest
> Age-adjusted death rate: 889.4 per 100,000 people – 25th highest
> Total population: 1,372,247 – 19th highest
10. Mississippi
> Estimated births in 2021: 35,156 – 18th lowest
> Estimated deaths in 2021: 41,085 – 22nd lowest
> Birth rate: 60.7 births per 1,000 women – 12th highest
> Age-adjusted death rate: 1204.5 per 100,000 people – 2nd highest
> Total population: 2,949,965 – 15th highest
9. Kentucky
> Estimated births in 2021: 52,214 – 25th lowest
> Estimated deaths in 2021: 60,303 – 22nd highest
> Birth rate: 60.8 births per 1,000 women – 10th highest
> Age-adjusted death rate: 1139.6 per 100,000 people – 3rd highest
> Total population: 4,509,394 – 11th highest
8. South Carolina
> Estimated births in 2021: 57,185 – 25th highest
> Estimated deaths in 2021: 65,422 – 19th highest
> Birth rate: 57.5 births per 1,000 women – 24th highest
> Age-adjusted death rate: 1038.1 per 100,000 people – 9th highest
> Total population: 5,190,705 – 8th highest
7. Tennessee
> Estimated births in 2021: 81,717 – 14th highest
> Estimated deaths in 2021: 91,130 – 11th highest
> Birth rate: 59.8 births per 1,000 women – 16th highest
> Age-adjusted death rate: 1121.3 per 100,000 people – 5th highest
> Total population: 6,975,218 – 6th highest
6. Alabama
> Estimated births in 2021: 58,054 – 23rd highest
> Estimated deaths in 2021: 68,889 – 17th highest
> Birth rate: 59.5 births per 1,000 women – 17th highest
> Age-adjusted death rate: 1134.2 per 100,000 people – 4th highest
> Total population: 5,039,877 – 9th highest
5. West Virginia
> Estimated births in 2021: 17,198 – 12th lowest
> Estimated deaths in 2021: 29,503 – 16th lowest
> Birth rate: 54.7 births per 1,000 women – 15th lowest
> Age-adjusted death rate: 1229.1 per 100,000 people – the highest
> Total population: 1,782,959 – 17th highest
4. Michigan
> Estimated births in 2021: 104,980 – 10th highest
> Estimated deaths in 2021: 117,782 – 9th highest
> Birth rate: 55.4 births per 1,000 women – 19th lowest
> Age-adjusted death rate: 943.1 per 100,000 people – 17th highest
> Total population: 10,050,811 – 4th highest
3. Ohio
> Estimated births in 2021: 129,791 – 7th highest
> Estimated deaths in 2021: 147,635 – 6th highest
> Birth rate: 57.9 births per 1,000 women – 23rd highest
> Age-adjusted death rate: 1012.8 per 100,000 people – 10th highest
> Total population: 11,780,017 – 3rd highest
2. Pennsylvania
> Estimated births in 2021: 132,622 – 5th highest
> Estimated deaths in 2021: 155,390 – 5th highest
> Birth rate: 54.7 births per 1,000 women – 15th lowest
> Age-adjusted death rate: 895.0 per 100,000 people – 24th highest
> Total population: 12,964,056 – 2nd highest
1. Florida
> Estimated births in 2021: 216,260 – 3rd highest
> Estimated deaths in 2021: 261,369 – 3rd highest
> Birth rate: 54.9 births per 1,000 women – 18th lowest
> Age-adjusted death rate: 832.9 per 100,000 people – 18th lowest
> Total population: 21,781,128 – the highest