Alcohol abuse: The drunkest city in every state

Samuel Stebbins and Evan Comen | 24/7 Wall Street

Show Caption Hide Caption These are the places in the U.S. where alcohol abuse is most prevalent Drinking alcohol is a part of many of our lives no matter where you live. But alcohol abuse can take its toll on not only your health, but the economy as well.

Excessive drinking claims the lives of tens of thousands of Americans each year and is responsible for about 1 in every 10 deaths among working-age adults. Alcohol abuse also takes a heavy economic toll.

A recent study from the Centers for Disease Control and Prevention found that excessive alcohol consumption cost the U.S. economy an estimated $250 billion in 2010 — primarily in lost productivity, medical bills, and motor vehicle accidents.

Excessive alcohol consumption, according to the CDC, includes binge drinking — defined as four or more drinks in a single occasion for women and five or more for men — and heavy drinking, which is defined as at least eight drinks per week for women and 15 for men.

An estimated 18% of American adults drink excessively. However, binge and heavy drinking rates are not uniform across the country and can vary greatly from state to state and city to city. Across U.S. metro areas, excessive drinking rates range from fewer than 1 in every 10 adults to more than 1 in every 4 adults.

24/7 Wall St. reviewed data from the CDC to identify the metropolitan areas reporting the highest levels of binge and heavy drinking in each state.

Alabama

Drunkest city: Auburn-Opelika

> MSA adults binge or heavy drinking: 15.9%

> State adults binge or heavy drinking: 13.0% (4th lowest)

> Alcohol-related driving deaths: 32.5%

Excessive drinking is more common in the Auburn-Opelika area than in any other metro area in Alabama. An estimated 15.9% of area adults are either heavy or binge drinkers, a larger share than the 13.0% of adults across the state.

Despite ranking as the heaviest drinking metro area in the state, adults in Auburn-Opelika are less likely to drink excessively than the typical American adult. Nationwide, an estimated 18.0% of adults drink excessively.

Alaska

Drunkest city: Fairbanks

> MSA adults binge or heavy drinking: 22.7% (top 10%)

> State adults binge or heavy drinking: 22.1% (3rd highest)

> Alcohol-related driving deaths: 37.8% (top 25%)

Of the two metropolitan areas in Alaska — Fairbanks and Anchorage — Fairbanks has the largest share of adults who report excessive drinking. Some 22.7% of Fairbanks adults binge or drink heavily, the largest share in Alaska and one of the largest shares of any U.S. metro area.

While a smaller share of Anchorage adults drink to excess, the metro area’s drinking rate is still relatively high. Some 22.2% of Anchorage adults drink heavily or binge drink, a larger share than the drunkest city in 39 states. Across the state, 22.1% of Alaskans drink heavily or binge drink, the third largest excessive drinking rate among states.

Arizona

Drunkest city: Flagstaff

> MSA adults binge or heavy drinking: 19.4%

> State adults binge or heavy drinking: 16.0% (13th lowest)

> Alcohol-related driving deaths: 24.1% (bottom 25%)

Of the seven metro areas in Arizona, Flagstaff is home to the largest share of adults who drink to excess. Some 19.4% of adults in the Flagstaff metro area are either heavy or binge drinkers. In comparison, only 16.0% of adults statewide and 18.0% of American adults over-consume alcohol.

Heavier drinking areas tend to be better educated, and Flagstaff is no exception. Some 35.4% of adults in the metro area have earned a bachelor’s degree. Across Arizona, only 28.9% of adults have a four-year college education.

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Arkansas

Drunkest city: Fayetteville-Springdale-Rogers

> MSA adults binge or heavy drinking: 15.6% (bottom 25%)

> State adults binge or heavy drinking: 15.3% (9th lowest)

> Alcohol-related driving deaths: 31.6%

Excessive drinking includes binge and heavy drinking. In Arkansas, 15.3% of adults report excessive drinking, less than the 18.0% share of adults nationwide and the ninth smallest share of any state. In the Fayetteville-Springdale-Rogers metro area, located in the northwest part of the state, some 15.6% of adults report excessive drinking, the highest share in Arkansas yet less than in most U.S. metro areas.

Wealthier individuals are more likely to drink excessively, and the typical household in Fayetteville earns $51,848 a year, the highest median household income of any Arkansas metro area.

California

Drunkest city: Chico

> MSA adults binge or heavy drinking: 20.9% (top 25%)

> State adults binge or heavy drinking: 18.0% (22nd highest)

> Alcohol-related driving deaths: 34.7%

Nearly 21% of adults in Chico regularly drink alcohol to excess, a larger share than in any of California’s 25 other metro areas and far more than the statewide excessive drinking rate of 18.0%.

Drinking too much can have serious health consequences, and by some measures, Chico’s population is less healthy than the state as a whole. Across California, adults report an average of 3.6 mentally unhealthy days and 3.6 physically unhealthy days per month. In Chico, adults report an average of 4.1 mentally unhealthy days and 4.3 physically unhealthy days each month.

