Every year, a few hundred U.S. citizens die abroad from non-natural causes such as crashes, drownings and violence. The State Department tracks these cases, and the same names keep showing up at the top of its records: Mexico, Costa Rica and the Dominican Republic. In 2019 to 2021, over 1,500 U.S. citizens died from non-natural causes abroad, and motor vehicle crashes were the leading cause at 26 percent.[1]
A raw ranking doesn’t say much about how risky a trip is, though. Below, we look at what the official numbers measure, why these three countries lead, and what the patterns suggest for travelers. The most detailed public breakdowns still come from the 2020 to 2022 file and a 2023 half-year worksheet, so treat them as the latest solid snapshot rather than a live tally.
What the Official Numbers Really Count
The State Department doesn’t keep a table of tourist deaths. It publishes reported non-natural deaths of U.S. citizens abroad, which can include more than just short-term travelers.[2] That means expats, long-term residents and dual nationals can appear in the same list as vacationers.
There are other limits too. The CDC notes that the data exclude deaths not reported to a U.S. embassy or consulate.[1] Natural causes, such as heart attacks, aren’t included either. So the ranking reflects where reported accidents, homicides and similar events happen most often, which is a different question from where a tourist faces the highest personal risk.
Mexico: Far Ahead of Everyone Else
Mexico leads by a wide margin. In the 2020 to 2022 State Department file, it had 537 recorded non-natural deaths of U.S. citizens.[3] That’s more than ten times the count of the country in second place. In the January to June 2023 sheet, it had 172 entries, which is nearly a third of that half-year file.[2]
Volume explains much of this. One summary says Mexico draws close to 39 percent of all American travelers while accounting for about one third of U.S. deaths abroad.[4] Still, the causes aren’t only accidents. From 2019 through 2021, Mexico had the highest number of U.S. citizen road traffic deaths, and more than 68 percent of all homicide deaths of U.S. citizens abroad occurred there.[2]
Costa Rica: Where the Water Does the Damage
Costa Rica sits in second place in the 2020 to 2022 file. It had 52 recorded cases, and drowning stands out as the dominant cause, far ahead of traffic incidents.[3] The country is known for surf beaches, rip currents and river activities, which helps explain the pattern.
Its numbers look small next to Mexico’s, but visitor counts are smaller too. An older Time analysis of State Department data found that Costa Rica, Vietnam and the Philippines had substantial American deaths relative to visitors, three to four times more than Mexico when adjusted for volume.[5] That analysis is dated, so it’s best read as a hint about proportions rather than a current rate.
The Dominican Republic: A Mixed Pattern
The Dominican Republic follows closely behind. It had 49 recorded deaths in the 2020 to 2022 window, spread across drowning, homicide, auto crashes and a noticeable cluster labeled as aviation accidents.[3] In the first half of 2023 it ranked ahead of Costa Rica, staying above both Thailand and Costa Rica in that tab’s ordering.[2]
Road safety is a recurring theme. The Dominican Republic ranked third in U.S. citizen road traffic deaths, with 21 deaths between 2019 and 2021.[6] The CDC’s Yellow Book also points out that trauma centers capable of treating serious injuries are uncommon outside urban areas.[4] A crash far from a big city can be more dangerous for that reason alone.
Why Rankings Shift Once You Adjust for Visitors
Count deaths per visitor and the picture changes. Thailand is the classic example. Time’s analysis showed its rate of American deaths per visitor was about nine times that of Mexico.[5] One recent period showed 35 deaths there, including 12 suicides and 10 attributed to motorcycles.[7]
The other consistent finding is that most of these deaths aren’t exotic. Crashes, drownings and violence dominate, and they’re partly preventable. Wearing a helmet on rented scooters, respecting posted beach warnings and avoiding night driving on unfamiliar roads address the most common causes. Those are ordinary habits, but the data suggests they matter.
Conclusion
Mexico, Costa Rica and the Dominican Republic top the State Department’s reported non-natural death records for U.S. citizens abroad, with Mexico far ahead. Much of that reflects how many Americans travel there, along with the way the data mixes tourists, residents and different causes of death. The lesson isn’t to avoid these destinations. It’s that the biggest dangers are usually the everyday ones: traffic, water and alcohol.
A ranking tells you where tragedies get recorded, not how likely one is on your trip. Knowing that is a better safeguard than any headline.
