41. South Dakota
> Drunkest city: Sioux Falls
> Pct. of MSA adults binge or heavy drinking: 19.4%
> Pct. of state adults binge or heavy drinking: 18.3%
> Pct. of alcohol related driving deaths: 30.5%
Compared with South Dakota, Sioux Falls is healthier by several measures. Metro residents report a lower incidence of premature death. Also, just 11% of adults report being in fair or poor health, lower than the statewide percentage of 13.2% — itself one of the lower shares in the nation. The relative health of the city’s population is despite the higher share of excess alcohol consumption, which can lead to harmful health consequences.
Economic prosperity among Sioux Falls residents — the median household income of nearly $60,000 annually is well above both the state and national median incomes — largely explains the health outcomes as well as the alcohol consumption. According to the CDC, people earning $75,000 annually or more are among the most likely to drink excessively. At the same time, wealthier people tend to report better health.
> Drunkest city: Nashville-Davidson–Murfreesboro–Franklin
> Pct. of MSA adults binge or heavy drinking: 13.5%
> Pct. of state adults binge or heavy drinking: 11.6%
> Pct. of alcohol related driving deaths: 26.3%
Trailing only West Virginia, Tennessee has the second lowest excessive drinking rate in the country. Even in Nashville, the state’s heaviest drinking metro area, only 13.5% of adults are excessive drinkers, a far smaller share than the national 18.0% excessive drinking rate.
Relatively low rates of alcohol abuse do not mean the area is devoid of bad habits. Slightly more than 21% of adults in Nashville and 24% of adults across the state identify as smokers, well above the 17% nationwide smoking rate.
> Drunkest city: Austin-Round Rock
> Pct. of MSA adults binge or heavy drinking: 21.5%
> Pct. of state adults binge or heavy drinking: 17.4%
> Pct. of alcohol related driving deaths: 34.9%
The Austin-Round Rock region is the heaviest drinking metro area in a state with relatively low alcohol consumption levels. The share of adults in the Austin area who drink excessively is 21.5%, well above the national percentage of 18.0%, while the share in Texas of 17.4% is lower. Excessive drinking in a community does not necessarily increase the likelihood of drunk driving, but high alcohol consumption may partially explain such risky behavior in the Austin area. Alcohol is involved in 34.9% of driving deaths in the area, higher than both the state and national rates.
Since people — especially white men — who earn $75,000 or more annually are among the most likely to drink excessively, higher incomes may help explain the excessive drinking in Austin-Round Rock. The typical household earns $67,195 a year, well above the median incomes in Texas and the U.S.
> Drunkest city: Salt Lake City
> Pct. of MSA adults binge or heavy drinking: 14.1%
> Pct. of state adults binge or heavy drinking: 12.1%
> Pct. of alcohol related driving deaths: 21.8%
Utah has one of the lowest excessive drinking rates of any state in the country. This may not come as a surprise, as more than half of the state’s population identifies as Mormon, a religion that strongly discourages alcohol consumption.
Of the state’s five metro areas, Salt Lake City has the highest share of excessive drinkers. Still, the 14.1% of adults who either binge or heavily drink in the Salt Lake metro area, is relatively small when compared to the 18.0% share of American adults who drink to excess. The relatively infrequent heavy drinking in the Salt Lake metro area likely contributes to healthier communities. Adults in the capital city metro area are more likely to report good overall health and more likely to live to age 75 than Americans in general.
> Drunkest city: Burlington-South Burlington
> Pct. of MSA adults binge or heavy drinking: 23.0%
> Pct. of state adults binge or heavy drinking: 20.6%
> Pct. of alcohol related driving deaths: 32.4%
The Burlington region is the only metropolitan area in Vermont, which means it is by default the heaviest drinking area in the state.
Burlington, with a median household income of $66,807 a year, is one of the wealthier metro areas in the country and the highest income area in Vermont. Because binge drinking is most common among people — particularly white men — earning $75,000 or more annually, the higher incomes in Burlington could explain the metro’s similarly high excessive drinking rate. At 23% of adults, it is slightly higher than the percentage across Vermont, itself one of the higher figures compared with other states.