This Is the Drunkest County in the US: Ranking America’s Top 50

Published: February 17, 2024 by John Harrington

Excessive alcohol consumption is a national concern, and if the national problem has a ground zero, it is Wisconsin. Binge drinking is as much a part of the state culture as cheese, the Green Bay Packers, and ice fishing.

Using the most recent data from County Health Rankings & Roadmaps, a joint program between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute, 24/7 Tempo identified the U.S. counties with the highest excessive drinking rates. Additional information on the share of driving deaths with alcohol involvement also from the 2023 CHR.Population estimates are from the U.S. Census Bureau’s 2022 American Community Survey.

Excessive drinking is defined by the Centers for Disease Control and Prevention as adults who reported heavy or binge drinking within the prior 30 days. Binge drinking is consuming four or more drinks for women and five or more drinks for men on one occasion. Of the 50 counties in the U.S. whose adults reach that threshold, Wisconsin is represented by 42.

The CDC tracked the prevalence of adults who reported binge drinking by state in 2021 and found that Wisconsin led the U.S. with 23.5% of adults reporting excessive-drinking behavior. (Also See the States with the Highest Rates of Binge Drinking.)

In a report by Wisconsin Public Radio, Julia Sherman, the coordinator for the Wisconsin Alcohol Policy Project in Wisconsin, outlined the reasons for excessive drinking in Wisconsin. She said alcohol is sold in more places in the Badger State than other states. The price of liquor has some of the lowest prices in the nation. Liquor is heavily advertised, particularly on public transit. And there is a cultural expectation in Wisconsin to drink.

Excessive drinking also has been associated with automobile accidents and fatalities, and Wisconsin counties occupy eight of the 10 highest percentages of fatal car accidents involving alcohol. The outliers are Sheridan and Powell counties in Montana.

Scroll below to see America’s drunkest counties:

50. Carroll, Iowa

Source: carlwwycoff / Flickr

Adults who drink excessively: 26.4%
Alcohol-related driving deaths: 41.7% – No.401 out of 3,140 US counties
Total alcohol-related driving deaths: 5

49. Eau Claire, Wisconsin

Source: William Reagan / iStock via Getty Images

Adults who drink excessively: 26.4%
Alcohol-related driving deaths: 46.9% – No.271 out of 3,140 US counties
Total alcohol-related driving deaths: 15

48. Rusk, Wisconsin

Source: Public Domain / Wikimedia Commons

Adults who drink excessively: 26.4%
Alcohol-related driving deaths: 23.1% – No.1,896 out of 3,140 US counties
Total alcohol-related driving deaths: 3

47. Forest, Wisconsin

ForestCountyWisconsinCourthouseUS8WIS32WIS55 by Royalbroil

Source: Royalbroil / Wikimedia Commons

ForestCountyWisconsinCourthouseUS8WIS32WIS55 (CC BY-SA 3.0) by Royalbroil

Adults who drink excessively: 26.4%
Alcohol-related driving deaths: 55.6% – No.128 out of 3,140 US counties
Total alcohol-related driving deaths: 5

46. Vilas, Wisconsin

Source: wackybadger / Flickr

Adults who drink excessively: 26.5%
Alcohol-related driving deaths: 50.0% – No.165 out of 3,140 US counties
Total alcohol-related driving deaths: 12

45. Lafayette, Wisconsin

Source: wackybadger / Flickr

Adults who drink excessively: 26.5%
Alcohol-related driving deaths: 53.8% – No.143 out of 3,140 US counties
Total alcohol-related driving deaths: 7

44. Marquette, Wisconsin

Marquette County Courthouse Feb 2012 by Royalbroil

Source: Image of a stray abandoned kitten.

Marquette County Courthouse Feb 2012 (CC BY-SA 3.0) by Royalbroil

Adults who drink excessively: 26.5%
Alcohol-related driving deaths: 43.8% – No.325 out of 3,140 US counties
Total alcohol-related driving deaths: 7

43. Shawano, Wisconsin

Source: Royalbroil / Wikimedia Commons

ShawanoCounty… (CC BY-SA 3.0) by Royalbroil

Adults who drink excessively: 26.5%
Alcohol-related driving deaths: 36.8% – No.617 out of 3,140 US counties
Total alcohol-related driving deaths: 14

42. Brown, Wisconsin

Source: DenisTangneyJr / iStock via Getty Images

Adults who drink excessively: 26.6%
Alcohol-related driving deaths: 37.9% – No.548 out of 3,140 US counties
Total alcohol-related driving deaths: 33

41. Winnebago, Wisconsin

Source: wackybadger / Flickr

Adults who drink excessively: 26.6%
Alcohol-related driving deaths: 31.5% – No.1,048 out of 3,140 US counties
Total alcohol-related driving deaths: 17

40. Saunders, Nebraska

Source: Public Domain / Wikimedia Commons

Adults who drink excessively: 26.7%
Alcohol-related driving deaths: 4.8% – No.2,944 out of 3,140 US counties
Total alcohol-related driving deaths: 1

39. Dane, Wisconsin

Source: iip-photo-archive / Flickr

Adults who drink excessively: 26.7%
Alcohol-related driving deaths: 35.1% – No.722 out of 3,140 US counties
Total alcohol-related driving deaths: 59

38. Madison, Montana

Source: urbancow / iStock via Getty Images

Adults who drink excessively: 26.8%
Alcohol-related driving deaths: 33.3% – No.807 out of 3,140 US counties
Total alcohol-related driving deaths: 5

37. Iowa, Wisconsin

Source: wxmom / Flickr

Adults who drink excessively: 26.8%
Alcohol-related driving deaths: 19.0% – No.2,279 out of 3,140 US counties
Total alcohol-related driving deaths: 4

36. Jefferson, Montana

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Source: Robstutz / Wikimedia Commons