The USA saw the highest number of fatalities from road accidents in 2019, at 36,120 deaths. That's around 110 deaths for every one million of its citizens. According to state-by-state analysis in 2019, South Carolina had the highest death rate per 100 million miles (160 million km) travelled at 1.73, compared with Massachusetts, the lowest, at just 0.51. It also found 45% of motor vehicle crash deaths in 2019 occurred in rural areas.

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