Special Report
The Drunkest City in Each State
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Alcohol abuse cost the United States $250 billion in 2010, according to a 2015 study from the Centers for Disease Control and Prevention. These costs include health care expenses associated with alcohol consumption as well as estimated lost productivity. Binge drinking was related to three-quarters of the total cost. Residents of different states report different drinking habits, as do residents of metropolitan areas within each state.
The CDC defines binge drinking as the consumption of four or more drinks for women and five or more drinks for men during a single occasion. Heavy drinking is defined as the consumption per week of 15 or more drinks for men, and typically eight or more drinks for women.
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24/7 Wall St. reviewed the metropolitan areas reporting the highest levels of binge and heavy drinking in each state. Appleton, the drunkest city in Wisconsin, also leads the nation with 26.8% of adults reporting excessive drinking in the metropolitan area. The Nashville-Davidson–Murfreesboro-Franklin, Tennessee metro area, where 13.5% of adults report such a drinking habit, is the booziest city in Tennessee. Nationwide, 87.6% of adults have drank alcohol at some point in their lives, 71.0% consumed alcohol in the past year, 56.9% say they drank in the past month, and 18.0% of adults report excessive drinking.
Click here to see the drunkest city in each state.
While there can be health benefits to moderate drinking as an adult, consuming excessive amounts of alcohol is associated with a range of health problems. Close to 88,000 people die from alcohol-related causes each year, and one in 10 deaths among U.S. adults is due to excessive drinking. According to the National Institute of Health, alcohol is the fourth leading cause of preventable death in the United States.
While it is established that excessive drinking can lead to negative health outcomes, drinking is only one of the many factors that can affect the health of a population. For this reason, many of the cities with high rates of excessive alcohol consumption do not exhibit the negative consequences that might be expected to accompany alcohol abuse.
For example, just under half of the cities with the highest rates of alcohol consumption in their state report an above average incidence of premature death. Similarly, in slightly less than half of the 50 cities, relatively more adults report being in fair or poor health than the average nationwide.
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 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. 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 characteristics, 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 2015 American Community Survey.
These are the drunkest cities in each state.
1. Alabama
> Drunkest city: Auburn-Opelika
> Pct. of MSA adults binge or heavy drinking: 16.2%
> Pct. of state adults binge or heavy drinking: 13.3%
> Pct. of alcohol related driving deaths: 28.1%
More than 16% of adults in the Auburn-Opelika metro area report heavy drinking or binge drinking — defined as at least five drinks for men and four drinks for women on a single occasion — in the past 30 days, according to the CDC.
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While Auburn’s excessive drinking rate is the highest of any of the state’s dozen metro areas, it is relatively low when compared to other metro areas in the country. Nationwide, 18% of American adults report binge or heavy drinking in the last month.
2. Alaska
> Drunkest city: Fairbanks
> Pct. of MSA adults binge or heavy drinking: 23.0%
> Pct. of state adults binge or heavy drinking: 21.7%
> Pct. of alcohol related driving deaths: 36.7%
People with higher incomes are more likely to drink to excess than those with lower incomes. In Alaska, the typical household earns $73,355 a year, about $17,000 more than the typical American household. Not surprisingly, more than one in five adults in the state identify as excessive drinkers, compared to 18% of American adults.
Binge and heavy drinking in Alaska is somewhat concentrated in the state’s two main metro areas, Anchorage and Fairbanks. At 22.9% and 23.0% respectively, both metro areas have even higher excessive drinking rates than the state a whole.
3. Arizona
> Drunkest city: Flagstaff
> Pct. of MSA adults binge or heavy drinking: 19.2%
> Pct. of state adults binge or heavy drinking: 16.6%
> Pct. of alcohol related driving deaths: 24.9%
In the Flagstaff metro area, 19.2% of adults report unhealthy drinking habits, the highest share of any metro area in Arizona. Unhealthy behavior in the metro area does not stop with alcohol. Roughly one in five area adults identify as smokers, a larger rate than both the national and state smoking rates of 17.0% and 16.5% respectively.
Bad habits may be putting Flagstaff residents at greater risk of early death. In the Flagstaff metro area, just 324 out of every 100,000 residents die before the age of 75 due to preventable causes, compared to the national premature death rate of 474 per 100,000.
4. Arkansas
> Drunkest city: Fayetteville-Springdale-Rogers
> Pct. of MSA adults binge or heavy drinking: 16.0%
> Pct. of state adults binge or heavy drinking: 14.3%
> Pct. of alcohol related driving deaths: 35.2%
Adults in Arkansas are among the least likely in the country to report unhealthy drinking habits. Even in the Fayetteville-Springdale-Rogers metro, the area with the largest share of excessive drinkers in the state, only 16% of adults are heavy or binge drinkers, slightly lower than national 18% excessive drinking rate.
People with higher incomes are statistically more likely to drink excessively than people with lower incomes, and Fayetteville is an apt example of the pattern. The median income in Fayetteville of $50,788 a year is roughly $8,800 more than the median annual income statewide.