Colorado

Drunkest city: Fort Collins

> MSA adults binge or heavy drinking: 21.0% (top 25%)

> State adults binge or heavy drinking: 19.1% (15th highest)

> Alcohol-related driving deaths: 30.6%

Home to Colorado State University, Fort Collins is a midsize college city located along the Cache La Poudre River in Colorado’s Front Range. College students drink more than nearly any other group. According to the National Institute on Alcohol Abuse and Alcoholism, nearly 3 in 5 U.S. college students aged 18 to 22 drink alcohol. In the Fort Collins metro area, some 11.6% of the population are enrolled in college or graduate school — nearly the largest share in Colorado — and 21.0% of adults drink to excess or binge drink, the largest share in the state.

Connecticut

Drunkest city: Bridgeport-Stamford-Norwalk

> MSA adults binge or heavy drinking: 20.6% (top 25%)

> State adults binge or heavy drinking: 18.6% (18th highest)

> Alcohol-related driving deaths: 34.6%

Bridgeport-Stamford-Norwalk is the only metro area in Connecticut in which more than 1 in every 5 adults drinks excessively. 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 Bridgeport area. Some 34.6% of roadway fatalities in the metro area involve alcohol, higher than both the state and national rates.

Delaware

Drunkest city: Dover

> MSA adults binge or heavy drinking: 15.4% (bottom 25%)

> State adults binge or heavy drinking: 16.6% (16th lowest)

> Alcohol-related driving deaths: 38.6% (top 25%)

While Dover is the only metro area in Delaware and by default has the largest share of adults who drink excessively, the city actually has one of the lowest excessive drinking rates in the country. Just 15.4% of adults in Dover binge or drink heavily, lower than both the national rate of 18.0% and even the state rate of 16.6%.

Better educated populations also often also have higher excessive drinking rates. In Dover, just 22.6% of adults have a bachelor’s degree, less than the 31.0% state and 31.3% national rates.

Florida

Drunkest city: Crestview-Fort Walton Beach-Destin

> MSA adults binge or heavy drinking: 20.8% (top 25%)

> State adults binge or heavy drinking: 17.4% (22nd lowest)

> Alcohol-related driving deaths: 39.4% (top 10%)

Across Florida, only 17.4% of adults drink excessively, a smaller share than the 18.0% of adults nationwide. However, not all parts of the state report lower than typical excessive drinking rates. In Crestview-Fort Walton Beach-Destin, some 20.8% of adult residents drink excessively, the largest such share of any metro area in the Sunshine State.

In addition to having the state’s highest excessive drinking rate, the Crestview-Fort Walton Beach-Destin metro area also has the state’s highest alcohol-related roadway fatalities rate. Some 39.4% of driving deaths in the metro area involve alcohol. To compare, 28.2% of roadway fatalities statewide and 30.0% nationwide are alcohol-related.

Georgia

Drunkest city: Athens-Clarke County

> MSA adults binge or heavy drinking: 17.5%

> State adults binge or heavy drinking: 16.8% (18th lowest)

> Alcohol-related driving deaths: 22.4% (bottom 25%)

The Athens-Clarke County metro area is home to the University of Georgia, the largest college or university in the state. College students are much more likely to participate in activities involving alcohol. According to the National Institute on Alcohol Abuse and Alcoholism, close to 3 in 5 college students between the ages of 18 and 22 drink alcohol on at least one occasion per month. In the Athens metro area, 16.3% of residents are enrolled in college or graduate school — the largest share in the state — and 17.5% of adults binge or drink heavily, also the largest share in the state.

Hawaii

Drunkest city: Kahului-Wailuku-Lahaina

> MSA adults binge or heavy drinking: 21.8% (top 10%)

> State adults binge or heavy drinking: 20.5% (8th highest)

> Alcohol-related driving deaths: 50.5% (top 10%)

Nearly 22% of adults in Kahului-Wailuku-Lahaina either binge or heavily drink, a larger share than both the statewide and nationwide excessive drinking rates. Driving deaths that involve alcohol are often more common in areas with heavy drinking populations, and the Kahului-Wailuku-Lahaina is no exception. The metro area is one of only five nationwide in which over half of all roadway fatalities involve alcohol.

Idaho

Drunkest city: Coeur d’Alene

> MSA adults binge or heavy drinking: 17.9%

> State adults binge or heavy drinking: 15.4% (10th lowest)

> Alcohol-related driving deaths: 38.3% (top 25%)

An estimated, 15.4% of Idahoans drink excessively, the 10th smallest share of any state. While in the wettest metro area in the state — Coeur d’Alene — the excessive drinking rate is 17.9%, it is still lower than the national rate of 18.0% and less than close to half that of all U.S. cities.

