States with the Most Binge Drinkers

About 1 in 5 adults in Iowa (20.4%) report binge drinking — the highest rate in the country, narrowly ahead of Montana (20.39%), with Nebraska (19.71%), North Dakota (19.38%), and Wisconsin (19.06%) right behind. The gap between the top and bottom of this map is smaller than on most of our health rankings: Iowa's 20.4% is a little under twice the 11.26% in Utah, which ranks last. But the most striking thing here isn't the spread — it's how tightly the top clusters into one part of the map.

The top five are essentially a single block: the Upper Midwest and Northern Plains. Iowa, Montana, Nebraska, North Dakota, and Wisconsin sit shoulder to shoulder geographically, and they pack the top of the ranking. This is one of the cleaner regional stories in any of our maps — where the leaders on, say, obesity or arthritis are scattered, binge drinking concentrates in a recognizable belt of states that share long-standing reputations for heavy social and seasonal drinking. The pattern tends to track culture more than it tracks the broader health geography we see elsewhere.

It helps to be precise about what this metric does and doesn't measure. Binge drinking, as CDC's survey defines it, counts adults who report a heavy single-occasion episode — roughly five-plus drinks for men or four-plus for women in one sitting — within the past month. That is not the same as chronic or daily heavy drinking. Our separate Heaviest Drinkers map captures a different behavior, and the difference shows: Montana ranks #2 here and #1 for heavy drinking (9.81%), but Iowa tops *this* list without leading that one. So binge drinking is best read as a measure of episodic, occasion-driven excess — common in states where a big night out is the norm — rather than steady, everyday consumption.

It's also worth noting who sits at the bottom. Utah (11.26%) ranks last for binge drinking, and it ranks last on our smoking map too (5.72%) — the only state to bottom out on both. That consistency likely reflects well-documented cultural and religious factors that hold down alcohol and tobacco use alike, which is a reminder that these rankings often capture local norms as much as anything physiological. West Virginia, near the bottom here at #44 (13.32%), is a useful contrast: it tops several of our other health maps yet drinks comparatively little by this measure.

A note on method: every figure here comes from the same CDC survey (BRFSS), one year (2024), and one definition of binge drinking, so the 50-state comparison is apples-to-apples. Because it is self-reported, the values reflect what adults are willing to tell a surveyor, which can nudge a sensitive behavior like heavy drinking downward; the ranking measures *reported* binge drinking. The numbers are CDC's; the ranking and analysis are ours.