These South Dakota counties are home to the most excessive drinkers, study finds

(NEXSTAR) — You may have an idea of how much alcohol your community drinks. But recently released data helps illustrate which areas in South Dakota are and aren’t prone to excessive drinking.

Earlier this year, the University of Wisconsin Population Health Institute released its 2023 County Health Rankings and Roadmaps report, which is meant to raise awareness about factors that can impact health outcomes and disparities nationwide.


Researchers use numerous data points to determine the length and quality of life on a state-by-state basis. Among those factors is alcohol use, including reported excessive drinking. 

To determine the rates of excessive drinking per state, researchers used self-reported data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance system. For the 2023 report, the University of Wisconsin used data from 2020 — the first year of the COVID pandemic. 

Excessive drinking encompasses both binge drinking (four or more drinks on one occasion for women, five or more for men) and heavy drinking (eight or more drinks a week for women, fifteen or more for men).

As a state, South Dakota had the sixth-highest percentage of adults self-reporting excessive drinking at 21%, tying with Pennsylvania.

Many of our neighboring states outranked us: Iowa came in second (25%), Montana ranks third (24%), Nebraska and North Dakota tied for fourth overall (23%), and Minnesota is part of a three-way tie for fifth (22%).

Wisconsin is home to the most self-reported excessive drinkers. Overall, 26% of adults in the state — which sports an MLB team named in honor of its beer brewing industry — self-reported excessive drinking. 

Overall, 19 states had an excessive drinking rate at or above 20%.

When reviewing county-level data, researchers found at least 20% of adults in 57 of South Dakota’s 67 counties reported excessive drinking. Marshall County, located in the northeast corner of the state, had the highest percentage at 25%.

Two counties, Todd and Oglala Lakota, reported the lowest excessive drinking rate at 17%.

The interactive map below shows the rates reported per South Dakota County. You can view a nationwide map here.

The University of Wisconsin also reviewed the number of alcohol-impaired driving deaths per state and county. 

Though it has a relatively low rate of adults drinking excessively (18%), California had the highest number of alcohol-impaired driving deaths at 5,185 between 2016 and 2020, according to data collected from the National Highway Traffic Safety Administration’s Fatality Analysis Reporting System

While South Dakota has a higher rate of adults drinking excessively, it reported far fewer alcohol-impaired driving deaths during the same time period at 223 — the 10th-lowest in the nation, just behind North Dakota at 221 deaths.

However, researchers found that 36% of driving deaths in South Dakota involved alcohol, the sixth-highest rate in the nation. Montana had the worst rate at 46%, followed by North Dakota at 41%.

In three counties in South Dakota, every driving death between 2016 and 2020 involved alcohol: Spink, Perkins, and Mellette. It is worth noting, though, that the counties reported a combined six driving deaths: four in Spink, and one each in Perkins and Mellette.

Nationally, 27% of all driving deaths involved alcohol, according to the County Health Rankings.

“When consumed in excess, alcohol is harmful to the health and well-being of those that drink as well as their families, friends, and communities,” researchers noted

A study recently published in the Journal of American Medicine found more Americans are dying from alcohol-related deaths, especially women. Between 2018 and 2020, researchers say CDC shows mortality rates among men increased by 12.5%, Nexstar’s WPIX reports. Among women, that rate was almost 15%.


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