5. California
> Drunkest city: San Luis Obispo-Paso Robles-Arroyo Grande
> Pct. of MSA adults binge or heavy drinking: 20.1%
> Pct. of state adults binge or heavy drinking: 17.2%
> Pct. of alcohol related driving deaths: 32.3%
Roughly one in five adults in the San Luis Obispo metro area report drinking to excess in the past month. While the potential health consequences associated with alcohol consumption are well established, metro area residents tend to be relatively healthy. Only 13.1% of area adults report being below optimal health, far less than the 18.1% statewide share and the 14.0% national share.
Still, high alcohol consumption may be taking its toll on metro area residents in other ways. Across the San Luis Obispo metro area, 32.3% of roadway fatalities involve alcohol, a larger share than both the state and nationwide figures.
6. Colorado
> Drunkest city: Denver-Aurora-Lakewood
> Pct. of MSA adults binge or heavy drinking: 20.6%
> Pct. of state adults binge or heavy drinking: 19.0%
> Pct. of alcohol related driving deaths: 35.0%
By many measures of both behavior and outcomes, Denver is one of the healthiest metro areas in the country. Adults in the city are more likely to live full lives, less likely to be obese, and more likely to exercise than most American adults. However, one major exception is the high share of adults in the area who drink excessively. More than one in five Denver area adults report binge or heavy drinking within the past month, more than in any other metro area across the state.
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Alcohol is closely linked to the metro area’s identity and economy. The city of Denver alone is home to dozens of breweries, including Blue Moon Brewing Company and Flying Dog Brewery.
7. Connecticut
> Drunkest city: Norwich-New London
> Pct. of MSA adults binge or heavy drinking: 19.7%
> Pct. of state adults binge or heavy drinking: 17.6%
> Pct. of alcohol related driving deaths: 36.0%
Adults in the Norwich-New London area are more likely to drink excessively than adults in any of Connecticut’s four metro areas. While alcohol abuse can come with negative, often serious consequences, area residents tend to be relatively healthy. The Norwich metro area has one of the lower premature death rates in the country, and area residents are far less likely to report feeling unhealthy than Americans on the whole.
Still, excessive drinking does not appear to be consequence-free in the Norwich-New London metro area. Alcohol is involved in 36.0% of all area roadway fatalities, more than the corresponding state and national rates of 33.2% and 31.0% respectively.
8. Delaware
> Drunkest city: Dover
> Pct. of MSA adults binge or heavy drinking: 15.3%
> Pct. of state adults binge or heavy drinking: 17.2%
> Pct. of alcohol related driving deaths: 46.5%
As the only metro area in Delaware, Dover has the highest share of excessive drinkers in the state by default. Dover is perhaps undeserving of the title as the share of adults who identify as heavy or binge drinkers is greater statewide than it is in the city. Only 15.3% of adults in the Dover metro area drink excessively, compared to 17.2% of adults statewide.
Despite lower binge and heavy drinking rates, an outsized share of deadly car accidents in the metro area involve alcohol. Nearly 47% of all roadway fatalities in Dover involve alcohol, nearly the highest share of any of the country’s 381 metro areas.
9. Florida
> Drunkest city: Tallahassee
> Pct. of MSA adults binge or heavy drinking: 21.2%
> Pct. of state adults binge or heavy drinking: 17.0%
> Pct. of alcohol related driving deaths: 34.3%
Of Florida’s 22 metro areas, Tallahassee has the highest share of adults who report drinking to excess in the past month at 21.2%. Across the state, only 17% of adults report an unhealthy drinking habit.
Bad habits do not stop with excessive drinking in Florida’s capital. Area residents are also more likely to be obese and identify as smokers than the typical Floridian. It is likely that the residents’ excessive alcohol consumption and other unhealthy habits have, at least partially, contributed to a higher premature death rate in the area. Tallahassee residents are more likely to die from preventable causes before age 75 than is typical across the state.
10. Georgia
> Drunkest city: Hinesville
> Pct. of MSA adults binge or heavy drinking: 18.3%
> Pct. of state adults binge or heavy drinking: 15.6%
> Pct. of alcohol related driving deaths: 28.1%
Excessive alcohol consumption is relatively rare in Georgia. Of all 14 metro areas in the Peach State, Hinesville has the highest share of adults who drink excessively, at 18.3%. Still, this is only slightly higher than the 18.0% national share.
While alcohol abuse does not necessarily lead to negative health outcomes, adults in Hinesville are more likely to be obese and less likely to report being in good health than the typical Georgia resident.
11. Hawaii
> Drunkest city: Kahului-Wailuku-Lahaina
> Pct. of MSA adults binge or heavy drinking: 22.6%
> Pct. of state adults binge or heavy drinking: 21.1%
> Pct. of alcohol related driving deaths: 44.6%
In the Kahului-Wailuku-Lahaina metro area, 22.6% of adults binge drink or drink heavily. In Urban Honolulu, Hawaii’s only other metro area, only 20.1% of adults drink excessively.
