Detailed findings & methodology:

Across broad populations, excessive alcohol consumption rates appear associated with some economic factors. Alcohol is expensive, and an individual’s ability to drink to excess can be limited by their income. Partially as a result, the cities with the lowest excessive drinking rates tend to have lower incomes, and vice-versa.

Of the 20 metro areas with the lowest excessive drinking rates, 18 have a lower median household income than the national annual median of $57,617. Meanwhile, median household incomes in 11 of the metro areas with the highest excessive drinking rates exceed the national median.

Social factors also play a role. In Wisconsin, alcohol consumption is, for many, an integral part of the state’s culture. Half of the heaviest drinking cities are in Wisconsin. On the other end of the spectrum, large segments of the population in Utah are teetotalers. Over 60% of the state’s population identify as Mormon, a religion that teaches its followers to avoid alcohol consumption. Four of Utah’s five metro areas rank among the cities with the lowest excessive drinking rates.

While the health risks associated with excessive alcohol consumption are well established, a large share of excessive drinkers often does not translate to poor health outcomes across a population. Alcohol consumption is just one of a multitude of factors that can affect personal well-being. In fact, because cities with higher excessive drinking rates also tend to have higher incomes, residents can afford healthier diets and lifestyles than lower-income residents in many cities with low excessive drinking rates.

Partially as a result, just one of the 20 cities with the highest excessive drinking rates is home to a larger share of adults in fair or poor health than the 16.0% national average. Meanwhile, 16 of the 20 cities with the lowest excessive drinking rates are home to a larger than typical share of adults in sub-optimal health.

Similarly, fatal car accidents that involve alcohol are not necessarily more common in the cities with the highest excessive drinking rates. Nationwide, 30% of all driving deaths involve alcohol. In eight of the cities with the lowest excessive drinking rates and in 11 of the cities with the highest excessive drinking rates, the share is higher than the nationwide rate.

Business patterns in the cities on both sides of this list also reflect residents’ drinking habits. Nationwide, there are 184 bars and restaurants for every 100,000 people. The concentration of such drinking establishments is higher in all but four of the cities with the highest excessive drinking rates. Meanwhile, only two of the cities with the lowest excessive drinking rates have a higher than average concentration of bars and restaurants.

To identify the U.S. metro areas with the highest and lowest excessive drinking rates, 24/7 Wall St. reviewed the percentage of adults 18 and older who report binge or heavy drinking within a 30 day period across 381 metro areas. Metro-level data was 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. All excessive drinking data is as of 2016. Median household incomes, poverty rates, and share of the population in college or graduate school came from the U.S. Census Bureau’s 2016 American Community Survey. The number of bars and restaurants per 100,000 people is also as of 2016 and comes from County Business Patterns, a program maintained by the Census. Health outcomes and factors, including the percentage of adults who report being in fair or poor health and the share of driving deaths that involved alcohol were also aggregated from county-level data obtained from County Health Rankings & Roadmaps and are for the most recent years available.