There are more horses and more race days annually in the U.S. than there are in any other racing country. With horse racing in 37 states, the U.S. makes up the largest racing market in the world. Safety and welfare in horse racing is currently regulated across the country at the level of state government, and racing injury and fatality rates vary across states. In California, in the wake of effective reforms implemented during the Santa Anita Park meet that ended on June 23, the 2019 racing fatality rate has declined by more than 50%, to 1.86 per 1,000 racing starts, a figure comparable to the national average of 1.68, as measured by the Equine Injury Database maintained by the Jockey Club. Recent medication and safety protocol reforms in California are designed to align horse racing in the state with the standards of the International Federation of Horseracing Authorities and to further reduce the risk of catastrophic injury.