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Just as heavy drinking is more common in the Kahului metro area, so too are alcohol-related roadway deaths. Nearly 45% of all driving deaths in the Kahului region involve alcohol, a higher share than across the state, the country, and all but a dozen other U.S. metro areas.
12. Idaho
> Drunkest city: Coeur d’Alene
> Pct. of MSA adults binge or heavy drinking: 18.1%
> Pct. of state adults binge or heavy drinking: 16.1%
> Pct. of alcohol related driving deaths: 31.4%
Adults in Idaho are less likely than the typical American to report unhealthy drinking habits. In Coeur d’Alene — the metro area with the highest excessive drinking rate in the state — only 18.1% of adults report drinking to excess in the past month, slightly higher than the corresponding national rate of 18.0%.
While higher excessive drinking rates sometimes indicate unhealthy lifestyles overall, people tend to be in good health in Coeur d’Alene. Area adults report fewer days of poor mental and physical health and are less likely to be obese than the typical American.
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13. Illinois
> Drunkest city: Bloomington
> Pct. of MSA adults binge or heavy drinking: 22.2%
> Pct. of state adults binge or heavy drinking: 21.4%
> Pct. of alcohol related driving deaths: 31.5%
All 10 metro areas in Illinois have a higher excessive drinking rate than the nation as a whole. In Bloomington, 22.2% of adults report binge drinking or drinking heavily in the past month, the highest share in the state.
Heavy drinking alone does not explain risky behavior in a community, but it may help explain the high prevalence of sexually transmitted diseases in Bloomington. For every 100,000 metro area residents, there are 510 cases of chlamydia, considerably more than the 447 cases per 100,000 people nationwide.
14. Indiana
> Drunkest city: Bloomington
> Pct. of MSA adults binge or heavy drinking: 17.3%
> Pct. of state adults binge or heavy drinking: 15.8%
> Pct. of alcohol related driving deaths: 25.0%
Of the dozen metro areas across Indiana, Bloomington has the largest share of adults who report drinking excessively. While the area’s self-reported rate of binge and heavy drinking is high compared to the state’s rate of 15.8%, it is relatively modest on a national scale — at 17.3% versus 18.0% nationwide.
While alcohol abuse is not healthy, excessive drinking has either not taken a meaningful toll on Bloomington residents’ health, or is mitigated by other factors. People in Bloomington are less likely to die before age 75, be in fair or poor health, or be obese than the average Indiana resident.
15. Iowa
> Drunkest city: Ames
> Pct. of MSA adults binge or heavy drinking: 24.4%
> Pct. of state adults binge or heavy drinking: 22.3%
> Pct. of alcohol related driving deaths: 11.8%
Residents of all eight metro areas in Iowa report higher excessive drinking rates than the nation as a whole. In Ames, 24.4% of adults report heavy or binge drinking — the largest share in the state and the eighth highest in the country.
While heavy drinking can potentially lead to impaired judgement and risky situations, a higher than typical share of drinkers in Ames appear to understand those risks. Only 11.8% of deadly car accidents in the area involve alcohol, one of the smallest shares in the country and well below the 31.0% nationwide share.
16. Kansas
> Drunkest city: Manhattan
> Pct. of MSA adults binge or heavy drinking: 21.0%
> Pct. of state adults binge or heavy drinking: 17.1%
> Pct. of alcohol related driving deaths: 11.1%
Excessive alcohol consumption is never healthy. However, in Manhattan, Kansas, the heaviest drinking metro area in the state, residents report far better than average health outcomes. Despite the area’s 21.0% excessive drinking rate, Manhattan residents are less likely to be obese, be in poor health, or die prematurely than residents across the state.
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Healthier outcomes in the area are likely the result of habits and behaviors unrelated to alcohol. Only 18.7% of area adults never make time for physical activity, and only 16.6% report a smoking habit, below the respective 24.6% and 18.1% statewide rates.
17. Kentucky
> Drunkest city: Louisville/Jefferson County
> Pct. of MSA adults binge or heavy drinking: 15.5%
> Pct. of state adults binge or heavy drinking: 13.6%
> Pct. of alcohol related driving deaths: 27.3%
While many may recognize Kentucky as the birthplace of American bourbon, adults in the state are far less likely to have unhealthy drinking habits than the average American. Statewide, only 13.6% of adults report either heavy or binge drinking in the past month, well below the 18.0% share of American adults. Lower than average excessive drinking rates are likely due to the fact that several dozen counties in the state are completely dry, meaning that the sale of any alcoholic beverage is prohibited.
No part of the Louisville/Jefferson County metro area is dry. The region is also the heaviest drinking metro area in the state. Of adults in Louisville, 15.5% report either binge or heavy drinking in the last 30 days.
