FRIDAY, April 2, 2004 (HealthDayNews) -- In San Antonio, they remember the Alamo but forget when to say when.
The metropolitan area around the historic Texas city has the highest rate of binge drinking -- imbibing till you're drunk -- in the entire United States, according to a new federal study. Other hotspots for booze consumption include the Midwest (particularly the Dakotas and Iowa) and Nevada, while teetotalers rule the roost in Mormon-dominated Utah as well as Chattanooga, Tenn.
So do booze-happy cities deserve a bad rap? That's not the point of the research, said study co-author Dr. Timothy S. Naimi, an epidemiologist with the U.S. Centers for Disease Control and Prevention.
"It's not to say they're bad people. This just points out that that kind of level [of drinking] is associated with bad things like injuries, interpersonal violence and unprotected or unplanned sexual encounters," he said.
Naimi and his colleagues examined two national health surveys from 1997 and 1999 and compared the results from 120 metropolitan areas in 48 states and Washington, D.C. They looked for people who reported binge drinking -- for men, downing five or more drinks at one time; for women, four drinks -- at least once in the past 30 days.
"The net effect of drinking five or more drinks in a short amount of time is that everyone will be impaired," Naimi said. "Drinking at that level tends to be associated with problems."
The study findings appear in the April issue of the American Journal of Public Health.
The researchers found that an average of 14.5 percent of adults surveyed were binge drinkers, with the highest level in San Antonio (23.9 percent). Of the 20 metropolitan areas with the highest levels of binge drinking, 17 are in the Midwest, Texas and Nevada.
After San Antonio at No. 1, the top 10 metropolitan areas, in descending order, are: Grand Forks, N.D.; Milwaukee; Austin, Texas; Sioux Falls, S.D.; Davenport, Iowa.; Cedar Rapids, Iowa.; Duluth, Minn.; Lincoln, Neb.; and Springfield, Mass. (Some of the metropolitan areas include residents in more than one state and more than one city.)
In the top three metropolitan areas -- San Antonio, Grand Forks and Milwaukee -- an estimated one third of adult men are binge drinkers.
Chattanooga residents reported the lowest level of binge drinking (4.1 percent). The study didn't rank other alcohol-averse metropolitan areas in order, but the driest regions include Arizona, most of the South (with the exceptions of Texas and Louisiana), and Ohio.
Utah is on list of dry states, too, but its residents who do drink tend to imbibe more than those in other states, according to the study.
Naimi said religious and cultural factors may be at play. Utah and the South report lower levels of overall binge drinking, and it may be no coincidence that Mormons in Utah and Southern Baptists in the South frown on alcohol, he said. "Another contributing factor is that prices and tax rates in different parts of the country vary," he added.
Overall, young men -- and men in general -- report more binge drinking, Naimi said. Whites and Latinos, meanwhile, report more boozing than blacks.
And what of San Antonio, which is already reeling from a newfound reputation as one of the nation's fattest cities?
"Maybe now we have another indicator that we do need to give more attention to prevention of the abuse of alcohol," said Sharon Shook, executive director of the San Antonio Council on Alcohol and Drug Abuse, who pointed out that the city already has a high rate of drunken driving.
While Shook said she's not sure if the federal study used the right measures for binge drinking, she acknowledged that San Antonio is a fast-growing city with plenty of colleges and universities where booze may be popular. She added the city could put more emphasis on alcoholism treatment and prevention.
Worthwhile programs include those that work with families, she said. "We could be teaching people how to feel great in other ways [besides alcohol consumption], and that needs to start in early childhood and go all the way through," Shook said.
From the federal perspective, Naimi said other possible strategies to combat binge drinking include higher alcohol taxes and training of bartenders to prevent them from serving booze to drunk patrons. "The problem is that there are powerful financial interests [who] are not necessarily served by some of these things," he said.
More information
Learn more about binge drinking from the Harvard School of Public Health. The State University of New York at Potsdam also offers a fact sheet on binge drinking.
