For many Americans, traveling for Fourth of July celebrations is a tradition, and this year is no different, with 72.2 million Americans expected to travel at least 50 miles from home during the week of July 4th.

And as Fourth of July festivities ramp up, so does a nationwide spike in injuries, with more than 45,000 Americans expected to end up in emergency rooms during the holiday. 

According to per diem healthcare staffing platform Nursa, Independence Day is the second most dangerous holiday in the US, with an estimated 47,000 ER visits in 2024 – an almost 15% increase on the average day. 

With this in mind, the experts at Nursa have revealed the most dangerous states to spend Independence Day.

Study highlights:

• North Dakota is the most dangerous state to spend Fourth of July in, scoring a July 4th Danger score of 8.88 out of 10 
• New Jersey is the safest state this Independence Day (5.04 out of 10)
• California reported the most Independence Day fires last year (604), followed by Texas (262) and Washington (251)
• South Dakota spends the most on fireworks at $12.29 worth of imports per person ($11,442,706 total)
• Texas had the most car accidents on Independence Day 2024 (18), followed by California (17)
• Car accidents increase the most in New Hampshire during July (120%)

Fireworks: The main cause of injury on July 4th

According to Nursa, the second most dangerous holiday is Independence Day, which saw an estimated 47,400 ER visits in 2024, a 14.8% increase in visits from the average day. The main offender of 4th of July injuries is fireworks. According to research, more than half of all fireworks-related injuries in the U.S. happen during the first eight days of July. The most common types of injuries on this holiday include burns (38%), bruises (19%), and cuts (15%). 

The Most Dangerous States to Spend Independence Day

Rank	State	Unintentional fatal injury rates per 100k people	Alcohol consumption per person 2023 (gallons)	Excessive drinking rate 2023	Driving fatalities involving alcohol (2023)	Arrests July 2025	July 4th car accidents (2024)	July driving accidents (2024)	July car accident increase (2024)	July 4th fires (2025)	Total firework import value ($US)	Max day temperature °F (July 2026)	July 4th Danger Score /10
1	North Dakota	52	3.16	24.7%	46.7%	2,966	1	380	42.86%	55	$2,344,100	84.2	8.88
2	Montana	64	3.1	21.8%	46.3%	2,617	1	720	49.22%	20	$3,960,932	82.4	8.70
3	South Dakota	58	2.37	17.7%	35.2%	3,885	4	874	70.15%	15	$11,442,706	86.0	8.51
4	Missouri	70	2.51	17.7%	31.7%	12,241	3	2523	18.37%	161	$72,903,308	89.6	8.19
5	Nebraska	43	2.16	20.4%	35.6%	4,994	1	682	18.39%	31	$9,497,272	87.8	7.88
6	Wisconsin	71	2.93	24.5%	36.9%	16,351	2	2310	-4.73%	62	$6,979,960	80.6	7.86
7	Wyoming	63	2.78	17.5%	35.3%	1,723	1	280	-41.18%	6	$2,308,312	82.4	7.63
=8	Nevada	59	3.42	15.8%	32.8%	10,059	0	800	-20.63%	49	$5,368,909	105.8	7.46
=8	Oregon	63	2.74	18.8%	32.8%	10,907	0	2378	41.75%	143	$1,321,764	80.6	7.46
=8	Colorado	65	2.88	19.1%	34.7%	16,283	1	600	40.19%	83

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