Special Report

America's Drunkest States

Detailed Findings & Methodology

The prevalence of excessive drinking varies substantially across the country. For example, the states with the highest rates of excessive drinking are concentrated in the Midwest. The states with with the lowest rates, on the other hand, are predominantly located in the South.

Roadway fatalities involving alcohol are one of the most common causes of preventable death in the United States. According to the CDC, nearly 30 people in the United States die in motor vehicle crashes involving an alcohol-impaired driver every single day. Overall, some 30.0% of all traffic fatalities nationwide involve alcohol. And this tragedy is costing the nation a significant amount of money. In a recent study, the CDC also found alcohol-related car crashes cost the U.S. economy over $44 billion each year.

Not surprisingly, states with higher excessive drinking rates are more likely to have deadly roadway accidents involving alcohol. Eight of the 10 states with the largest shares of adults binge drinking or drinking heavily have above average rates of alcohol-related roadway fatalities.

Excessive drinking is by no means healthy, yet the states with the highest excessive drinking rates tend to report better health outcomes than those with lower rates. Only three of the 15 states with the highest drinking rates report above average shares of adults in fair or poor health. In addition, seven of the 10 states with the highest excessive drinking rates report below average premature death rates.

24/7 Wall St. interviewed the director of the National Institute for Alcohol Abuse and Alcoholism, George Koob. Koob says there is a clear correlation between a state’s excessive drinking rate and income. Among the states with the highest excessive drinking rates, the annual median household income tends to be much greater than in states with lower drinking rates.

Of the 25 states with the highest excessive drinking rates, 14 have median annual household incomes that exceed the national figure of $57,617. Of the 10 states drinking the least, nine have median household incomes below the national median. One potential reason for this relationship is the fact that alcohol is expensive.

While there is a relationship between income and excessive drinking, Koob added that the pattern is complicated, and noted that while there is a correlation on the state level, “If you look at individuals, the pattern is somewhat different.” While indeed a larger share of affluent individuals drink excessively, “…they do so less heavily.” Similarly, while low-income individuals drink to excess less frequently, the amount of alcohol they consume tends to be greater when they do drink.

There are many other factors that can lead populations to binge drink and drink heavily beyond income, Koob explained. The reasons that may lead to more excessive drinking, such as availability of alcohol, taxes, cost of living, and even the weather, vary largely by state.

Overconsumption of alcohol is just one behavioral factor that that can negatively affect health. For example, smoking regularly and leading a sedentary life can also take a toll on health. Lung cancer and obesity are just two of the many poor health outcomes that can arise from such unhealthy behavioral factors.

To identify the drunkest states in America, 24/7 Wall St. reviewed the percentage of men and women over 18 who report binge or heavy drinking in every state. Excessive alcohol consumption, according to the CDC, includes binge drinking and heavy drinking. Binge drinking is defined as four or more drinks in a single occasion for women and five or more for men, and heavy drinking is defined as at least eight drinks per week for women and 15 for men. State data came from the County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program. Health outcomes, including the premature death rate, which is the number of deaths before age 75 per 100,000 people, and the percentage of adults who report being in fair or poor health also came from County Health Rankings & Roadmaps. All data are as of the most recent available year. Social and economic factors, including median household incomes and poverty rates, were retrieved 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.

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