Leading Causes of Death Among Travelers: A Hierarchy of Risks

by Robert McGarvey

You may die when you travel abroad.  2466 of us did in the period 2011-2013, per data from the Centers for Disease Control.

But just maybe what you fear is not what will kill you. And what you take for granted, may.

Terrorism is causing many of us to cancel vacas to Paris, Belgium, and I even hear of people skittish about Berlin, Madrid and Rome.

Understand: I am all in if you are afraid of Tunisia, Syria, Lebanon, Bangladesh, Pakistan, Afghanistan, Iraq, Iran, Sudan, Somalia, Mali, Libya.

If you are especially cautious, you might cross off Turkey, Egypt, Kenya, Venezuela, Honduras, Saudi Arabia, and a few more places.

I would not quibble with this, tho I would note that at least a few of those places (Venezuela and Honduras for instance) have a lot more worries about crime than terrorism. A criminal may kill you in Honduras but you are not likely to bump into any terrorists there.

But there are places I would not go and most of them were just named.

Which brings us to the money question: if thousands of us die abroad, what kills us?

This chart sums it up in one picture. (Deaths in wars are excluded from this count.)

The single biggest killer – eliminating 600 of us, nearly a fourth in that CDC count – is road accidents.  

“The real risk is motor vehicle accidents – that’s the greatest threat,” agreed Phil Sylvester,  a safety expert with travel insurer World Nomads.

Have you ever been in a speeding car in India, for instance? Be afraid, be very afraid.

Even if you do not set foot in a car, you may be killed as a pedestrian in India, but also in many other nations.

In many countries – particularly in the developing world – road infrastructure is wretched, traffic laws are never obeyed, and the only thing that keeps motor vehicle deaths down are the horrendous traffic jams where nothing moves more than a mile or two an hour.

Countries with frightening traffic related death counts include Angola, Benin, the Central Africa Republic, Mozambique, Rwanda, the Solomon Islands, Sudan, and Uganda.

For travelers 55 and older, by the way, the leading cause of death is what you would predict: cardiovascular disease. By most counts, heart related deaths account for one in two American deaths abroad. In that vein, Jim Hutton, chief security officer at travel assistance company On Call International, said: “Most of the cases we deal with are medical.”

This CDC list is only a count of deaths from non natural causes.  

Leading cause #2 of non natural deaths: Homicides, with over 500 deaths.  Cf. the comments on Honduras above.

Said Sylvester, “your chances of dying in a terrorist incident are one in 20 million.” Your chances of dying in a mugging in Central or South America or parts of Asia just are higher.

Cause 3: suicide, with almost 400 victims. Mexico is where the largest number are recorded.  South Korea is 2.  Germany, Thailand and Costa Rica fill out the top five.  

That is a hard one to parse and it also is fact that different nations are quicker than others to label a death a suicide. (In the US we often prefer “accidental overdose.”) The US State Dept., which gathers these data, admits that very probably the count is incomplete – but nobody ventures an alternative guess.

Cause 4: Drowning. Per the CDC, “Drowning accounts for 13% of all deaths of US citizens abroad. Although risk factors have not been clearly defined, these deaths are most likely related to unfamiliarity with local water currents and conditions, inability to swim, and the absence of lifeguards on duty. Rip currents can be especially dangerous, as are sea animals such as urchins, jellyfish, coral, and sea lice. Alcohol also contributes to drowning and boating mishaps.

“Drowning was the leading cause of injury death to US citizens visiting countries where water recreation is a major activity, such as Fiji, the Bahamas, Jamaica, and Costa Rica.”

No other cause merits special notice because, by CDC count, none of them produces that many corpses.  In that bucket are all terrorist related deaths.
How to stay safe overseas? Simple. Avoid nations with horrible roads (at least don’t get in cars). Avoid nations with high violent crime rates. Avoid nations with lots of gun toting terrorists (mainly in the Middle East and Africa).  Just take those three  precautions and you’ll be as safe overseas – maybe safer – than you are in the US.