Live in West Virginia or Kentucky? You’re more likely than most Americans to die of heart disease, cancer or a drug overdose. Residents of Arkansas, Louisiana, and Mississippi are most likely to succumb to diabetes, while people in the Rocky Mountain states of Idaho, Wyoming and Colorado have lower rates of both cancer and heart disease. A new county-by-county breakdown of what kills people in the U.S. finds big differences. Perhaps most startling, death rates from drug overdoses shot up by 1,000 percent in clusters of counties in six states: Kentucky, West Virginia, Ohio, Indiana, western Pennsylvania, and east-central Missouri. Age-standardized mortality rate from cardiovascular diseases, 2014. JAMA “We found huge variation in all the leading causes of death,” said Dr. Christopher Murray at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington in Seattle. “There’s more than 20 years difference across the communities.” Some of the findings are not surprising. “Heart disease is particularly high in the southeast of the United States,” said Murray, who has pioneered many different ways to crunch health statistics. Experts know lifestyle — poor diet, a lack of exercise and less access to good medical care — are mostly to blame. Other patterns may depend on economic and social factors. Age-standardized mortality rate from self-harm and interpersonal violence, 2014 JAMA “The highest levels, for example, for violent death, from suicide and homicide, are in the West of the U.S.,” Murray said. “The highest death rates from drug use disorders are in West Virginia and eastern Kentucky and New Mexico.” Health experts have known there are big geographical differences in health across the U.S. The Centers for Disease Control and Prevention has called it death by zip code. The new analysis, published in the Journal of the American Medical Association, takes it to a deeper level, and looks at changes in death rates since 1980 using individual death certificates for 80 million people. Here’s a look: Mental and substance use disorders caused 1 percent of deaths between 1980 and 2014. Highest mortality: Eastern Kentucky; southwestern West