My Home County Healthiest In State Despite Higher Than Average Binge Drinking

My family and I live just north of San Francisco, in Marin County. We moved here a number of years ago to be closer to my wife’s family, who live in Sonoma County. When she was working in San Francisco, Marin was in the middle of work and family, so it made sense. There’s a lot of good things to recommend here, though it is a very expensive place to live, and in fact a few years ago I saw that it was the third-most expensive county for real estate in the United States.

Our local newspaper, the Marin Independent Journal (or I.J.) — which in the interest of full disclosure is part of the Bay Area Newsgroup, the group I write my newspaper column for — had an interesting headline today about the health of Marin’s residents. In Marin County ranked healthiest county in state for third year in a row, despite residents’ love of alcohol, the author reports on a new study recently released by the neo-prohibitionist Robert Wood Johnson Foundation, along with the University of Wisconsin Population Health Institute. This is the third year of the survey, which ranks the health of America’s counties. For the third straight year Marin County was declared the most healthy California county. For an equal number of years, Marin also has the dubious distinction of a higher than average level of binge drinking.

The percentage of Marin residents who told the pollsters they had engaged in binge drinking within the past 30 days — 24 percent — exceeded the state average of 17 percent and the national benchmark of 8 percent. The survey defines binge drinking as consuming more than four alcoholic beverages on a single occasion, if you’re a women, and five drinks if you’re a man.

But maybe that’s the case because there’s little or no correlation between the two, or at least not the correlation that the neo-prohibitionists who funded the study would prefer. They assume, for primarily political and philosophical reasons, that binge drinking is unhealthy. But what if it’s not? What if it has more to do with the way it’s now defined, which again has more to do with politics than reality. The way “binge drinking” is defined has greatly narrowed over the past few decades which is at least one reason why anti-alcohol groups keep insisting that binge-drinking is such a growing societal problem. But at the same time, several recent studies and meta-studies have revealed that people who drink moderately tend to live longer than those who abstain, an inconvenient fact that is rarely mentioned by neo-prohibitionist groups because it doesn’t fit with their agenda. But even worse, from their point of view, some of these same studies have concluded that even people who binge drink tend to be healthier and live longer than the total abstainers. So perhaps binge drinking and health are more closely associated than we think, just not in the way that neo-prohibitionists would prefer. The least healthy county for which there’s data, Del Norte, has a lower rate of binge drinking (10%) than the healthiest.

But as even the Robert Wood Johnson Foundation makes clear in the own press release about the survey, “healthier counties are no more likely than unhealthy counties to have lower rates of excessive drinking.”

Here’s the top counties in states, followed by the county’s “excessive drinking” percentage, followed by their state’s average, with the “national benchmark” being 8%:

  1. Alabama (Shelby): 13%/12%
  2. Alaska (Southeast Fairbanks): 13%/19%
  3. Arizona (Santa Cruz): 18%/19%
  4. Arkansas (Benton): 12%/12%
  5. California (Marin): 24%/17%
  6. Colorado (Pitkin): 30%/18%
  7. Connecticut (Tolland): 17%/18%
  8. Delaware (New Castle): 21%/19%
  9. Florida (St. Johns): 21%/16%
  10. Georgia (Fayette): 18%/14%
  11. Hawaii (Honolulu): 18%/19%
  12. Idaho (Blaine): 23%/15%
  13. Illinois (Kendall): 23%/19%
  14. Indiana (Hamilton): 17%/16%
  15. Iowa (Winneshiek): 19%/20%
  16. Kansas (Riley): 22%/15%
  17. Kentucky (Oldham): 16%/11%
  18. Louisiana (St. Tammany): 19%/15%
  19. Maine (Sagadahoc): 17%/17%
  20. Maryland (Howard): 14%/15%
  21. Massachusetts (Dukes): 29%/19%
  22. Michigan (Leelanau): 20%/18%
  23. Minnesota (Steele): 18%/19%
  24. Mississippi (DeSoto): 10%/11%
  25. Missouri (St. Charles): 24%/17%
  26. Montana (Gallatin): 22%/19%
  27. Nebraska (Cedar): 23%/19%
  28. Nevada (Douglas): 20%/19%
  29. New Hampshire (Merrimack): 16%/18%
  30. New Jersey (Hunterdon): 18%/16%
  31. New Mexico (Los Alamos): 11%/13%
  32. New York (Putnam): 21%/17%
  33. North Carolina (Wake): 15%/13%
  34. North Dakota (Griggs): 19%/22%
  35. Ohio (Delaware): 20%/17%
  36. Oklahoma (Cleveland): 16%/14%
  37. Oregon (Benton): 15%/16%
  38. Pennsylvania (Union): 16%/18%
  39. Rhode Island (Bristol): 17%/19%
  40. South Carolina (Beaufort): 20%/14%
  41. South Dakota (Brookings): 20%/19%
  42. Tennessee (Williamson): 15%/9%
  43. Texas (Collin): 13%/16%
  44. Utah (Morgan): 9%/9%
  45. Vermont (Chittenden): 20%/19%
  46. Virginia (Fairfax): 20%/16%
  47. Washington (San Juan): 21%/17%
  48. West Virginia (Pendelton): 12%/10%
  49. Wisconsin (St. Croix): 31%/24%
  50. Wyoming (Teton): 22%/17%

