Michigan County has Nation’s Highest Rate of Death vs. Birth Rate
Business Insider has the latest numbers from the U.S. Census Bureau including "the 10 counties with the largest natural decreases" in population.
More specifically, this addresses "change in population caused by the total number of births in a county minus the total number of deaths."
Michigan counties hold three of the top ten spots including the top spot.
Ontonagon County had the highest natural net deaths per 1,000 births from July 1, 2015 to July 1, 2016 with 13.6 deaths per 1,000 births.
Alcona County ranked sixth with 11.0 deaths per 1,000 births.
Montmorency County ranked eighth with 10.8 deaths per 1,000 births.
It's not surprising to find a northern Michigan county on this list. Having a small population makes it easier to move the death-per-1,000 ratio, but it is a bit surprising to see three Michigan counties in the top ten.
There are many other sparsely population areas of the country to compete for these spots, but Michigan dominates the list for 2015 - 2016.