America’s Drunkest States

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40. Maryland
> Adults drinking excessively: 15.5%
> Alcohol-related driving deaths: 32.8% (20th highest)
> Adults in fair or poor health: 13.3% (8th lowest)
> Drunkest metro area: California-Lexington Park, MD

Some 15.5% of adults in Maryland binge drink or drink heavily, which is less than the national share of American adults who drink in excess at 18.0%. According to the CDC, excessive alcohol consumption can lead to depression and anxiety — and Maryland’s low excessive drinking rate may help explain better than average mental health outcomes. Adults in the state report an average of just 3.4 mentally unhealthy days per month, fewer than the 3.7 day national average.

States with smaller shares of adults who drink excessively tend to have lower median household incomes. Maryland, however, is the exception. The median annual household income in the state of $78,945 is the highest of any state and over $20,000 above the national median of $57,617.

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39. Nevada
> Adults drinking excessively: 15.8%
> Alcohol-related driving deaths: 32.8% (21st highest)
> Adults in fair or poor health: 17.2% (17th highest)
> Drunkest metro area: Reno, NV

Nationwide, 18.0% of adults drink to excess, whereas in Nevada, only 15.8% of adults binge drink or drink heavily. Drinking large quantities of alcohol can lead to many health issues, yet states with lower shares of adults drinking excessively tend to be less healthy than those with higher shares. For example, the premature death rate is higher in Nevada than in most states — likely due to several factors other than alcohol consumption. For every 100,000 people in Nevada, 360 die before the age of 75.

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38. Arizona
> Adults drinking excessively: 16.0%
> Alcohol-related driving deaths: 27.6% (9th lowest)
> Adults in fair or poor health: 18.5% (11th highest)
> Drunkest metro area: Flagstaff, AZ

Binge drinking or drinking heavily are not healthy habits. Despite this, states with a lower portion of adults who drink in excess tend to report poorer health outcomes than those with larger portions of adults who drink excessively. In Arizona, 16.0% of adults engage in binge drinking or drinking heavily, less than the national average of 18.0%. Despite the lower excessive drinking rate, 18.5% of adults in the state report they are in fair or poor health, the 11th highest share of any state.

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37. Kentucky
> Adults drinking excessively: 16.3%
> Alcohol-related driving deaths: 28.5% (14th lowest)
> Adults in fair or poor health: 20.9% (7th highest)
> Drunkest metro area: Louisville/Jefferson County, KY-IN

Some 16.3% of Kentucky adults drink to excess, which is less than the comparable national share of 18.0%. Excessive drinking can lead to a slew of health conditions such as hypertension and liver disease. However, states with lower shares of adults who binge drink or drink heavily are typically less healthy than those with higher shares of adults who drink excessively. In Kentucky, nearly 21% of adults report they are in fair or poor health, the seventh highest share of all states. This could be because many of the states that report lower excessive drinking rates have lower incomes — and states with lower incomes and higher poverty rates tend to report less healthful behavior and worse health outcomes than wealthier states.

This appears to be the case in Kentucky, which is one of the poorest states in the country. The state reports 25.9% smoking rate among adults, the highest of any state. Also, 32.9% of state adults are obese, which is well above the national obesity rate of 28.0%.

36. South Carolina
> Adults drinking excessively: 16.6%
> Alcohol-related driving deaths: 37.8% (7th highest)
> Adults in fair or poor health: 17.0% (19th highest)
> Drunkest metro area: Hilton Head Island-Bluffton-Beaufort, SC

Some 16.6% of adults in South Carolina binge drink or drink heavily, which is below the 18.0% share of American adults who drink to excess. States with low incomes and high poverty rates tend to report worse health outcomes than wealthier states, and this is the case in South Carolina. The median income of households in the state is $49,501 a year, which is well below the nationwide median household income of $57,617. The poverty rate in South Carolina is 15.3%, one of the higher state poverty rates.

While drinking too much alcohol is unhealthy, it is only one factor that can cause adverse health effects. Obesity and smoking are some of the other factors. In South Carolina, 31.8% of adults are obese — the ninth highest share of any state — and the smoking rate is higher than the national average.