18. Louisiana
> Drunkest city: New Orleans-Metairie
> Pct. of MSA adults binge or heavy drinking: 19.4%
> Pct. of state adults binge or heavy drinking: 17.7%
> Pct. of alcohol related driving deaths: 30.2%
Residents of the New Orleans metro area, which includes Metairie, are the heaviest drinkers in Louisiana. Nearly one in five adults in the area report binge or heavy drinking at least once per month. Like a number of other southern cities, New Orleans does not restrict drinking in public — a feature that shapes the dining and nightlife culture in New Orleans for residents and tourists alike.
Residents of cities where excessive drinking is prevalent are not necessarily more likely to engage in other unhealthy behaviors. In the New Orleans area, however, 20.6% of adults are smokers, and 28.6% do not exercise in their leisure time — each among the highest percentages in the nation.
19. Maine
> Drunkest city: Portland-South Portland
> Pct. of MSA adults binge or heavy drinking: 20.6%
> Pct. of state adults binge or heavy drinking: 19.0%
> Pct. of alcohol related driving deaths: 37.3%
The residents of affluent regions of the country are more likely to drink to excess than those living in poorer communities. The typical household in the Portland metro area earns $62,074 a year, about $10,600 more than the statewide median income. The Portland area also has a slightly higher excessive drinking rate than the state as whole. More than one in five metro area adults drank to excess in the last 30 days compared to 19% of adults in Maine.
The higher excessive drinking rate in the metro area could help explain the area’s roadway fatality statistics. Of all fatal car accidents in Portland, 37.3% involved alcohol, a higher share than across both Maine and the country as a whole.
20. Maryland
> Drunkest city: California-Lexington Park
> Pct. of MSA adults binge or heavy drinking: 20.0%
> Pct. of state adults binge or heavy drinking: 16.8%
> Pct. of alcohol related driving deaths: 27.3%
In the California-Lexington Park metro area, one in five adults drink excessively, the highest share of any metro area in Maryland. People living in more affluent regions of the country are more likely to drink to excess than those living in poorer communities, and California-Lexington Park is one of the wealthiest metro areas in the country. The typical area household earns $85,163 a year, more than all but three other U.S. metro areas.
21. Massachusetts
> Drunkest city: Boston-Cambridge-Newton
> Pct. of MSA adults binge or heavy drinking: 20.5%
> Pct. of state adults binge or heavy drinking: 19.6%
> Pct. of alcohol related driving deaths: 30.9%
All five metro areas in Massachusetts have a larger share of adults who drink excessively than the corresponding 18% national figure. Within the Boston metro area, 20.5% of adults report either binge or heavy drinking in the last month, the highest share in the state.
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While excessive drinking is relatively common in Boston, others unhealthy activities are not. Only 14% of area adults identify as smokers, a smaller share than both the state and national smoking rates. Additionally, Boston metro area residents are more likely to exercise in their leisure time than the typical American or Massachusetts resident.
22. Michigan
> Drunkest city: Monroe
> Pct. of MSA adults binge or heavy drinking: 22.9%
> Pct. of state adults binge or heavy drinking: 20.4%
> Pct. of alcohol related driving deaths: 37.9%
Monroe is the heaviest drinking metro area in one of the heaviest drinking states in the country. Nearly 23% of adults in Monroe and more than 20% of adults across Michigan drink excessively.
The relatively high alcohol consumption may partially explain Monroe’s drunk driving problem. About 38% of the area’s traffic fatalities involve alcohol, a far larger share than is typical nationwide.
23. Minnesota
> Drunkest city: Mankato-North Mankato
> Pct. of MSA adults binge or heavy drinking: 24.2%
> Pct. of state adults binge or heavy drinking: 21.2%
> Pct. of alcohol related driving deaths: 20.8%
Adults in the Mankato metro area are far more likely to drink excessively than the typical adult nationwide. Slightly more than 24% of Mankato adults report drinking excessively in the last 30 days, a larger share than in all metro areas in Minnesota and all but nine other metros nationwide. Mankato residents are also slightly more likely to be smokers than the typical Minnesota resident.
While certain unhealthy habits, such as smoking and excessive drinking, often lead to negative health outcomes, their effect on the Mankato population appears to be minimal. Mankato metro area residents are less likely to die before age 75 than the broader population across the state.
24. Mississippi
> Drunkest city: Gulfport-Biloxi-Pascagoula
> Pct. of MSA adults binge or heavy drinking: 15.3%
> Pct. of state adults binge or heavy drinking: 13.8%
> Pct. of alcohol related driving deaths: 24.5%
Located on the state’s southern border along the Gulf of Mexico, Gulfport-Biloxi-Pascagoula metro area residents tend to be far healthier than people across Mississippi. Adults in the area are less likely to be obese or be a smoker, and more likely to exercise than the typical adult in Mississippi.
Slightly more than 15% of area adults have either binge or heavily drank in the last 30 days, however, more than in any other state metro area. Excessive drinking is only one aspect of an individual’s overall health. So although excessive drinking is far less common in Mississippi than nationwide, the state consistently ranks as one of the least healthy.