While the typical Coeur d’Alene adult is less likely to binge or heavily drink than the typical American adult, motorists in the metro area may be more likely to be involved in a fatal alcohol-related accident. Alcohol is involved in an estimated 38.3% of all fatal car crashes in Coeur d’Alene, far more than the 30.0% national figure.

Illinois

Drunkest city: Bloomington

> MSA adults binge or heavy drinking: 21.5% (top 10%)

> State adults binge or heavy drinking: 21.2% (5th highest)

> Alcohol-related driving deaths: 35.1%

With a 21.5% excessive drinking rate, Bloomington is the heaviest drinking metro area in Illinois. Unhealthy alcohol consumption is more common among better-educated populations, and Bloomington is home to a relatively large share of adults with a bachelor’s degree. Some 42.4% of adults in Bloomington have a four-year college degree, compared to the statewide college attainment rate of 34.0% and the nationwide rate of 31.3%.

Indiana

Drunkest city: Bloomington

> MSA adults binge or heavy drinking: 19.7% (top 25%)

> State adults binge or heavy drinking: 16.8% (17th lowest)

> Alcohol-related driving deaths: 26.2% (bottom 25%)

Colleges students are more likely to drink heavily than nearly any other group. The Bloomington metro area is the home of Indiana University, one of the largest universities in the United States. Nearly 1-in-4 metro area residents are enrolled in college or graduate school, the third-highest share in the country, and 19.7% of residents over the age of 18 drink excessively, the largest share of any Indiana metro.

College graduates are also more likely to drink than the average American. Some 38.9% of Bloomington adults have a bachelor’s degree, also the largest share in the state.

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Iowa

Drunkest city: Iowa City

> MSA adults binge or heavy drinking: 23.1% (top 10%)

> State adults binge or heavy drinking: 21.0% (7th highest)

> Alcohol-related driving deaths: 17.7% (bottom 10%)

Iowa City is the heaviest drinking metro area in a relatively heavy drinking state. Across Iowa, 21.0% of adults drink excessively, a larger share than in all but six other states and well above the U.S. excessive drinking rate of 18.0%. Meanwhile, Iowa City is one of only 13 metro areas nationwide in which more than 23% of adults either binge drink or drink excessively. Like many of the heaviest drinking metro areas, Iowa City is in the Midwest.

Kansas

Drunkest city: Lawrence

> MSA adults binge or heavy drinking: 22.2% (top 10%)

> State adults binge or heavy drinking: 16.9% (19th lowest)

> Alcohol-related driving deaths: 24.4% (bottom 25%)

College students are more likely to drink, and to drink heavily, than the average American. According to the National Council on Alcoholism and Drug Dependence, Inc., about half of all college students who consume alcohol do so through binge drinking. In Lawrence, home to the University of Kansas — the largest university in the state — an estimated 21.7% of the population is enrolled in college or graduate school, the largest such share in Kansas. Meanwhile, 22.2% of adults drink excessively, also the largest share in the state. College graduates are also more likely to drink heavily than most Americans. An estimated 52.0% of adults in Lawrence have a bachelor’s degree, the largest share in Kansas and the fifth largest share nationwide.

Kentucky

Drunkest city: Louisville/Jefferson County

> MSA adults binge or heavy drinking: 17.6%

> State adults binge or heavy drinking: 16.3% (14th lowest)

> Alcohol-related driving deaths: 27.0%

Only about 16.3% of adults in Kentucky drink excessively, a smaller share than the 18.0% of American adults. Even in Louisville, the heaviest drinking metro area in the state, adults are less likely than the typical American adult to consume unhealthy amounts of alcohol.

Alcohol consumption is only one behavioral factor that can affect health, and Louisville residents are more likely to smoke and less likely to be physically active than the typical American. Partially as a result, and despite a lower excessive drinking rate, adults in Louisville are less likely to report being in good or excellent health than the typical American adult.

Louisiana

Drunkest city: Houma-Thibodaux

> MSA adults binge or heavy drinking: 20.7% (top 25%)

> State adults binge or heavy drinking: 18.8% (17th highest)

> Alcohol-related driving deaths: 40.4% (top 10%)

Some 20.7% of adults in the Houma-Thibodaux metro area drinks excessively, the largest share in Louisiana and one of the largest shares of any U.S. metro. While college graduates are more likely to drink heavily than those without a degree, just 16.1% of Houma-Thibodaux adults have a bachelor’s degree, close to half the 31.3% national rate and nearly the smallest share of any city.

Maine

Drunkest city: Portland-South Portland

> MSA adults binge or heavy drinking: 20.6% (top 25%)

> State adults binge or heavy drinking: 19.6% (11th highest)

> Alcohol-related driving deaths: 43.1% (top 10%)

Of the three metropolitan areas in Maine, Portland-South Portland has the highest excessive drinking rate at 20.6%. Excessive drinking tends to be more common in more affluent areas, and Portland is also the highest earning metro area in the state. The typical Portland household earns $63,422 a year, over $14,000 more than the next highest earning metro area in the state.

