How Boozy Is Your City?

When it comes to health, where you live matters. A lot. This probably doesn’t come as a big surprise. For example, very affluent Marin County ranks far and away as California’s healthiest county across nearly all measures. It’s tops in the state for healthy behaviors like low rates of smoking and higher rates of physical activity and health care and also for social and economic factors, like its relatively high number of people who attended college and lower rates of violent crime.

Yet, for all its health wonders, Marin County, which is situated in the North San Francisco Bay area, ranks near the bottom of the state when it comes to excessive drinking: Twenty-two percent of the population polled for a major report admitted to bingeing on alcohol or drinking heavily. The state average, by comparison, is 17%; the national average is 16%.

What the County Health Rankings Tell Us

This data is part of an annual report, the County Health Rankings, an assessment of every single county in the United States. The 2015 findings, jointly produced by the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, were recently released and included, among a wealth of data, information on the unhealthiest counties when it comes to people drinking to excess. Citizens who throw back too many drinks pose a real problem for local governments. At its worst, excess drinking leads to alcohol-impaired driving deaths. But it also accounts for alcohol poisoning emergency room visits and reckless and destructive behavior, and plays a role in the number of unwanted pregnancies.

The County Health Rankings make clear that almost no place in the U.S. is free from the effects of alcohol, no matter how wealthy or impoverished. “Drinking and substance abuse crosses income levels and education levels,” says Jan O’Neill, an associate researcher at the University of Wisconsin and a Community Coach for the County Health Rankings and Roadmaps. “It’s one of those odd things that doesn’t necessarily go down as a county’s health improves.”

How Boozy Is Your City?The County Health Rankings, published annually since 2010, piggyback on America’s Health Rankings, which compare each state on a variety of measures. The county rankings compare data within a state (not between states) by blending information on an exhaustive list of behaviors and outcomes that account for health. “We don’t just look at how many times somebody sees a doctor,” says O’Neill. “We look at various items that contribute to health, from education levels to income levels to commuting times to access to healthy food and clean water. It’s in-depth and very nuanced.”

To measure alcohol abuse, the researchers defined excessive drinking as bingeing on four or five drinks at least once in the prior month, or consuming more than one drink daily for women or more than two for men. They then pulled data from seven years of the Behavioral Risk Factor Surveillance System to create the rankings and ranked each county’s rate of drunk-driving deaths by crunching five years of data from the Fatality Analysis Reporting System.

That’s not where they stopped. “It’s not enough just to offer rankings,” says O’Neill. “We look at policies, evaluate how much scientific evidence there is to suggest something works and make recommendations based on that research.” The researchers evaluated 36 different policies and programs that can improve health related to drugs and alcohol, from alcohol screenings — health practitioners discussing the dangers of alcohol abuse with their patients — to limiting alcohol advertisements. O’Neill points to three efforts as particularly effective when it comes to lowering the rate of drunk-driving or substance-abuse induced fatalities and injuries: strict enforcement of blood-alcohol limits, ignition interlocking devices and family treatment drug courts. On the other hand, campus-wide alcohol bans, ads to encourage designated driving, limiting ads for alcohol brands and setting a minimum age for someone to sell alcohol have not been proven effective.

How Much Does Your Town Drink?

Since the County Health Rankings don’t compare one state to another, to see how your city fares for excessive drinking rates, among other health measures, you’ll need to look up your county on the County Health Rankings site.

Here are the County Health Rankings for excessive drinking within the best and worst counties within each of the nation’s seven most populous states:

 

California:

17% of the state’s population drinks excessively, on average.

 

Best Performers: (lowest rates of excessive drinking)

CountyExcessive Drinking %
Sutter11%
Merced14
Kings15
Santa Clara15
Madera15
Monterey15
Los Angeles15

 

Worst Performers: (highest rates of excessive drinking)

CountyExcessive Drinking %
Sonoma22
Humboldt22
Marin22
Napa24
San Benito24
Calaveras24
Mendocino24
Mono26
Tuolumne27

 

New York:

17% of the state’s population drinks excessively, on average.

 

Best Performers:

CountyExcessive Drinking %
Livingston11
Seneca11
Rockland11
Cattaraugus12
Schoharie12
Washington12

 

Worst Performers:

CountyExcessive Drinking %
Ulster23
Schuyler23
Putnam23
Columbia23
Clinton25
St. Lawrence25

 

Texas:

16% of the state’s population drinks excessively, on average. County Health Rankings published excessive drinking rankings for only 61 of Texas’ 254 counties.

 

Best Performers:

CountyExcessive Drinking %
Polk8
Taylor10
Angelina10
Maverick10
Van Zandt10

 

Worst Performers:

CountyExcessive Drinking %
Hunt24
Victoria25
Anderson26
Nueces28
Hudspeth56

 

Florida

16% of the state’s population drinks excessively, on average.

 

Best Performers:

CountyExcessive Drinking %
Washington7
Dixie7
Lafayette8
Calhoun8
Jefferson9
Homes9

 

Worst Performers:

CountyExcessive Drinking %
Indian River20
Brevard20
Pasco20
Seminole20
St. John’s21
Bay21
Wakulla21
Monroe28

 

Illinois

20% of the state’s population drinks excessively, on average.

 

Best Performers:

CountyExcessive Drinking %
Boone9
Marion10
Franklin12
Coles14
Williamson14
Kankakee14

 

Worst Performers:

CountyExcessive Drinking %
Livingston25
Washington27
Randolph27
Monroe28
Effingham31

 

Pennsylvania

17% of the state’s population drinks excessively, on average.

 

Best Performers:

CountyExcessive Drinking %
Bedford8
Miffin11
Lawrence11
Montour11
Crawford11
Franklin11

 

Worst Performers:

CountyExcessive Drinking %
Lackawana24
Elk24
Monroe24
Fulton24
Clinton25

 

Ohio:

18% of the state’s population drinks excessively, on average.

 

Best Performers:

CountyExcessive Drinking %
Wayne10
Defiance10
Athens10
Hancock11
Williams11
Darke11

 

Worst Performers:

CountyExcessive Drinking %
Belmont23
Lake23
Putnam23
Huron26
Ottawa27
Crawford27
Mercer31

America’s Health Rankings does rank U.S. states for excessive drinking. Below are rankings from the 2014 report:

Lowest rates of excessive drinking:

  1. Tennessee (lowest rate in the U.S.)
  2. West Virginia
  3. Alabama
  4. Utah
  5. Mississippi, Oklahoma (tie)

 

Highest rates of excessive drinking:

  1. Iowa
  2. Illinois
  3. Minnesota
  4. Wisconsin
  5. North Dakota

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