5. Fargo, ND-MN
>Pct. adults drinking to excess: 25.2%
>Pct. driving deaths involving alcohol: 29.5%
>Premature death: 280 deaths before age 75 per 100,000
>Median household income: $53,867

As is the case with many of the cities with relatively high shares of heavy drinkers, Fargo has plenty of bars. There are 63 drinking establishments in the metro area, or about 2.8 bars for every 10,000 residents — enough to put Fargo among the top 50 U.S. cities with the most bars per capita.

4. Madison, WI
>Pct. adults drinking to excess: 25.5%
>Pct. driving deaths involving alcohol: 38.7%
>Premature death: 259 deaths before age 75 per 100,000
>Median household income: $60,903

Wisconsin tops all states in alcohol consumption, and more than half of the 20 cities on this list are in the state. In Madison, 25.5% of adults report heavy or binge drinking on a regular basis, fourth highest nationwide. While excessive drinking does not always lead to adverse outcomes, it may be causing serious problems in the Madison area. Of driving deaths in a given year, 38.7% are alcohol related, one of the highest percentages nationwide.

3. Green Bay, WI
>Pct. adults drinking to excess: 25.6%
>Pct. driving deaths involving alcohol: 47.5%
>Premature death: 290 deaths before age 75 per 100,000
>Median household income: $53,208

More than one in every four adults report heavy or binge drinking on a regular basis in the Green Bay area, nearly the highest excessive drinking rate in the country. While premature death in Green Bay is not more common compared to other metros, it would certainly be much lower if the current level of excessive drinking were to decline. Nearly half of all driving fatalities in Green Bay can be linked to alcohol consumption, the seventh highest percentage in the country.

2. Oshkosh-Neenah, WI
>Pct. adults drinking to excess: 26.0%
>Pct. driving deaths involving alcohol: 44.6%
>Premature death: 299 deaths before age 75 per 100,000
>Median household income: $52,387

In the Oshkosh-Neenah metro area, 26.0% of adults drink excessively, a considerably higher share than the corresponding 18.0% national rate. Excessive drinking is taking a heavy toll on metro area residents. Alcohol is involved in 44.6% of roadway fatalities in Oshkosh-Neenah, one of the highest shares in the country and far higher than the corresponding 31% national rate.

1. Appleton, WI
>Pct. adults drinking to excess: 26.8%
>Pct. driving deaths involving alcohol: 30.3%
>Premature death: 257 deaths before age 75 per 100,000
>Median household income: $60,106

Appleton is home to the largest share of binge and heavy drinkers in both Wisconsin and the country. According to the CDC, binge drinking is more common in households earning at least $75,000 annually. In Appleton, 38.5% of households earn that much, a higher share than the 35.6% of household nationwide earning at least this much. Also, for every 10,000 area residents, there are 4.4 drinking establishments, the ninth highest concentration of bars of any U.S. area.