In every single case, for the healthiest county in every one of the 50 states, their “excessive drinking” percentage is above the national benchmark, and in many cases well above it. 38 of the 50 states’ healthiest counties are at least twice the national benchmark and six are within a point, or more, of tripling it. Every state’s binge drinking average is well above the national average, which seems strange. And in 35 of the states, the healthiest county also has a binge drinking percentage that’s the same or higher than the state average, too. But the obvious takeaway is what you’d expect given total mortality studies, which is that there’s an inverse correlation between binge drinking and health. The counties with the healthiest residents also have higher numbers of binge drinkers. That much is obvious and is supported by the data, despite the story being spun being very different, even the opposite of what conclusions can be drawn from the numbers. Not that they’re making it easy to see. I had to look at each state and then each county’s records to make a chart of this somewhat damning data.

Of course, part of this is how meaningless our definition of binge drinking has become. Including people who drink five or more drinks in a single setting once a month or even once a year distorts the real issues of problem drinkers. It inflates the numbers, which is good if your agenda is to make false accusations about how bad alcohol is for society but terrible if you really want to adress those problems.

Here in California, the five healthiest counties are:

  1. Marin
  2. Santa Clara
  3. San Benito
  4. Placer
  5. San Mateo

Every single one of the ten healthiest counties in California have an excessive drinking rate above national benchmark, too.

Larry Meredith, director of the Marin County Department of Health and Human Services, is quoted in the IJ’s article, saying. “Our strategy must continue — to eliminate health disparities, and conditions that undermine a long and happy life.” Except that he keeps insisting that binge drinking, as defined by the study, “continues to be an issue,” despite the fact that the same study’s numbers seem to indicate the opposite. In the healthiest counties across the nation, binge drinking, as they define it, is higher in every instance.

Real binge drinkers, the more undefinable people who simply keep drinking and rarely ever stop, are not really captured by this type of survey, because they’re lumped together with responsible people who on occasion drink a little more than usual, whether in celebration of something or to drown their sorrows. As long as we keep drawing more and more people into the category of “binge drinkers,” we dilute the real problem. When that mistake is obvious even by a study conducted by an anti-alcohol organization, and then those results all but ignored, it exposes the propaganda and dishonesty of their agenda.

It’s almost funny to see Marin County’s own anti-alcohol organization, Alcohol Justice (who until last year were the Marin Institue) try to distance themselves from this. Their public affairs director, Michael Scippa, says AJ “shouldn’t be faulted for not being more effective in reducing Marin County’s alcohol consumption.” He lists a number of excuses, such as “availability and Marin being a mostly affluent community” and that “[they’re] constantly battling an industry that has enormous resources.” But what is he apologizing for? That Marin County has the state’s healthiest people living in it, despite ignoring his group’s propaganda? Maybe it’s not the people, but the propaganda that’s wrong? Because people all over the country are ignoring his advice and are all the healthier for it.


  1. Erik says

    I also live in the healthiest county (Los Alamos) in my state (New Mexico), but I know excessive drinking has nothing to do with it. 80-90 percent of the county either works at, or is a family member of someone who works at the national lab here, so basically everyone has insurance. Only 5% uninsured, well below the state average of 23% and even below the national benchmark of 11%. It is also a pretty wealthy county, so people are getting health care when they need it.

    I was also confused by the national benchmark being lower than all the states averages for excessive drinking, so I went and looked at the report and their definition is that it is the 90th percentile, so 10 percent of the counties have a lower excessive drinking percentage and 90 percent higher. Seems like a weird thing to compare to, especially when the state numbers are given as averages.

    New Mexico has some towns that are pretty notorious for drinking problems, so I thought maybe our unhealthy counties might show a correlation with high drinking rates. Looking at the five unhealthiest counties and comparing their rates vs the state average, 1 had a higher drinking rate, 2 the same, and 2 lower, so excessive drinking seems to have minimal impact on health here. Looking at the other factors, the most glaring causes seem to be children in poverty (5-0, double digits over state average for 3 of them), uninsured (5-0), obesity (5-0), and physical inactivity (5-0). Even smoking (4-1) and fast food (2-3) don’t really seem to be big factors. If I had the time, it would be interesting to look at the other states unhealthiest counties. I bet the results are similar and it would help debunk their claims that “excessive drinking” is linked to unhealthiness.

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