Objectives. We investigated the extent to which the political economy of US states, including the relative power of organized labor, predicts rates of fatal occupational injury. Methods. We described states’ political economies with 6 contextual variables measuring social and political conditions: “right-to-work” laws, union membership density, labor grievance rates, state government debt, unemployment rates, and social wage payments. We obtained data on fatal occupational injuries from the National Traumatic Occupational Fatality surveillance system and population data from the US national census. We used Poisson regression methods to analyze relationships for the years 1980 and 1995. Results. States differed notably with respect to political–economic characteristics and occupational fatality rates, although these characteristics were more homogeneous within rather than between regions. Industry and workforce composition contributed significantly to differences in state injury rates, but political–economic characteristics of states were also significantly associated with injury rates, after adjustment accounting for those factors. Conclusions. Higher rates of fatal occupational injury were associated with a state policy climate favoring business over labor, with distinct regional clustering of such state policies in the South and Northeast.