As is often the case in heavy drinking areas, a large share of roadway fatalities involves alcohol in Portland. Alcohol is involved in 43.1% of driving deaths in the metro area compared to 39.8% of driving deaths statewide and 30.0% nationwide.

Maryland

Drunkest city: California-Lexington Park

> MSA adults binge or heavy drinking: 18.8%

> State adults binge or heavy drinking: 15.5% (11th lowest)

> Alcohol-related driving deaths: 35.7% (top 25%)

Alcohol is expensive and wealthy individuals are more likely to be able to afford alcohol on a regular basis and are also more likely to participate in activities where alcohol is present. The California-Lexington Park metro area, where the typical household earns approximately $21,000 more than the U.S. median household income, is the wealthiest in Maryland and one of the wealthiest in the country. Some 18.8% of adults in the city drink heavily or binge drink, more than in any other metro area in Maryland.

Excessive drinking habits may have adverse health outcomes for residents of California-Lexington Park. An estimated 10 out of every 100,000 metro area residents die from alcohol-induced causes annually, double the state alcohol-related mortality rate.

Massachusetts

Drunkest city: Barnstable Town

> MSA adults binge or heavy drinking: 21.0% (top 25%)

> State adults binge or heavy drinking: 19.5% (13th highest)

> Alcohol-related driving deaths: 23.1% (bottom 25%)

Binge and heavy drinking are never healthy behaviors. Still, 21.0% of adults in the Barnstable Town metro area drink excessively, a larger share than in any other metro area in Massachusetts.

In other key measures, however, adults in Barnstable Town are relatively healthy. Of the five metro areas in Massachusetts, Barnstable Town has the lowest smoking rate, the lowest obesity rate, and the largest share of adults who are regularly physically active.

Michigan

Drunkest city: Lansing-East Lansing

> MSA adults binge or heavy drinking: 21.9% (top 10%)

> State adults binge or heavy drinking: 20.0% (10th highest)

> Alcohol-related driving deaths: 27.8%

According to a nationwide survey by the National Institute on Alcohol Abuse, nearly 3-in-5 college students aged 18 to 22 drink alcohol on a monthly basis. In the Lansing-East Lansing metro area — home to Michigan State University, the largest school in Michigan and the ninth largest in the country — some 14.2% of residents are enrolled in college, more than double the 7.0% share nationwide. An estimated 21.9% of adults in the Lansing-East Lansing metro area drink excessively, more than the comparable 20.0% statewide share and more than any other metro in Michigan.

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Minnesota

Drunkest city: Mankato-North Mankato

> MSA adults binge or heavy drinking: 23.6% (top 10%)

> State adults binge or heavy drinking: 21.1% (6th highest)

> Alcohol-related driving deaths: 18.0% (bottom 10%)

Nearly 24% of adults in the Mankato-North Mankato drink excessively, the largest share of any of any of Minnesota’s five metro areas. Despite ranking as the state’s heaviest drinking metro area, driving deaths attributable to alcohol are relatively uncommon. Only 18% of all roadway fatalities in the metro area involve alcohol, the smallest share of any metro area in Minnesota and well below the comparable 30.9% statewide share.

Mississippi

Drunkest city: Gulfport-Biloxi-Pascagoula

> MSA adults binge or heavy drinking: 14.0% (bottom 10%)

> State adults binge or heavy drinking: 13.3% (5th lowest)

> Alcohol-related driving deaths: 26.4%

Some 13.3% of Mississippi adults drink excessively, the fifth smallest share of any state. While the 14.0% excessive drinking rate in the Gulfport-Biloxi-Pascagoula metro area is the highest of any metro in the state, it is far below the 18.0% national excessive drinking rate and among the lowest of any city nationwide.

Alcohol is expensive — prohibitively so for many lower-income individuals. In Gulfport, the typical household earns just $46,434 a year, far below the national median household income of $57,617.

Missouri

Drunkest city: Columbia

> MSA adults binge or heavy drinking: 20.9% (top 25%)

> State adults binge or heavy drinking: 17.7% (25th lowest)

> Alcohol-related driving deaths: 44.4% (top 10%)

Columbia is the only metro area in Missouri in which more than 1 in every 5 adults drink excessively. Alcohol consumption is only one lifestyle factor that can impact health, however, and by other measures, Columbia residents are relatively healthy. For example, adults in Columbia are more likely to lead physically active lives than those in any other metro area in the state. Additionally, only 28.4% of metro area adults are obese, the smallest share in Missouri and well below the 30.8% statewide obesity rate.

Montana

Drunkest city: Missoula

> MSA adults binge or heavy drinking: 24.3% (top 10%)

> State adults binge or heavy drinking: 21.8% (4th highest)

> Alcohol-related driving deaths: 44.4% (top 10%)

Some 21.8% of adults in Montana drink excessively, the fourth largest share of any state. Even more adults drink heavily or binge drink in Missoula, where the excessive drinking rate is 24.3%.

