The motor vehicle death rate in the U.S. has dropped 31% since 2000, which may sound impressive until you see that these deaths dropped by an average of 56% in 19 other comparable countries during the same period of time, leaving America as the country with the highest vehicle crash death rate among these high-income nations.

This is according to the Centers for Disease Control and Prevention which makes this motor vehicle death data the focus of its latest weekly Morbidity and Mortality report.

Back in 2000, several countries—the U.S., Belgium, Slovenia, Spain, and France—were all basically tied for having the highest rate of vehicle deaths at around 14 fatalities per 100,000 people.

However, by 2013 the U.S. had not only the highest death rate, but the only rate that was in double digits (10.3/100,000 people), while those other nations had made more significant headway in reducing their rates of motor vehicle crash fatalities.

U.S. Now Has Highest Death Rate for Car Crashes
Infographic: CDC

Belgium remains the second highest, but its 6.5 rate is significantly lower than the U.S. Similarly, Slovenia slashed its rate by nearly 62% to reach a level of 6 deaths per 100,000 people. The most dramatic reduction in death rate was seen in Spain, where fatalities plummeted by more than 75% between 2000 and 2013.

Nearly 33,000 people died in the U.S. in 2013 from vehicle-related crashes. If the U.S. had managed to reach the same 2013 fatality rate as Belgium—still far above the median for the other nations (4.1)—the CDC estimates that 12,000 fewer lives would have been lost in 2013, resulting in $140 million in direct medical costs being averted.

Had the U.S. seen a decline in keeping with the average of the comparison nations, the CDC says that at least 18,000 fewer lives would have been lost. That’s more than half the number of those that died here in 2013.

Canada had the second least significant rate decrease (42.9%) during these years, however its current rate of 5.4 is a little more than half of what we see on this side of the border.

The CDC also looked at two other mortality rates related to car crashes, and the U.S. was at or near the top for those categories as well.

While the U.S. has the fifth-highest rate of vehicle crash deaths per 100 million miles traveled (1.10; compared to an average of .85 for the remaining 19 countries), it did the least to cut down on deaths in this category over the 13-year span. While the other countries averaged a decline of 57% in deaths/miles traveled, the U.S. only demonstrated a 28% drop.

Finally, the report looks at the rate of crash deaths per 10,000 registered vehicles, and here the U.S. rate (1.24) is nearly double the average other countries (.68).

Additional data points:

• Among countries with available national data on seat belt use, the U.S. ranked 18th out of 20 for front seat use, and 13th out of 18 for rear seat use.

• The United States reported the second highest percentage of vehicle crash deaths involving alcohol-impaired driving (31%).

• The U.S. had the eighth highest percentage of crash deaths that involved speeding (29%).

“Although substantial progress has been made in reducing the number of motor vehicle crash deaths in the United States, motor vehicle crashes remain a serious public health problem,” reads the report.

The nearly 33,000 people who died in the U.S. in vehicle crashes in 2013 is around 10,000 more than all of the deaths in the 19 other countries combined. While none of the other countries comes close in size to the U.S. population, the total population of the other 19 nations is about 1.5 times the size of the U.S.

Likewise, the U.S. may have 265 million registered vehicles—nearly three times the number of Japan, the country on the list with the next most registrations—but the total of vehicles registered in the 19 other countries is more than 350 million.

The CDC acknowledges that it’s difficult to pinpoint exactly why the U.S. has come up so short in combating vehicle crash deaths compared to these other countries, but notes that “differences in policies and their enforcement, use of advanced engineering and technology, and differences in public acceptance and use of effective strategies have all contributed to reducing death rates in the best performing countries.”

There is also the issue—especially for Americans who live outside the center of major cities—that we rely a lot more on our cars than some other nations where public or shared transportation is more widely used and deployed.

“In 2014, there were 1.2 vehicles per licensed driver and 2.1 vehicles per household in the United States, and the U.S. share of world car registrations was 15.1%,” writes the CDC. “Given this reliance on personal vehicles, and need to address safety issues without delay, bringing policies in line with best practices (e.g., related to child passenger safety, seat belt use, and alcohol-impaired driving), enforcement, infrastructure, vehicles, and technologies such as ignition interlocks and automated enforcement (cameras) could help narrow the gap between the United States and higher performing countries.”

Increasing the use of seat belts is of key importance, says the CDC, pointing to data showing that nearly half of those who die in passenger vehicle crashes are unrestrained at the time of the incident.

“Implementing primary enforcement seat belt laws that cover occupants in all seating positions, and requiring the use of car seats and booster seats for motor vehicle passengers through at least age 8 years could increase restraint use and prevent injuries and deaths in the United States,” argues the report, pointing out that 12,500 lives were saved in the U.S. in 2013 because the person was wearing a seat belt.

Similarly, contends the report, more could be done to reduce the approximately 10,000 vehicle deaths per year in the U.S. that involve alcohol impairment.

“Several proven prevention strategies could accelerate progress in the United States, including publicized sobriety checkpoints, ignition interlocks… for all convicted offenders, having lower blood alcohol concentration limits, and maintaining and enforcing the minimum legal U.S. drinking age of 21 years,” concludes the CDC.

“Motor vehicle injuries are predictable and preventable, and yet, in 2013, 90 persons died every day on U.S. roads. Lower rates in other high-income countries, as well as a high prevalence of risk factors in the United States, suggest that the United States can make more progress toward reducing motor vehicle crash deaths,” reads the report. “With a projected increase in U.S. crash deaths in 2015, the time is right to reassess progress and set new goals.”