Small, Aging Population

Vermont has the 2nd lowest population among U.S. states with 623,989 residents (behind only Wyoming), but ranks as the 14th most densely populated state. Despite its small size, Vermont has experienced population decline of 0.3% between 2010 and 2019.

With a median age of 43.0 years, Vermont ranks as the nation’s 3rd oldest state (behind Maine and New Hampshire, tied with West Virginia). The state has the nation’s lowest fertility rate and the 2nd lowest racial and ethnic diversity (behind Maine).

Age-Related Mortality Pattern

Vermont’s annual mortality rate of 962.3 per 100,000 population ranks 17th highest nationally and is nearly 100 deaths higher than the overall national rate of 869.7. This elevated rate reflects Vermont’s aging population structure.

However, when adjusted for age, Vermont’s overall mortality rate improves to 11th lowest nationally, indicating that the state’s health outcomes are actually quite good relative to the age of its population.

Outstanding Health Performance

Vermont demonstrates exceptional performance in multiple health categories:

• Kidney Disease: Lowest rate nationally (3.6 per 100,000)
• Diabetes: 2nd lowest rate (behind only Massachusetts)
• Stroke: 7th lowest rate nationally
• Septicemia: 4th lowest rate
• Liver Disease: 9th lowest rate
• Pneumonia/Flu: Lowest rate nationally
• Homicide: Effectively zero rate (lowest nationally)

Health Challenge: Hypertension

Despite Vermont’s excellent performance in most health categories, the state has the 4th highest rate of death due to high blood pressure (tied with West Virginia, behind only Mississippi, California, and North Dakota). This represents a significant outlier in Vermont’s otherwise strong health profile.

Exceptional Safety Record

Vermont consistently demonstrates one of the safest environments in the nation:

• Homicide Rate: Effectively zero – fewest annual homicides of any U.S. state
• Obesity Rate: 5th lowest nationally among adults
• Smoking Rate: 10th lowest nationally among adults

Vermont’s suicide rate is about 15% above the overall national rate, representing one of the few areas where the state performs below average.

Workplace and Accidental Death Concerns

Despite overall safety, Vermont faces specific challenges:

• Workplace Safety: Most dangerous state for workers in the Northeast (3.2 occupational deaths per 100,000 workers)
• Accidental Falls: 3rd highest rate nationally at 26.3 deaths per 100,000 (behind only Wisconsin and Maine)

These elevated accidental death rates likely reflect Vermont’s rural nature, older population, and industries such as agriculture and forestry.

National Leader in COVID Response

Vermont demonstrated exceptional pandemic response and outcomes:

• 2020 COVID Deaths: Lowest rate nationally at 16.2 per 100,000
• Through August 2021: 2nd lowest COVID death rate (behind Hawaii)

Vermont’s rural nature, smaller population density, and effective public health measures contributed to this outstanding performance during the pandemic.

Life Insurance Considerations

Given the relative health of Vermont’s population, we find that many Vermont residents will likely be able to qualify for a no medical exam term life insurance policy.

For those that won’t be able to qualify for such a policy, fully underwritten life insurance policies and guaranteed issue life insurance policies may still be an option.

Due to Vermont’s elevated accidental fall rate, we commonly recommend that many of our clients consider purchasing an accidental death policy if they don’t have enough traditional life insurance coverage in place.

Cancer vs. Heart Disease: A Notable Pattern

Vermont is unique among U.S. states in that cancer slightly exceeds heart disease as the leading cause of death (150.4 vs 151.6 per 100,000). This pattern, while the difference is small, reflects Vermont’s older, generally healthier population with lower rates of traditional cardiovascular risk factors.

The state’s excellent performance in diabetes, kidney disease, and stroke prevention contributes to relatively lower heart disease mortality, while the aging population faces typical cancer risks associated with longer lifespans.

Rural Health Challenges and Strengths

Vermont’s rural character presents both advantages and challenges:

Advantages: Lower pollution, reduced infectious disease transmission, strong community ties, and healthy lifestyle opportunities contribute to low rates of many chronic diseases and exceptional COVID-19 outcomes.

Challenges: Rural industries and terrain contribute to higher workplace fatality rates and accidental falls. The aging, declining population presents long-term sustainability concerns for healthcare infrastructure and community vitality.

Summary: Vermont’s Health Profile

Vermont represents a paradox in American health demographics: a small, aging, declining population that nonetheless achieves some of the nation’s best health outcomes. The state excels in preventing chronic diseases, maintaining exceptional safety from violence, and demonstrated remarkable pandemic resilience.

While challenges exist around workplace safety, accidental falls, and hypertension, Vermont’s overall health profile reflects the benefits of rural living, strong community health practices, and a population committed to healthy lifestyle choices. The state’s main long-term challenge may be sustaining these positive outcomes as the population continues to age and decline.

Data Sources

U.S. Department of Agriculture, Economic Research Service (citing U.S. Census Bureau, 2019)

Statista, Population Density in the U.S. by Federal States (2020)

StatsAmerica (Indiana Business Research Center), Median Age in 2019

WalletHub, Most and Least Diverse States in America (2020)

CDC, National Center for Health Statistics, State & Territorial Data (2018-2019)

Kaiser Family Foundation, Number of Deaths per 100,000 Population (2019)

CDC, National Center for Health Statistics, Life Expectancy at Birth by State (2018)

CDC, State Tobacco Activities Tracking and Evaluation System (2018)

Statista, Percentage of Adults with Obesity in the United States (2019)

CDC, Provisional Death Rates for COVID-19 (2020)

National Safety Council, Work Deaths by State (2019)

National Safety Council, State Overview Table (2019)