Alcohol – Heavy Alcohol Consumption
This indicator reports the percentage of adults who self-report excessive drinking in the last 30 days. Data were from the 2022 Behavioral Risk Factor Surveillance System (BRFSS) survey and are used for the 2025 County Health Rankings.
Excessive drinking is defined as the percentage of the population who report at least one binge drinking episode involving five or more drinks for men and four or more for women over the past 30 days, or heavy drinking involving more than two drinks per day for men and more than one per day for women, over the same time period. Alcohol use is a behavioral health issue that is also a risk factor for a number of negative health outcomes, including: physical injuries related to motor vehicle accidents, stroke, chronic diseases such as heart disease and cancer, and mental health conditions such as depression and suicide. There are a number of evidence-based interventions that may reduce excessive/binge drinking; examples include raising taxes on alcoholic beverages, restricting access to alcohol by limiting days and hours of retail sales, and screening and counseling for alcohol use disorder (Centers for Disease Control and Prevention, Preventing Excessive Alcohol Use, 2020).
Source
Accessed via County Health Rankings.
Source Description
The Behavioral Risk Factor Surveillance System (BRFSS) is
“… a collaborative project of the Centers for Disease Control and Prevention (CDC) and U.S. states and territories. The BRFSS, administered and supported by CDC’s Behavioral Risk Factor Surveillance Branch, is an ongoing data collection program designed to measure behavioral risk factors for the adult population (18 years of age or older) living in households.”
Citation: Centers for Disease Control and Prevention, Office of Surveillance, Epidemiology, and Laboratory Services. Overview: BRFSS 2010.
The health characteristics estimated from the BRFSS include data pertaining to health behaviors, chronic conditions, access and utilization of healthcare, and general health. Surveys are administered to populations at the state level and then delivered to the CDC and tabulated into county estimates by the BRFSS analysis team. Beginning with the 2016 County Health Rankings, the CDC produces county estimates using single-year BRFSS data and a multilevel modeling approach based on respondent answers and their age, sex, and race/ethnicity, combined with county-level poverty, as well as county- and state-level contextual effects. To produce estimates for those counties where there were no or limited data, the modeling approach borrowed information from the entire BRFSS sample as well as Census Vintage 2014 population estimates. CDC used a parametric bootstrapping method to produce standard errors and confidence intervals for those point estimates. This estimation methodology was validated for all U.S. counties, including those with no or small (<50 respondents) samples.
Methodology
Indicator percentages are acquired for year 2022 from Behavioral Risk Factor Surveillance System (BRFSS) prevalence data, accessible through the University of Wisconsin’s County Health Rankings. This indicator reports the percentage of adults that report either binge drinking or heavy drinking. Percentages are generated based on the valid responses to the following questions: “One drink is equivalent to a 12-ounce beer, a 5-ounce glass of wine, or a drink with one shot of liquor. During the past 30 days, on the days when you drank, about how many drinks did you drink on the average?” and “During the past 30 days, what is the largest number of drinks you had on any occasion?”
Respondents are considered heavy drinkers if they were male and reported having more than 2 drinks per day, or females that reported having more than 1 drinks per day on average. Respondents are considered binge drinkers if they were male and reported having more than 5 drinks on a single occasion, or females that reported having more than 4 drinks on a single occasion. Percentages are age-adjusted and only pertain to the non-institutionalized population aged 18 and up. Both numerators and denominators (number of adults) are not provided in the CHR data tables, so population age >= 18 (as calculated from CHR raw variables) is used as denominator and the numerator is back calculated using the following formula:
Additional detailed information about the BRFSS, including questionnaires, data collection procedures, and data processing methodologies are available on the BRFSS web site. For additional information about the single-year estimates displayed here, please visit the Excessive Drinking indicator information.
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