25. Missouri
> Drunkest city: Columbia
> Pct. of MSA adults binge or heavy drinking: 19.0%
> Pct. of state adults binge or heavy drinking: 16.1%
> Pct. of alcohol related driving deaths: 45.6%
In Columbia, 19% of adults drink excessively, more than in any of Missouri’s seven other metro areas. While excessive alcohol consumption does not necessarily cause major problems in a population, it appears to be an issue in Columbia. Alcohol is involved in 45.6% of all fatal car accidents in the area, nearly the largest share of any metro area in the country.
According to national advocacy group Mothers Against Drunk Driving, Missouri could reduce drunk driving fatalities by mandating ignition interlocks for all convicted drunk drivers and adding additional penalties for offenders driving with young passengers.
26. Montana
> Drunkest city: Missoula
> Pct. of MSA adults binge or heavy drinking: 23.8%
> Pct. of state adults binge or heavy drinking: 20.8%
> Pct. of alcohol related driving deaths: 48.6%
Missoula is the heaviest drinking metro area in Montana. Nearly 24% of area adults drink excessively, a larger share than in all but a dozen other U.S. metros. Excessive drinking can lead to long term health problems, but sometimes poor judgement can make the consequences more immediate. Of all fatal car accidents in the Missoula metro area, close to half involve alcohol, nearly the highest proportion anywhere in the country.
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According to national advocacy group Mothers Against Drunk Driving, Montana ranks among the worst states in the country for its legislation aimed at reducing rates of alcohol impaired driving.
27. Nebraska
> Drunkest city: Lincoln
> Pct. of MSA adults binge or heavy drinking: 23.3%
> Pct. of state adults binge or heavy drinking: 21.4%
> Pct. of alcohol related driving deaths: 26.7%
Just over 21% of adults in Nebraska report drinking excessively in the last 30 days, the fifth highest percentage of all states. The percentage of adults who drink excessively in Lincoln, at 23.3%, is both the highest in Nebraska and one of the highest of any metro in the country.
Excessive drinking can lead to harmful health consequences. High levels of excessive drinking in a metro area, however, does not necessarily mean residents are more likely to be in poor health — as is the case in Lincoln. Fewer than one in 10 Lincoln adults report being in fair or poor health, one of the lowest percentages in the country.
28. Nevada
> Drunkest city: Reno
> Pct. of MSA adults binge or heavy drinking: 21.4%
> Pct. of state adults binge or heavy drinking: 17.6%
> Pct. of alcohol related driving deaths: 30.7%
Reno is the heaviest drinking metro area in Nevada. Of all metro area adults, 21.4% report drinking to excess, far more than the 17.6% statewide and 18.0% national excessive drinking rates.
Alcohol abuse can be harmful to both physical and mental health, and a high excessive drinking rate can also contribute to negative health outcomes across a metro area. Adults in Reno are far more likely to report being in poor health and more likely to die before age 75 than the typical American.
29. New Hampshire
> Drunkest city: Manchester-Nashua
> Pct. of MSA adults binge or heavy drinking: 18.3%
> Pct. of state adults binge or heavy drinking: 18.9%
> Pct. of alcohol related driving deaths: 32.8%
In the Manchester-Nashua area, 18.3% of adults report excessive drinking, slightly higher than the national rate of 18.0%. The area is the only metro in New Hampshire, however, so it is by default the heaviest drinking metro.
Manchester is near the New Hampshire border and a short drive from Boston. Because New Hampshire does not levy a sales tax, alcohol is cheaper there than in many other states. This may encourage more drinking among residents, and it typically attracts people shopping for alcohol from other states.
30. New Jersey
> Drunkest city: Trenton
> Pct. of MSA adults binge or heavy drinking: 18.2%
> Pct. of state adults binge or heavy drinking: 17.3%
> Pct. of alcohol related driving deaths: 23.6%
In Trenton, 18.2% of adults report binge or heavy drinking, a slightly larger share than across New Jersey and the country as a whole.
According to the CDC, excessive alcohol consumption is more likely among households earning $75,000 or more per year. Trenton, one of the highest income areas in the country, fits this pattern. The median household income in Trenton of $72,417 a year is roughly in line with the state median income but well above the national median income of $55,775 annually.
31. New Mexico
> Drunkest city: Las Cruces
> Pct. of MSA adults binge or heavy drinking: 16.5%
> Pct. of state adults binge or heavy drinking: 15.1%
> Pct. of alcohol related driving deaths: 34.0%
The percentage of adults in New Mexico who report excessive drinking, at 15.1%, is among the smallest shares compared with other states. Yet, alcohol is involved in nearly one-third of driving deaths in the state, one of the higher proportions. The problem is slightly more pronounced in Las Cruces, the city reporting the highest level of excessive drinking in New Mexico. Of driving deaths in the city, 34% are alcohol related.
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Higher levels of excessive drinking can be associated with financial well-being. Las Cruces, however, is one of a minority of cities on this list where the typical household income of $39,902 a year does not exceed the statewide median income.