Excessive drinking is never healthy, and Missoula residents are more likely to die from alcohol-related causes than the average American. Approximately 14 in every 100,000 residents in Missoula die from alcohol-induced causes annually, compared to 10 in every 100,000 Americans nationwide.

Nebraska

Drunkest city: Lincoln

> MSA adults binge or heavy drinking: 22.7% (top 10%)

> State adults binge or heavy drinking: 20.4% (9th highest)

> Alcohol-related driving deaths: 25.5% (bottom 25%)

Lincoln’s excessive drinking rate of 22.7% is the highest among Nebraska’s three metro areas and higher than the vast majority of metro areas nationwide. Binge drinking is relatively commonplace on college campuses, and a large college population may partially explain Lincoln’s high excessive drinking rate, which includes binge drinking. Home to the University of Nebraska, Lincoln’s population is 12.0% college and graduate students, by far the largest such share of any metro area in the state.

Nevada

Drunkest city: Reno

> MSA adults binge or heavy drinking: 21.3% (top 25%)

> State adults binge or heavy drinking: 15.8% (12th lowest)

> Alcohol-related driving deaths: 33.3%

While as a state Nevada is fairly dry — just 15.8% of adults drink excessively, compared to 18.0% of adults nationwide — Reno is one of the heaviest drinking cities in the country. Some 21.3% of adults in Reno binge or drink heavily, a larger share than in nearly 90% of all U.S. metropolitan areas.

Increased alcohol consumption may have adverse health outcomes for many Reno residents. In 2015, approximately 18 in every 100,000 Reno residents died from causes related to alcohol, far more than the national rate of 10 alcohol-related deaths per 100,000 Americans.

New Hampshire

Drunkest city: Manchester-Nashua

> MSA adults binge or heavy drinking: 19.7% (top 25%)

> State adults binge or heavy drinking: 18.4% (19th highest)

> Alcohol-related driving deaths: 30.3%

The only metro area in New Hampshire, Manchester-Nashua, is the heaviest drinking area by default. Still, the metro area’s excessive drinking rate of 19.7% tops both the statewide excessive drinking rate of 18.4% and the U.S. rate of 18.0%.

Excessive drinking is more common among well-educated, affluent populations. In Manchester-Nashua, the typical household earns $76,254 a year, nearly $19,000 more than the typical American household. Additionally, 37.3% of area adults have a bachelor’s degree or higher, well above the comparable share of American adults of 31.3%.

New Jersey

Drunkest city: Ocean City

> MSA adults binge or heavy drinking: 18.3%

> State adults binge or heavy drinking: 17.6% (24th lowest)

> Alcohol-related driving deaths: 32.7%

In the Ocean City metro area, some 18.3% of adults drink heavily, a larger share than the 17.6% of adults across New Jersey as a whole and a slightly larger than the 18.0% national rate. While the populations in cities that report the largest shares of adults who drink to excess tend to be wealthy and well educated, the typical household in Ocean City earns $62,548 a year and 31.5% of adults have a bachelor’s degree, each lower than the corresponding state figures.

New Mexico

Drunkest city: Santa Fe

> MSA adults binge or heavy drinking: 14.9% (bottom 25%)

> State adults binge or heavy drinking: 13.8% (6th lowest)

> Alcohol related driving deaths: 22.5% (bottom 25%)

Despite ranking as the heaviest drinking metro area in New Mexico, unhealthy drinking habits are relatively uncommon in Santa Fe. Only 14.9% of adults New Mexico’s capital city drink excessively compared to 18.0% of adults nationwide. In addition to a relatively low excessive drinking rate, adults in Santa Fe are less likely to be obese, less likely to smoke, and more likely to be physically active than the typical American adult. Due in part to their healthy lifestyles, adults in Santa Fe are less likely to die prematurely of preventable causes than the typical American.

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New York

Drunkest city: Watertown-Fort Drum

> MSA adults binge or heavy drinking: 22.9% (top 10%)

> State adults binge or heavy drinking: 18.2% (20th highest)

> Alcohol-related driving deaths: 32.8%

Some 22.9% of adults in the Watertown-Fort Drum metro area drink binge drink or drink heavily, the largest share of any metro area in New York state. While wealthy individuals are more likely to drink excessively than the average American overall, the typical household in the Watertown-Fort Drum metro area earns just $45,624 a year, the least of any city in New York.

One factor likely contributing to the metro’s high excessive drinking rate may be the presence of Fort Drum, a U.S. Army military base comprising approximately 10% of the metro area’s population. According to a study by the Military Suicide Research Consortium, more than 50% of Army personnel binge drink — four drinks in a single sitting for women and five for men — on a monthly basis.

