All things being equal, you're more likely to get into a deadly crash in a rural area than an urban one. All things are never equal, though, so we can't go fully TLDR on this one. We wrote "deadly crash" and that's the key way the National Highway Transportation Safety Agency (NHTSA) looks at car accidents. In other words, they don't study car accidents as much as car accidents that end in death, like hit-and-run crashes.
But a deadly car crash is still a car accident. And there's good news even in car accidents that end in death. Yes, we wrote those words. First, according to the Insurance Institute for Highway Safety (IIHS) analysis of NHTSA's system, the ratio of urban deaths versus rural ones continues to fall.
That matters, because up until recently, the numbers have been grisly. According to data from the Federal Highway Administration, from 2017 to 2021, over 83,000 people died on rural roads. That's despite only 20% of the U.S. population living outside cities. And only one in three car trips Americans took during that period bisected these less populated roads.
But as we said, according to the IIHS, rural fatality rates are falling, and the urban-versus-rural death count is getting less stark. Back in 2000, 61% of people who died in car-crashes were driving in the country. By 2024 that's down to 41%. However, take a 100-million-mile slice of car travel in the U.S. and drivers and passengers in the country still have a 1.56% chance of being killed on the road. That's versus just 1.01% in urban areas. On paper, then, it's still deadlier to drive in what snobs call "flyover country." But that isn't the full story.
Time is the critical life-saving factor
There's some evidence that rural driving deaths can be attributed to riskier behavior, but also to poorer sightlines and road conditions, plus fewer cops and other traffic enforcement, and even inconsistently painted lanes on roadways.
Weaker enforcement may be why when speeds are posted at 50 mph or below, there are more speeding deaths (72%) for rural drivers than urban ones (61%). This dovetails with some studies about the attitudes of risky driving behavior, and that people who live in more remote locations not only have to drive longer distances, but they're more apt to do so and not buckle up. Prior data showed that rural drivers were more likely to drink and get behind the wheel, but DUI-related deaths are fortunately falling for all Americans.
Naturally, there's another grim reason why fatalities could be higher in ex-urban-and-beyond zones: Longer travel times to hospitals and for help to arrive. A Journal of the American Medical Association study from 2017 found that rural accident victims wait an average of 14 minutes for EMS to arrive, while if you're in a car crash in a city you wait only seven minutes. The longer the wait, the more likely you won't get critical care.
Walking and biking is still deadly in cities
We know that city slickers think that because they don't drive, they're somehow safer. Sadly, they're not, not even if they practice "defensive walking". Positively, the Governor's Highway Safety Association (GHSA) says that in the first half of 2025, car crashes with pedestrians finally dropped closer to 2019 levels. That's thankfully way off the 2022 rate, which had reached a 40-year high.
But as you might guess, folks on foot and on bikes tend to be in cities. So in 2024, more than 80% of deaths among bike riders and walkers were in densely populated locations. Also, sadly, if you ride a motorcycle you're more likely to die in a city than out on some pretty backcountry lane.
Get granular, however, and the picture gets a hair cloudier. Several more rural states saw double-digit increases in pedestrian fatalities during the first half of 2025, with Michigan (26%), Missouri (23%) and Utah (54%), all rising. Idaho, Wyoming, North Dakota and Montana also saw increases. Not to downplay death, but you have to take those statistics with a handful of salt. Utah's alarming jump is from 13 deaths to 20 deaths. That's awful, but it's an increase of seven, which suddenly doesn't sound quite as bad. Especially when California had 154 fewer deaths in the first half of 2025 than in the same period the previous year. That's a 27% decline.
What's it all mean? Well, urban travelers by car die at a higher rate, though thankfully not as frequently as they used to. And pedestrian deaths are falling back to more "normal" levels, but they're still 2.5% higher than they were pre-pandemic. But hey, we don't want to leave you feeling doomed. So if you live in California you dwell in an ever-safer state for walkers and bikers, since the Golden State's recent decline follows two previous years where they led the nation in improved pedestrian safety.
