America’s Drunkest States

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25. South Dakota
> Adults drinking excessively: 17.7%
> Alcohol-related driving deaths: 35.2% (11th highest)
> Adults in fair or poor health: 12.8% (5th lowest)
> Drunkest metro area: Sioux Falls, SD

The rate of adults drinking excessively in South Dakota is 17.7%, slightly less than the national share of 18.0%. Lower excessive drinking rates tend to reflect worse health outcomes, and as might be expected in a state with average excessive drinking, South Dakota’s health outcomes appear in line with the national average as well. Out of every 100,000 state residents, 323 die before the age of 75, just slightly below the national rate of 333 per 100,000.

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24. Washington
> Adults drinking excessively: 17.8%
> Alcohol-related driving deaths: 35.0% (12th highest)
> Adults in fair or poor health: 14.3% (18th lowest)
> Drunkest metro area: Seattle-Tacoma-Bellevue, WA

Some 17.8% of adults in Washington state drink excessively, slightly less than the comparable national share of 18.0%. States with lower shares of adults who are excessive drinkers tend to have lower incomes, and the opposite tend to be true in states where heavy drinking is more common. In Washington, the median household income is $67,106, somewhat higher than the national figure of $57,617.

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23. Rhode Island
> Adults drinking excessively: 17.9%
> Alcohol-related driving deaths: 40.4% (3rd highest)
> Adults in fair or poor health: 15.8% (24th highest)
> Drunkest metro area: Providence-Warwick, RI-MA

A total of 17.9% of adults in Rhode Island drink to excess — just below the national share of adults binge drinking or drinking heavily at 18.0%. States where adults drink at near the national rate also tend to have to report alcohol-related driving deaths similar to the country as a whole. In Rhode Island, however, some 40.4% of driving deaths were due to alcohol, the third highest alcohol-related driving death rate of any state and well above the national rate of 30.0%.

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22. California
> Adults drinking excessively: 18.0%
> Alcohol-related driving deaths: 29.0% (15th lowest)
> Adults in fair or poor health: 17.8% (15th highest)
> Drunkest metro area: Chico, CA

Some 18.0% of adults in California drink excessively, equivalent to the national excessive drinking rate. Wealthier states tend to report better health outcomes, likely because of better health care access and the ability to afford healthier lifestyles. In California, the median household income of $67,739 a year is nearly $10,000 greater than the national income of $57,617 and one of the wealthiest states in America.

Despite higher rates of drinking excessively, adults in California are some of the healthiest in all the country. Only 22.7% of adults are obese, the third lowest share among all states and well below the national obesity rate of 28.0%. In addition, only 11.7% of adults smoke, the second lowest share nationwide. Both low obesity and smoking rates may have positively contributed to the state’s low premature death rate. At 468 deaths before age 75 for every 100,000 state residents, it is the third lowest premature death rate of any state.

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21. Pennsylvania
> Adults drinking excessively: 18.1%
> Alcohol-related driving deaths: 32.0% (24th lowest)
> Adults in fair or poor health: 15.3% (25th lowest)
> Drunkest metro area: State College, PA

An estimated 18.1% of adults in Pennsylvania drink excessively, which slightly surpasses the national rate of 18.0%. Excessive drinking can lead to several serious health issues including cardiovascular disease and liver cancer. In Pennsylvania, where the excessive drinking rate is just slightly higher than the national rate, the premature death rate is also just slightly higher. For every 100,000 Pennsylvania residents, about 342 die before the age of 75, slightly more than the nationwide rate of 333 premature deaths per every 100,000.