Excessive drinking patterns vary considerably by region. The states with the lowest excessive drinking rates are concentrated in the South, while most of the states with the highest excessive drinking rates are in the Midwest.

Because excessive drinking rates vary so much by state, excessive drinking in a state’s metro area reporting the highest rate may not be especially high compared to the rest of the country. The heaviest drinking metro areas in 13 states have lower excessive drinking rates than the U.S. rate of 18.0%.

Areas where residents report more excessive drinking often share several socioeconomic characteristics. For example, heavier drinking populations tend to have higher median incomes than areas where the population drinks less. Of the 50 metro areas on this list, 34 have a higher median household income than the state a whole.

Heavier drinking metro areas also tend to be relatively well educated. Of the 50 metro areas on this list, 34 are home to a larger share of adults with a bachelor’s degree than their respective state as a whole.

The overall health of a population is tied to a range of economic and lifestyle factors. While excessive drinking is never healthy, the metro areas with the highest excessive drinking rates are often home to healthier populations than their respective state’s population. Of the 50 cities on this list, 44 are home to a larger share of adults who report being in good health than the share across the state as a whole.

To identify the drunkest city in each state, 24/7 Wall St. reviewed the percentage of men and women over 18 who report binge or heavy drinking in each state’s metro areas. Metro level data were aggregated from county level data provided by County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. Health outcomes, including the number of deaths before age 75 per 100,000 people, also known as the premature death rate, and the percentage of adults who report fair or poor health were also aggregated from county-level data obtained from County Health Rankings & Roadmaps. All data are as of the most recent available year. Social and economic factors, including median household income and percentage of adults who have completed at least a bachelor’s degree came from the U.S. Census Bureau’s 2016 American Community Survey. Data on alcohol-induced mortality rates came from the CDC and are for 2015.