North Carolina

Drunkest city: Jacksonville

> MSA adults binge or heavy drinking: 20.7% (top 25%)

> State adults binge or heavy drinking: 14.9% (8th lowest)

> Alcohol-related driving deaths: 35.1% (top 25%)

Of the 15 metro areas in North Carolina, Jacksonville is the only one where more than 1 in every 5 adults drink excessively. While a high binge and heavy drinking rate does not necessarily mean residents are more likely to drive under the influence, alcohol is a relatively common factor in roadway fatalities in Jacksonville. Some 35.1% of driving deaths in the metro area involve alcohol, more than both the comparable 32.3% statewide and the 30.0% U.S. shares.

North Dakota

Drunkest city: Fargo

> MSA adults binge or heavy drinking: 25.2% (top 10%)

> State adults binge or heavy drinking: 24.7% (the highest)

> Alcohol-related driving deaths: 38.0% (top 25%)

North Dakota has the highest excessive drinking rate of any state. Some 24.7% of adults in the state drink excessively, far more than the 18.0% national rate. In the Fargo metro area, an even higher 25.2% of adults drink excessively, the most of any metro area in North Dakota and the fifth most of any city nationwide.

One factor contributing to the city’s high excessive drinking rate may be the presence of several colleges and universities, where, according to a national survey by the National Institute on Alcohol Abuse and Alcoholism, nearly 3 in 5 students drink alcohol. Fargo is home to North Dakota State University, the second largest university in North Dakota, as well as a number of private colleges. An estimated 12.0% of Fargo residents are enrolled in college, compared to only 7.4% of the state population.

Ohio

Drunkest city: Columbus

> MSA adults binge or heavy drinking: 19.6% (top 25%)

> State adults binge or heavy drinking: 19.2% (14th highest)

> Alcohol-related driving deaths: 30.5%

An estimated 19.6% of adults in the Columbus metro area drink excessively, the largest share of any of the state’s 11 metro areas. Excessive drinking rates tend to be higher among better-educated, wealthier populations, and Columbus has both the highest median income and bachelor’s degree attainment rate of any metro area in Ohio.

Despite being home to the largest share of adults who either binge drink or drink heavily in the state, Columbus residents appear to be relatively healthy. Only 14.5% of area adults are in fair or poor health, below the corresponding 15.0% of adults nationwide and the smallest such share in the state.

Oklahoma

Drunkest city: Lawton

> MSA adults binge or heavy drinking: 14.5% (bottom 25%)

> State adults binge or heavy drinking: 13.9% (7th lowest)

> Alcohol-related driving deaths: 41.5% (top 10%)

Just 13.9% of adults in Oklahoma drink excessively, the seventh smallest share of any state. While Lawton’s excessive drinking rate of 14.5% is the highest in Oklahoma, it is still far below the 18.0% national rate and below that of nearly 90% of all U.S. metropolitan areas.

The relatively uncommon heavy drinking habits among Lawton residents may contribute to some positive health outcomes. While nationwide 10.3 in every 100,000 Americans die from alcohol-induced causes annually, in Lawton the alcohol-related mortality rate is 8.9 deaths per 100,000 residents.

Oregon

Drunkest city: Portland-Vancouver-Hillsboro

> MSA adults binge or heavy drinking: 21.1% (top 25%)

> State adults binge or heavy drinking: 18.8% (16th highest)

> Alcohol-related driving deaths: 34.7%

At 21.1%, the excessive drinking rate in the Portland-Vancouver-Hillsboro metro area is the highest of any of Oregon’s eight metro areas. Binge and heavy drinking tend to be more common in wealthier populations, and relatively many Portland-area residents are high earners. Some 7.4% of area households earn more than $200,000 a year, the largest share of any metro area in the state and well above the corresponding share of households statewide of 5.3%.

Pennsylvania

Drunkest city: State College

> MSA adults binge or heavy drinking: 22.3% (top 10%)

> State adults binge or heavy drinking: 18.1% (21st highest)

> Alcohol-related driving deaths: 29.6%

Few groups are more likely to drink excessively than college students. In the State College metro area — home to Pennsylvania State University, the largest school in the state — 24.1% of residents are enrolled in college or graduate school, the fourth largest share of any city nationwide. Some 22.3% of State College adults report drinking excessively, much larger than both the state share of 18.1% and 18.0% national share. College graduates are also more likely to drink than the average American. Nearly 50% of State College adults have graduated from a four-year college, one of the largest shares of any U.S. metro.

Rhode Island

Drunkest city: Providence-Warwick

> MSA adults binge or heavy drinking: 17.9%

> State adults binge or heavy drinking: 17.9% (23rd highest)

> Alcohol-related driving deaths: 35.1% (top 25%)

As the only metro area in Rhode Island, Providence-Warwick is the heaviest drinking by default. The 17.9% of area adults who either binge drink or drink heavily is roughly in line with both state and nationwide rates.

