Violent death is a problem in the United States. Not only are mass shootings seemingly routine, but also U.S. firearm-related homicide and suicide rates are much higher than in other wealthy countries.

According to a study published in the American Journal of Medicine this spring, the gun homicide rate in the United States is more than 25 times higher than the rate in other high-income nations. Among 15-24 year olds, the rate is nearly 50 times higher. Of all gun fatalities in the 23 countries the researchers reviewed, 82% occur in the United States.

The incidence of firearm-related deaths varies considerably across the country. In Hawaii, there were 2.7 gun deaths per 100,000 people in 2014. While this is the lowest of any state it is still well above the rates in other high-income nations — all of which are under 1 per 100,000 people.

These relatively safe states still have higher rates of gun fatalities than that of every other high-income nation, but gun deaths are far less of an issue in states like Hawaii and Rhode Island than in other states like Alaska, where there are close to 20 firearm deaths per 100,000 people. 24/7 Wall St. reviewed the 10 states with the least gun violence based on the latest data from the Centers for Disease Control and Prevention, which tracks the number of gun-related deaths in each state. Fatalities include homicides, suicides, and accidents.

3. Massachusetts

> Firearm deaths per 100,000 people: 3.4

> Total firearm deaths 2005-2014: 2,504 (16th lowest)
> Violent crime rate per 100,000: 391.4 (18th highest)
> Adult gun ownership rate: 22.6% (12th lowest)
> Poverty rate: 11.6% (10th lowest)

The firearm death rate of 3.4 per 100,000 people in Massachusetts is barely a third of the national rate. Just 67 of the nation’s 10,945 gun homicides in 2014 occurred in the state, as did only 130 of the 21,334 suicides by firearm that year. This may be due in part to the state’s relatively strict gun laws. For example, the state bans some assault-style rifles, high-capacity magazines, and certain handguns considered especially dangerous.

The state actually has an above-average concentration of gun shops, with 23 licensed dealers per 1,000 establishments, higher than the national figure of 23 for every 1,000 businesses. However, gun ownership is still among the lowest in the country, with 22.6% of adults owning a firearm compared to a national ownership rate of 29.1%.

In contrast with the states with the highest gun death rates, the states on this list tend to have fewer guns, more restrictive gun laws, higher incomes, and less poverty. For a host of reasons, government-funded research into firearm fatalities is highly limited. Therefore, while there appears to be a strong connection between social and economic conditions such as poverty and gun fatality, such a relationship is poorly understood.

Nationwide, an estimated 30% of adults own at least one firearm. In six of the 10 states with the lowest incidence of gun death, the ownership rate is lower than the national rate. In some states it is much lower. In Rhode Island, for example, only 5.8% of adults report owning at least one firearm. Gun laws in no state are especially restrictive compared to firearm regulations in many other nations. In all but two of the states with the least gun violence, however, a license, permit to purchase, and registration for all types of guns are required.

Numerous countries around the world have lowered gun deaths in recent decades by dialing up gun restrictions. In the United States, however, not only are legislative efforts to curb gun violence politically unfeasible, but also past laws have been largely ineffective.

For example, the 1994 Federal Assault Weapons Ban, which expired in 2004, has been widely criticized for relying on arbitrary distinctions between weapons — so-called cosmetic features that do not increase the lethality of the weapon. As a result, gun manufacturers were able to redesign their weapons to meet legal requirements without sacrificing performance. So over the 10 years through 2004, a number of powerful rifles such as the AR-15 style gun, the model used in Sandy Hook and numerous other shootings, were banned. However, similarly powerful weapons such as the Hi-Point 995, the model used to commit the Columbine massacre in 1999, were still available.

To determine the states with the most gun violence, 24/7 Wall St. examined 2014 firearm-related deaths data from the CDC. We also considered violent crime rates from the Federal Bureau of Investigation’s 2014 Uniform Crime Report. From the U.S. Census Bureau we reviewed poverty rates by state for 2014. Information on firearm policies for each state are from the National Rifle Association’s Institute for Legislative Action. Gun ownership rates for each state are as of 2013, and were obtained from a study published in 2015 from the Mailman School of Public Health at Columbia University. The number of licensed gun sellers per 1,000 business establishments for each state are as of 2015 and comes from the Bureau of Alcohol, Tobacco, Firearms and Explosives.

Click here to see the 10 states with the least gun violence.

Click here to see the 10 states with the worst gun violence.