21. Massachusetts
> Drunkest city: Pittsfield
> Pct of MSA adults binge or heavy drinking: 21.3%
> Pct. of state adults binge or heavy drinking: 19.5%
> Pct of driving deaths alcohol related: 25.4%

Massachusetts is one of 11 states where happy hour deals are outlawed. Nevertheless, nearly one-fifth of Massachusetts adults drink excessively, a higher share than in all but five other states. High rates of heavy and binge drinking are widespread across Massachusetts, and one metropolitan area leads the state — Pittsfield. Among Pittsfield adults, 21.3% report heavy drinking or binge drinking, slightly higher than the state proportion of 19.5% and well above the national share of 15.0%.

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22. Michigan
> Drunkest city: Monroe
> Pct of MSA adults binge or heavy drinking: 22.0%
> Pct. of state adults binge or heavy drinking: 18.3%
> Pct of driving deaths alcohol related: 35.8%

Across the United States, 15.0% of adults drink excessively. In Monroe, the Michigan metropolitan area with the highest share of adults drinking to excess, 22.0% do so. Widespread heavy and binge drinking in a city can increase the health risks among its population. Almost 36% of driving deaths in Monroe are alcohol related, about 5 percentage points higher than both the state and national figures.

23. Minnesota
> Drunkest city: Duluth
> Pct of MSA adults binge or heavy drinking: 20.7%
> Pct. of state adults binge or heavy drinking: 19.3%
> Pct of driving deaths alcohol related: 42.1%

Almost 21% of Duluth residents report an excessive drinking habit, slightly higher than Minnesota’s share of 19.3%, and well above the national proportion of 15.0%. Excessive alcohol use is tied to a variety of poor health outcomes. However, while Minnesota has one of the higher heavy and binge drinking rates of any state, it has the among the best health outcomes nationwide. Just 10.5% of Minnesota adults report fair or poor health, the lowest share of any state. Duluth adults are similarly healthy, with just 10.3% of adults reporting fair or poor health.

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24. Mississippi
> Drunkest city: Gulfport-Biloxi-Pascagoula
> Pct of MSA adults binge or heavy drinking: 13.9%
> Pct. of state adults binge or heavy drinking: 11.5%
> Pct of driving deaths alcohol related: 27.6%

In Gulfport-Biloxi-Pascagoula, 13.9% of adults report an excessive drinking habit. While this is the highest of any metro area in the state, it is a relatively small share compared to the rest of the country, where 15.0% of adults report heavy or binge drinking. Just 11.5% of Mississippi residents report drinking to excess, the fourth smallest share of any state. Despite its relatively sensible alcohol consumption, Mississippi has one of the least healthy populations in the country. Across the state, 21.5% of adults report being in fair or poor health, the highest share nationwide.

25. Missouri
> Drunkest city: St. Louis
> Pct of MSA adults binge or heavy drinking: 22.0%
> Pct. of state adults binge or heavy drinking: 17.0%
> Pct of driving deaths alcohol related: 38.3%

Missouri has some of the lowest alcohol taxes nationwide. Perhaps as a result, 17.0% of Missouri adults report heavy or binge drinking, compared to the national share of 15.0%. In St. Louis, meanwhile, 22.0% of adults report excessive drinking. St. Louis is less healthy than the state and the nation as a whole, which may be due at least in part to its population’s drinking habits. An aggregate 8,036 years of potential life per 100,000 people are lost each year due to premature death, compared to 7,714 years in the state and 6,622 years of life lost nationwide.