Heavy drinking is on the rise in many parts of the U.S. — up more than 17 percent since 2005, researchers reported Thursday. And rates are rising faster among women than among men.
But there's a big difference county by county, the statistics show. In some counties, more than a third of the residents are binge drinkers and more than 20 percent are heavy drinkers. The hardest-drinking U.S. county? Menominee County, Wisconsin.
Heavy drinkers are setting themselves up for liver disease and many forms of cancer, while binge drinkers can see not only health effects but damage to their jobs, marriages and friendships — not to mention the risk of vehicle accidents.
"In 2012, 8.2 percent of all Americans were considered heavy drinkers and 18.3 percent were binge drinkers," the University of Washington's Institute for Health Metrics and Evaluation says in a statement.
"Madison County, Idaho, had the lowest levels of binge drinking in 2012 (5.9 percent), while Menominee, Wisconsin, had the highest rates of binge drinking (36 percent among residents). For heavy drinking, Hancock County, Tennessee, had the fewest heavy drinkers (2.4 percent of its population) and Esmeralda County, Nevada, recorded the largest proportion of heavy drinkers (22.4 percent)."
Rates of binge drinking spiked by 17.5 percent among women between 2005 and 2012 but went up just 4.9 percent among men, the analysis showed.
The statistics jibe with what federal health officials are seeing.
"It confirms what we been seeing in a whole other group of metrics," says Dr. George Koob, director of the National Institute on Alcohol Abuse and Alcoholism.
"We have seen an increase in the same time period of hospitalizatons due to alcohol and emergency room visits due to alcohol," Koob told NBC News.
What do the hard-drinking counties have in common? It's not so easy to define, says IHME's Dr. Ali Mokdad, who helped write the report.
"Three things explain it," Mokdad told NBC News. "Socioeconomic factors — people who are educated, people who have the means to enjoy a drink when they come home from work, will drink." But people with lower education are more likely to binge drink — which the Centers for Disease Control and Prevention defines as having five or more drinks in two hours for a man, or four or more for a woman.
Availability is also a factor. "If you have more outlets selling alcohol and you have more bars next to each other, people tend to go from one to another and have more drinks," Mokdad said.
The third factor: social norms. If your friends and family knock back a few to celebrate, or commiserate, you are more likely to, also. Binge drinking and heavy drinking go on in poor times as well as prosperous times, Mokdad said.
Nationally, 18.3 percent of Americans were binge drinkers in 2012, an increase of nearly 9 percent since 2005. But the percentage of drinkers hasn't changed — in both 2005 and 2012, 56 percent of Americans said they drank alcohol at all.
"When you can map out what's happening county by county, over time, and for men and women separately, that's also when you can really pinpoint specific health needs and challenges — and then tailor health policies and programs accordingly," IHME director Dr. Christopher Murray said in a statement.
Koob says NIAAA has seen a big increase in college drinking. "It's not that the percentage of young people is increasing alcohol use," Koob said. "It's that bingeing is more intense."
And Koob has also seen the increase among women drinking more heavily.
"Women are drinking more like men, to put it bluntly," he said.
What works to curb heavy drinking? Taxes, for one thing, says Mokdad. So do laws holding bars and restaurants responsible for letting patrons get overserved. Screening for alcohol dependency can also help, he says.
Koob says college-based programs are important, also.
"It is rapidly becoming obvious to people that you can't just turn kids loose at college and expect them to handle this themselves," he said.
It's clear from the data that the hardest-drinking counties don't necessarily have a lot in common.
Counties with highest rates of binge drinking in 2012
- Menominee County, Wisconsin -36 percent
- Loving County, Texas - 35.5 percent
- Nance County, Nebraska - 35 percent
Counties with lowest rates of binge drinking in 2012
- Madison County, Idaho 5.9 percent
- Utah County, Utah, 6.5 percent
- Hancock County, Tennessee, 7.1 percent.
Wisconsin's Menominee County, 45 miles northwest of Green Bay, abuts the Menominee Indian Reservation. "Unfortunately, drinking has been a problem on some of the reservations," Mokdad noted. "That is a consistent finding."
No. 2 for binge-drinking, Loving County, Texas, has a population of just 82 people, so there are not a lot of numbers to fuel its statistics.
And the counties with heavy drinkers are different. Heavy drinking is defined as having more than one drink on average a day for a woman, two drinks a day for a man.
Counties with highest rates of heavy drinking in 2012
- Esmerelda County, Nevada 22.4 percent
- Sioux County, North Dakota 21.4 percent
- Rolette County, North Dakota 19.6 percent
And the counties with highest rates of any type of drinking:
- Falls Church, Virginia 78.7 percent
- Summit County, Colorado 78.6 percent
- Pitkin County, Colorado 78 percent