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Where America drinks most: Study finds binge-drinking trouble spots

Where America drinks most: Study finds binge-drinking trouble spots


Source: USA Today

Kim Painter

April 24, 2015


How much alcohol you drink depends a lot on where you live. A new study finds more than a third of adults in some areas drinking at dangerous levels but “huge variations” in rates of heavy and binge drinking across the USA.


The study of adults ages 21 and up, published Thursday in the American Journal of Public Health, finds nationwide levels of heavy and binge drinking on the rise, led by increases among women – although women still drink much less than men do.


The nationwide increases have been reported previously. The new study is the first, though, to take a comprehensive, county-by-county look at where problem drinking is worst and growing fastest.


“The percentage of people who drink is not changing much, but among drinkers, we are seeing more heavy drinking and more binge drinking,” says Ali Mokdad, a lead author of the study who is a professor at the Institute for Health Metrics and Evaluation at the University of Washington. “We’re going in the wrong direction.”


Heavy drinking, defined as more than two drinks a day for men and more than one drink a day for women, is linked to heart disease, cancer, liver damage and many other health problems. Binge drinking, defined as at least five drinks on one occasion for men and at least four drinks for women, is linked to car crashes, injuries and alcohol poisoning.


Leading the nation in binge drinkers: Wisconsin’s Menominee County, home of the Menominee Indian Reservation, where 36% of drinking-age adults binge-drink. Least likely to binge: heavily Mormon Madison County, Idaho, where just 5.9% do.


Leading in heavy drinking: sparsely populated Esmeralda County in Nevada, where 22.4% drink that much. Least likely to drink heavily: Hancock County, in Tennessee’s Appalachian Mountains, where the rate is 2.4%.


In general, the study finds the highest rates of overall and problem drinking in New England, along the Pacific coast and in the northern parts of the West and Midwest.


Overall drinking – the share of adults who have even one drink in a month – is highest in affluent, well-educated communities, led by suburban Falls Church, Va., where 78.7% of drinking-age adults drink, and several counties in Colorado, including ski resort areas around Aspen and Breckenridge.


“Educated, affluent (people) enjoy a glass of wine every night,” Mokdad says. “They can afford it, and they are cautious about their health.”


Problem drinking is generally most common in poor and rural areas, he says. And while varying social norms and economic stresses play roles, access to alcohol matters too, he says.


“Several studies show that just having several bars close together can lead people to bar hop and binge drink,” he says.


The rankings give communities new ammunition to seek money and promote policies to address problem drinking, Mokdad says. Effective strategies include enforcing laws against drunk driving, holding bars responsible for serving drunk customers and limiting the number and operating hours of bars and liquor stores, he says.


Seeing how problem drinking varies even within one state should help such efforts, says William Kerr, senior scientist at the Alcohol Research Group. For example, he says, the study shows the heaviest binge drinking in Texas is along the border with Mexico. “That can be useful for directing prevention and treatment efforts” where they are needed most. He was not involved in the study.


Of course, many areas with serious drinking problems are well aware of them.


“This is nothing new to us,” says Diane Hietpas, a health educator at The Menominee Tribal Clinic in Keshena, Wis. She says the clinic screens every patient over age 12 for problem drinking and that the community supports many prevention and treatment programs, including an annual sobriety powwow.


“But people don’t understand that this is a symptom of a much larger problem of poverty and trauma,” Hietpas says. “Our people are hurting.”


The county is among dozens in Wisconsin that have made reducing problem drinking a health priority in recent years, county health officer Jaime Bodden said in an email. The data in the study, which goes through 2012, would not reflect many of those efforts, she says.