The Western States invariably had the highest death rates and the Northeastern States the lowest. Eight States had death rates above the national averages for all causes of death in all five time periods: Arizona, Idaho, Kentucky, Montana, Nevada, New Mexico, Texas, and Wyoming. Seven States had rates below the national averages for all causes in all periods: Connecticut, Massachusetts, Maryland, New Jersey, New York, Pennsylvania, and Rhode Island. The total death rates for youth in the six most dangerous Western States have been about twice as high as rates in the four safest Northeastern States for two generations. A stable geographical pattern of death has to be explained by equally stable regional environmental factors. The Western States have a cultural milieu that apparently has an effect on death rates. An emphasis on individualism, outdoor machismo, risk taking, and danger seeking may influence Western States' resistance to such measures as gun control restrictions, lower auto speed limits, seatbelt laws, higher drinking ages, economic development programs, and occupational safety and health laws. 1 footnote.