While unhealthy drinking habits are not more common than usual in Rhode Island or Providence, driving deaths attributable to drinking are. Some 35.1% of roadway fatalities in Providence and 40.4% of driving deaths in Rhode Island involve alcohol. In comparison, alcohol is involved in only 30.0% of driving deaths nationwide.

South Carolina

Drunkest city: Hilton Head Island-Bluffton-Beaufort

> MSA adults binge or heavy drinking: 19.3%

> State adults binge or heavy drinking: 16.6% (15th lowest)

> Alcohol-related driving deaths: 28.7%

Some 19.3% of adults in the Hilton Head Island-Bluffton-Beaufort metro area report drinking excessively, more than the 16.6% excessive drinking rate for South Carolina as a whole and the largest share of any metro area in the state. Wealthy individuals are more likely to participate in activities related to drinking, such as going out to eat, going on vacation, and socializing with coworkers, and are more likely to drink heavily than the average American. In the HIlton Head metro area, the typical household earns $63,756 a year, far more than the state median household income of $49,501.

U.S. military bans troops in Japan from drinking alcohol US Soldiers in Japan have been banned from drinking, with their movements restricted after a Marine was arrested over a car crash which killed a local.

South Dakota

Drunkest city: Sioux Falls

> MSA adults binge or heavy drinking: 18.2%

> State adults binge or heavy drinking: 17.7% (25th highest)

> Alcohol-related driving deaths: 26.7%

In Sioux Falls, 18.2% of adults drink excessively, a larger share than the 16.7% of adults who drink excessively in Rapid City, the only other metro area in South Dakota, and larger than the 17.7% statewide excessive drinking rate.

Binge and heavy drinking rates tend to be higher in wealthier, better-educated populations. In Sioux Falls, 34.1% of adults have a bachelor’s degree or higher, and the typical household earns $63,931 a year. Statewide, only 28.9% of adults have a bachelor’s degree, and the typical household earns only $54,467 annually.

Tennessee

Drunkest city: Nashville-Davidson–Murfreesboro–Franklin

> MSA adults binge or heavy drinking: 13.7% (bottom 10%)

> State adults binge or heavy drinking: 11.2% (the lowest)

> Alcohol-related driving deaths: 26.6%

Just 11.2% of adults in Tennessee report excessive drinking, the smallest share of any state. While the Nashville metropolitan area’s excessive drinking rate of 13.7% is the highest of any city in Tennessee, it is still far below the national rate of 18.0% and one of the smallest shares of any U.S. city.

The relatively uncommon excessive drinking habits in the Nashville metro area may partially contribute to positive health outcomes. While nationwide 10.3 in every 100,000 Americans die from causes related to alcohol, the alcohol-induced mortality rate in Nashville is just 7.4 deaths per 100,000 residents.

Texas

Drunkest city: Austin-Round Rock

> MSA adults binge or heavy drinking: 22.3% (top 10%)

> State adults binge or heavy drinking: 17.3% (20th lowest)

> Alcohol-related driving deaths: 32.1%

With a 22.3% excessive drinking rate, Austin-Round Rock is the heaviest drinking metro area in Texas and among the heaviest drinking nationwide. As is often the case in areas with high excessive drinking rates, the Austin population is also a relatively high earning and well educated. Some 42.8% of area adults have a bachelor’s degree, the largest share of any of the state’s 25 metro areas. Similarly, Austin’s $71,000 median annual household income is the highest of any metro area in Texas and about $14,400 more than what the typical household in the state earns.

Utah

Drunkest city: Salt Lake City

> MSA adults binge or heavy drinking: 15.2% (bottom 25%)

> State adults binge or heavy drinking: 12.4% (3rd lowest)

> Alcohol-related driving deaths: 20.6% (bottom 10%)

According to a study by Utah state government and the Church of Jesus Christ of Latter-day Saints, some 62.8% of Utah residents are Mormons, by far the largest share of any state. Alcohol is largely forbidden in the Mormon faith, which may be one reason why just 12.4% of adults in Utah binge drink or drink heavily, the third smallest share of any state. In the Salt Lake City metro area, some 15.2% of adults report excessive drinking, the largest share in Utah yet below the 18.0% national excessive drinking rate.

The relatively low of binge and heavy drinking in the state helps reduce the rate of alcohol-related fatalities. While nationwide 10.3 in every 100,000 Americans die from causes related to alcohol annually, in Utah the alcohol-induced mortality rate is 6.2 deaths per 100,000 residents.

Vermont

Drunkest city: Burlington-South Burlington

> MSA adults binge or heavy drinking: 21.9% (top 10%)

> State adults binge or heavy drinking: 19.6% (12th highest)

> Alcohol-related driving deaths: 31.0%

Burlington-South Burlington is the only metro area in Vermont and therefore the heaviest drinking by default. Still, 21.9% share of area adults drink excessively, a higher share than both the statewide and national excessive drinking rates of 19.6% and 18.0%, respectively.