32. New York
> Drunkest city: Watertown-Fort Drum
> Pct. of MSA adults binge or heavy drinking: 21.4%
> Pct. of state adults binge or heavy drinking: 16.5%
> Pct. of alcohol related driving deaths: 28.6%
At 21.4%, adults in the Watertown-Fort Drum area report higher levels of excessive drinking than adults in any other metro area in New York. Across the state, just 16.5% of adults report such high alcohol consumption, one of the lower percentages compared with other states. The share of driving fatalities that involve alcohol in the Watertown area of 28.6% is not especially high compared to national levels. However, it is far higher than the statewide incidence of alcohol-related driving fatalities, which at 23.4% is the second lowest of all states.
33. North Carolina
> Drunkest city: Jacksonville
> Pct. of MSA adults binge or heavy drinking: 19.2%
> Pct. of state adults binge or heavy drinking: 15.1%
> Pct. of alcohol related driving deaths: 33.3%
High alcohol consumption alone cannot explain poor health outcomes in a population. However, excessive drinking in Jacksonville, the city reporting the highest level of alcohol consumption in North Carolina, may partially explain the area’s prevalence of sexually transmitted diseases. This is often a consequence of risky behavior, which according to the CDC is associated with alcohol abuse. There are 808 cases of chlamydia for every 100,000 Jacksonville residents, in the top 10 compared with all U.S. metro areas.
34. North Dakota
> Drunkest city: Fargo
> Pct. of MSA adults binge or heavy drinking: 25.2%
> Pct. of state adults binge or heavy drinking: 25.0%
> Pct. of alcohol related driving deaths: 29.5%
More than one in four adults in Fargo, North Dakota drink excessively, a larger share than in any other metro area in the state and all but four other metro areas nationwide.
Drinking habits in Fargo are not exceptional compared with people living in North Dakota. No state has a higher share of heavy drinking adults than North Dakota. The state’s 25% excessive drinking rate is likely tied to its nation-leading share of alcohol related roadway fatalities. More than 47% of all deadly car accidents across the state might have been avoided if alcohol were not involved.
35. Ohio
> Drunkest city: Columbus
> Pct. of MSA adults binge or heavy drinking: 19.2%
> Pct. of state adults binge or heavy drinking: 19.1%
> Pct. of alcohol related driving deaths: 30.6%
Adults in Ohio are slightly more likely to have unhealthy drinking habits than adults across the country. In the Columbus metro area, 19.2% of adults drink excessively — the largest share of the state’s 11 metro areas. Excessive drinking is more common in high income areas, and the typical Columbus household earns $58,192 a year, more than in any other metro area in the state.
While binge and heavy drinking are relatively common in Columbus, other unhealthy habits are not. Only 18.3% of area adults smoke, and only 24.5% are not physically active — smaller shares than the corresponding 21.0% and 26.3% statewide shares.
36. Oklahoma
> Drunkest city: Oklahoma City
> Pct. of MSA adults binge or heavy drinking: 14.2%
> Pct. of state adults binge or heavy drinking: 13.5%
> Pct. of alcohol related driving deaths: 30.6%
Just 13.5% of adults in Oklahoma report an excessive drinking habit, nearly the lowest share of all states. So in Oklahoma City, where excessive drinking is more common than anywhere else in the state, the 14.2% share of adults who are abusing alcohol actually trails most U.S. metro areas. Excessive alcohol consumption can lead to physical harm, and lower levels of alcohol consumption in an area can help people reach favorable health outcomes. Oklahoma City reports a lower incidence of premature death than across the state. However, 427 lives are lost due to preventable causes per 100,000 people in Oklahoma City each year, higher than in most metro areas.
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37. Oregon
> Drunkest city: Corvallis
> Pct. of MSA adults binge or heavy drinking: 23.2%
> Pct. of state adults binge or heavy drinking: 18.9%
> Pct. of alcohol related driving deaths: 32.0%
Excessive drinking is more common in all eight metro areas in Oregon than it is across the country as a whole. In the Corvallis metro area, 23.2% of adults consume alcohol in excess, the highest share in the state.
While long-term excessive drinking can have some serious health consequences, it does not necessarily lead to poorer overall health. Despite the relative prevalence of binge and heavy drinking in Corvallis, people in the metro area are far more likely to lead full, healthy lives than the broader Oregon population. Each year, for every 100,000 Corvallis residents, 229 die before age 75 from preventable causes, a lower rate than the 309 per 100,000 statewide preventable death rate. In addition, people in Corvallis are more likely to report being in good overall health than residents statewide.
38. Pennsylvania
> Drunkest city: State College
> Pct. of MSA adults binge or heavy drinking: 20.2%
> Pct. of state adults binge or heavy drinking: 17.7%
> Pct. of alcohol related driving deaths: 28.4%
The share of adults in State College who drink in excess is the highest of any state metro area. As is generally the case, however, the excessive drinking — while not a healthy behavior — has not resulted in especially poor health outcomes in the city. Despite consuming more alcohol more frequently than across the state, State College residents report a lower incidence of premature death than statewide. Similarly, the 14% of adults who say they are in fair or poor health is also lower than the statewide percentage.
