Fewer births and an increasingly older population can lead to an imbalance with more deaths than births in a state. Pennsylvania leads all states with a natural population change—or the difference between births and deaths—of 10,708 people. Mississippi and Alabama both saw more than 2,000 deaths that exceeded births, while Arkansas lost more than 1,200 from natural population change. There are 17 states where deaths now outnumber births. Texas leads all states with 157,711 more births than deaths, followed by second-place California with a 109,715 increase in natural population.