While excessive drinking is relatively common in the Burlington metro area, other unhealthy habits are not. Adults in Burlington are less likely to smoke, less likely to be obese, and more likely to exercise regularly than the typical American. The healthier lifestyles contribute to favorable health outcomes. Only 9.1% of Burlington adults are in fair or poor health, well below the 15.0% share of adults nationwide.

Virginia

Drunkest city: Blacksburg-Christiansburg-Radford

> MSA adults binge or heavy drinking: 18.0%

> State adults binge or heavy drinking: 17.4% (21st lowest)

> Alcohol-related driving deaths: 25.8% (bottom 25%)

According to a nationwide survey by the National Institute on Alcohol Abuse, close to 3 in 5 college students aged 18 to 22 drink alcohol on a monthly basis. The Blacksburg metro area is the home of Virginia Tech, one of the largest universities in Virginia. Some 20.5% of residents in Blacksburg are enrolled in college or graduate school, the largest share in the state and the 10th largest share of any U.S. metro. Many college students are likely among the 18.0% of adults in Blacksburg who report drinking excessively, a larger share than the 17.4% rate for Virginia as a whole.

Washington

Drunkest city: Seattle-Tacoma-Bellevue

> MSA adults binge or heavy drinking: 20.5% (top 25%)

> State adults binge or heavy drinking: 17.8% (24th highest)

> Alcohol-related driving deaths: 34.0%

Of the 11 metro areas in Washington, Seattle-Tacoma-Bellevue is the only one in which more than 1 in every 5 adults drink excessively. Wealthier, better-educated Americans are more likely to drink excessively — and Seattle has the highest median income and bachelor’s degree attainment rate of any metro area in the state. The typical Seattle household earns $78,612 a year, about $11,500 more than median income statewide. Similarly, 42.0% of metro area adults have a four-year college degree compared to 35.1% of adults across Washington.

While excessive drinking is never healthy, higher educational attainment and incomes appear to affect health outcomes across broad populations more than excessive drinking rates. Despite ranking as the heaviest drinking metro area in Washington, Seattle is also the healthiest. Only 11.4% of adults in Seattle report being in fair or poor health, well below the 14.3% share of adults statewide.

West Virginia

Drunkest city: Morgantown

> MSA adults binge or heavy drinking: 16.1%

> State adults binge or heavy drinking: 11.4% (2nd lowest)

> Alcohol-related driving deaths: 28.0%

Alcohol is expensive — prohibitively so for many lower-income Americans. In West Virginia, the typical household earns just $43,385 a year, far less than the national median household income of $57,617. The state’s low incomes may be one reason why just 11.4% of adults in West Virginia report excessive drinking, the second smallest share of any state.

In the Morgantown metro area, the typical household earns $50,120 a year, the most of any metro area in West Virginia. Additionally, a greater than typical 16.5% share of residents are enrolled in college or graduate school, where heavy alcohol use is far more common. An estimated 16.1% of Morgantown adults drink heavily or binge drink, the largest share of any metro area in the state.

Wisconsin

Drunkest city: Green Bay

> MSA adults binge or heavy drinking: 26.5% (top 10%)

> State adults binge or heavy drinking: 24.5% (2nd highest)

> Alcohol-related driving deaths: 50.5% (top 10%)

Green Bay is the heaviest drinking metro area in both Wisconsin and the United States. Some 26.5% of area adults drink excessively compared to 24.5% of adults in Wisconsin and 18.0% of adults nationwide. Despite widespread alcohol abuse in the metro area, adults in Green Bay report fewer mentally or physically unhealthy days per month on average than is typical nationwide

As is often the case in heavy drinking areas, alcohol-impaired driving appears to be a considerable problem in Green Bay. The metro area is one of only five nationwide where more than half of all driving deaths involve alcohol.

Wyoming

Drunkest city: Casper

> MSA adults binge or heavy drinking: 18.2%

> State adults binge or heavy drinking: 17.5% (23rd lowest)

> Alcohol-related driving deaths: 40.0% (top 10%)

In the Casper metro area, 18.2% of adults drink excessively, the largest share of any city in Wyoming and slightly above the 18.0% national rate.

The high prevalence of heavy and binge drinking habits in Casper may contribute to adverse health outcomes. Alcohol is involved, for example, in 40% of all driving deaths in Casper, far more than the 30% national rate. Overall, 21 in every 100,000 Casper residents die from causes related to alcohol annually, more than double the national rate of 10 deaths per 100,000 Americans.

Drinking and smoking make you look older Drinking heavily and smoking for years are well-known features of an unhealthy lifestyle. They can also make you look older, according to a new study

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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. For more on how this list was produced, click here.

24/7 Wall Street is a USA TODAY content partner offering financial news and commentary. Its content is produced independently of USA TODAY.