The healthier outcomes are likely because of the area’s higher educational attainment and financial well-being — two factors common among people who drink excessively that also tend to lead to better health. More than two in five adults in State College have a college degree, and the typical household earns $56,337 a year — each higher than the state figures.
39. Rhode Island
> Drunkest city: Providence-Warwick
> Pct. of MSA adults binge or heavy drinking: 20.0%
> Pct. of state adults binge or heavy drinking: 20.2%
> Pct. of alcohol related driving deaths: 36.2%
As the only metro area in the state, Providence-Warwick’s excessive drinking rate is roughly in line with that of the state as a whole. Across Providence and Rhode Island, roughly one in five adults drink excessively, a slightly higher share than the 18% of American adults who either binge or heavily drink.
While it is not always the case, it appears that higher alcohol abuse rates in the Providence area and Rhode Island play an outsized role in fatal car accidents. Of roadway fatalities in Providence, 36.2% involve alcohol, and across Rhode Island 40.8% of traffic deaths involve alcohol — each far more than the 31% share nationwide.
40. South Carolina
> Drunkest city: Charleston-North Charleston
> Pct. of MSA adults binge or heavy drinking: 19.8%
> Pct. of state adults binge or heavy drinking: 15.5%
> Pct. of alcohol related driving deaths: 44.0%
Adults across South Carolina are less likely to abuse alcohol than adults nationwide, with 15.5% reporting heavy or binge drinking on a regular basis versus 18.0% nationwide. However, the percentage of driving fatalities that involve alcohol, at over 40%, is fourth highest compared with other states. Both excessive alcohol consumption and alcohol-related driving deaths are more prevalent in the Charleston metro area than across the state and nation. Nearly one in five area adults drinks excessively, and alcohol is involved in approximately 44% of driving fatalities in the area.
41. South Dakota
> Drunkest city: Sioux Falls
> Pct. of MSA adults binge or heavy drinking: 19.4%
> Pct. of state adults binge or heavy drinking: 18.3%
> Pct. of alcohol related driving deaths: 30.5%
Compared with South Dakota, Sioux Falls is healthier by several measures. Metro residents report a lower incidence of premature death. Also, just 11% of adults report being in fair or poor health, lower than the statewide percentage of 13.2% — itself one of the lower shares in the nation. The relative health of the city’s population is despite the higher share of excess alcohol consumption, which can lead to harmful health consequences.
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Economic prosperity among Sioux Falls residents — the median household income of nearly $60,000 annually is well above both the state and national median incomes — largely explains the health outcomes as well as the alcohol consumption. According to the CDC, people earning $75,000 annually or more are among the most likely to drink excessively. At the same time, wealthier people tend to report better health.
42. Tennessee
> Drunkest city: Nashville-Davidson–Murfreesboro–Franklin
> Pct. of MSA adults binge or heavy drinking: 13.5%
> Pct. of state adults binge or heavy drinking: 11.6%
> Pct. of alcohol related driving deaths: 26.3%
Trailing only West Virginia, Tennessee has the second lowest excessive drinking rate in the country. Even in Nashville, the state’s heaviest drinking metro area, only 13.5% of adults are excessive drinkers, a far smaller share than the national 18.0% excessive drinking rate.
Relatively low rates of alcohol abuse do not mean the area is devoid of bad habits. Slightly more than 21% of adults in Nashville and 24% of adults across the state identify as smokers, well above the 17% nationwide smoking rate.
43. Texas
> Drunkest city: Austin-Round Rock
> Pct. of MSA adults binge or heavy drinking: 21.5%
> Pct. of state adults binge or heavy drinking: 17.4%
> Pct. of alcohol related driving deaths: 34.9%
The Austin-Round Rock region is the heaviest drinking metro area in a state with relatively low alcohol consumption levels. The share of adults in the Austin area who drink excessively is 21.5%, well above the national percentage of 18.0%, while the share in Texas of 17.4% is lower. Excessive drinking in a community does not necessarily increase the likelihood of drunk driving, but high alcohol consumption may partially explain such risky behavior in the Austin area. Alcohol is involved in 34.9% of driving deaths in the area, higher than both the state and national rates.
Since people — especially white men — who earn $75,000 or more annually are among the most likely to drink excessively, higher incomes may help explain the excessive drinking in Austin-Round Rock. The typical household earns $67,195 a year, well above the median incomes in Texas and the U.S.
44. Utah
> Drunkest city: Salt Lake City
> Pct. of MSA adults binge or heavy drinking: 14.1%
> Pct. of state adults binge or heavy drinking: 12.1%
> Pct. of alcohol related driving deaths: 21.8%
Utah has one of the lowest excessive drinking rates of any state in the country. This may not come as a surprise, as more than half of the state’s population identifies as Mormon, a religion that strongly discourages alcohol consumption.
