Monroe County led the state last year in the rate of deaths by motor vehicle accidents and suicides.
That's according to the annual report from the Medical Examiners Commission. It tracks autopsies and causes of death throughout Florida.
The high rates of death from car accidents and suicides are part of a pattern for the Keys, according to Bob Eadie, administrator for the Florida Department of Health in Monroe County.
"Is it something that concerns me? Yes very much," he said. "Is it something that surprises me? No."
There are multiple reasons for the high accident rates, he said.
"It comes from being impaired while you're driving, to the fact that we have a two-lane road, one way in and out and people get impatient," he said.
About 75,000 people live in the Keys, but more than 5 million people visited the island chain last year.
Monroe has had one of the highest suicide rates in Florida for years, and the number increased after Hurricane Irma devastated parts of the island chain in 2017, disrupting and displacing people from homes and jobs.
"That's something we're working on right now very hard," Eadie said. "We're finishing up with a survey to see exactly how much we can attribute the suicides to the fallout from the storm and it seems like it's still impacting us."
Palm Beach County was sixth in the state on overdose rates and Broward was eighth.
Miami-Dade County had the highest number of violent deaths from all causes, with more than 1,600.
But it also has the highest population in the state. So it ranked last in the number of violent deaths per resident.
Miami-Dade did rank sixth in the state — and the highest in South Florida — in its homicide rate.