Traveling outside of the United States can be worrisome for most Americans who may not understand the customs of a different country or the lay of the land. A study out of Johns Hopkins University found that while most travelers are worried about drinking the water and transportation issues in a foreign country, road crashes actually cause most of the unnatural deaths among Americans who travel abroad.

"We know that the distribution of road traffic fatalities varies dramatically across different parts of the world," Huseyin Naci, from the London School of Economics and Political Science told Reuters. “While pedestrian deaths are more common in many parts of Africa, motorcycle and bicycle deaths occur more frequently in southeast Asia. One limitation of the study, which the authors acknowledge, is that we still do not know the characteristics of people who travel to different countries."

A research team headed up by Dr. David Bishai from the Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, used data from the U.S. State Department that represented 5,417 unnatural deaths between January 2003 and December 2009. The DoS spends around $51.6 billion each year to protect its citizens at home and abroad. Researchers calculated the rates of death by dividing the number of unnatural deaths by the number of Americans who visited each country.

Out of all the countries deemed unsafe for travel, Thailand ranked in first among the most traffic-related deaths with 16.5 deaths per one million visits, Reuters reported. Vietnam came in second with 15 deaths per one million visits, Morrocco third with 12 deaths per one million visits, and South Africa fourth with 11 deaths per one million visits. Researchers also reported that scooter and motorcycle deaths accounted a large portion of traffic-related deaths.

"We need more tourist-related research that gives us a better idea of exposure to road travel," said Dr. Stephen Hargarten, director of the Injury Research Center at Medical College of Wisconsin in Milwaukee told Reuters. "Wear your seatbelt, wear a helmet, avoid travel with unscheduled aircraft. You are going to these destinations, then you can lower your risk drastically by just not getting on a motorcycle or scooter."

To help American travelers plan a trip outside of the country, the U.S. Department Bureau of Consular Affairs issues Travel Warnings that includes countries with intense bouts of violence and crime government instability, civil war or frequent terrorist attacks. Country Specific Information is also a good travel tool. U.S. citizens can find detailed information on every country in the world including visa requirements, health and medical notices, crime and security information (including drug penalties) and hot spots that most tourists visit.