Of the state’s five metro areas, Salt Lake City has the highest share of excessive drinkers. Still, the 14.1% of adults who either binge or heavily drink in the Salt Lake metro area, is relatively small when compared to the 18.0% share of American adults who drink to excess. The relatively infrequent heavy drinking in the Salt Lake metro area likely contributes to healthier communities. Adults in the capital city metro area are more likely to report good overall health and more likely to live to age 75 than Americans in general.
45. Vermont
> Drunkest city: Burlington-South Burlington
> Pct. of MSA adults binge or heavy drinking: 23.0%
> Pct. of state adults binge or heavy drinking: 20.6%
> Pct. of alcohol related driving deaths: 32.4%
The Burlington region is the only metropolitan area in Vermont, which means it is by default the heaviest drinking area in the state.
Burlington, with a median household income of $66,807 a year, is one of the wealthier metro areas in the country and the highest income area in Vermont. Because binge drinking is most common among people — particularly white men — earning $75,000 or more annually, the higher incomes in Burlington could explain the metro’s similarly high excessive drinking rate. At 23% of adults, it is slightly higher than the percentage across Vermont, itself one of the higher figures compared with other states.
46. Virginia
> Drunkest city: Blacksburg-Christiansburg-Radford
> Pct. of MSA adults binge or heavy drinking: 18.1%
> Pct. of state adults binge or heavy drinking: 16.6%
> Pct. of alcohol related driving deaths: 30.1%
Virginians are on the whole less likely than adults nationwide to drink in excess. Even in the Blacksburg-Christiansburg-Radford metropolitan area, which has the state’s highest excessive drinking rate, just 18.1% of adults binge drink or drink heavily. This is in line with the national share of 18.0%.
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The unhealthy behaviors of Blacksburg residents do not appear to be limited to alcohol consumption. More than 20% of residents are smokers, the highest share in the state and well above the national adult smoking rate of 17%. The area’s poor health choices may have contributed to a higher premature death rate. Of every 100,000 residents, 388 die before the age of 75 due to preventable causes, the second worst premature death rate of the state’s metropolitan areas.
47. Washington
> Drunkest city: Bellingham
> Pct. of MSA adults binge or heavy drinking: 21.8%
> Pct. of state adults binge or heavy drinking: 18.8%
> Pct. of alcohol related driving deaths: 28.4%
Each of Washington’s 11 metro areas has a higher excessive drinking rate than the country as a whole. In the Bellingham metro area, 21.8% of adults either binge or heavily drink, the largest share in the state.
While unhealthy levels of alcohol consumption are relatively common across Bellingham, other unhealthy habits are far less common. Only 13.6% of area adults smoke, and 16.3% do not get any exercise — far lower than both the comparable state and national rates.
48. West Virginia
> Drunkest city: Wheeling
> Pct. of MSA adults binge or heavy drinking: 14.9%
> Pct. of state adults binge or heavy drinking: 10.3%
> Pct. of alcohol related driving deaths: 29.6%
In Wheeling, 14.9% of adults drink excessively. Though the metro area’s excessive drinking rate is the highest in the state, it is still well below the nationwide excessive drinking rate of 18.0% of adults.
Statewide, binge and heavy drinking are relatively uncommon. Only about one in 10 adults in West Virginia drink to excess, by far the smallest share of any state in the country. The low excessive alcohol consumption rate in the state is likely due to the fact that alcohol sales are prohibited in many counties. The Wheeling metro area is primarily located in the Marshall and Ohio counties, neither of which are dry.
49. Wisconsin
> Drunkest city: Appleton
> Pct. of MSA adults binge or heavy drinking: 26.8%
> Pct. of state adults binge or heavy drinking: 23.3%
> Pct. of alcohol related driving deaths: 30.3%
Only North Dakota reports higher alcohol consumption than Wisconsin, where 23.3% of adults report drinking excessively on a regular basis. Appleton is far and away the heaviest drinking city in both the state and the nation, with 26.8% of adults reporting drinking excessively. Despite the more excessive drinking habits, alcohol is involved in approximately 30.3% of driving deaths in the area, well below the statewide alcohol-related driving fatality rate of 37.8%, which is seventh highest compared with other states.
As is generally the case in the cities drinking the most in each state, Appleton residents have higher incomes than Wisconsin residents and people across the nation. The typical Appleton metro area household earns $61,245 annually, higher than the state median income of $55,638 a year and the national median income of $55,775 a year.
50. Wyoming
> Drunkest city: Casper
> Pct. of MSA adults binge or heavy drinking: 18.1%
> Pct. of state adults binge or heavy drinking: 18.5%
> Pct. of alcohol related driving deaths: 35.6%
There are only two metropolitan areas in Wyoming — Casper and Cheyenne. Residents of the area reporting the highest level of excessive drinking, Casper, do not drink much heavier than adults nationwide and actually less than Wyoming residents as a whole. Across the state, 18.5% of adults drink excessively, also right in line with the national excessive drinking level. Alcohol drinkers in Wyoming living outside metro areas likely drive up the overall state percentage.
Alcohol is involved in 35.6% of driving fatalities in Casper, in line with the state percentage — but both are well above the national incidence.
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