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There is a difference between having a drink and flat-out drinking, as I like to say, but it is a difference that appears to be appreciated to varying degrees across the country. As we shake off our collective hangovers from New Year’s Eve revelry, the Daily Beast has released its annual list of the country’s drunkest cities – those metropoli that have the biggest cross-reference of a couple of different statistics related to alcohol consumption. It is a pretty interesting list, and this year, the country’s drunkest city is Boston, MA. When I mentioned this to my wife, she was not surprised. A graduate of Boston College, she immediately noted that Boston has numerous colleges and universities – perhaps more than any other major city in the country – and all of those students make a habit of getting plastered on a fairly regular basis.

Boston’s dubious honor was anecdotally backed up by Ford Vox, a Boston-based brain injury physician and journalist, who noted that his own experience in head injury rehabilitation units suggests that Boston’s serious drinking habits are both real and nothing to be proud of. Vox noted that Boston suffers high numbers of casualties from driving under the influence, as well as injuries suffered in drunken fighting, falls and chronic alcohol abuse.

The insurance world is hardly unaware of all of this. After all, there is a reason why life underwriters ask you about your drinking habits when you get a policy. But this step seems only likely to flag people who a) routinely drink too much and b) are compelled to be honest about it to their life insurer. While that carries its own challenges, the Daily Beast list made me think of how the industry can tackle the issue of binge drinking. After all, the list of tipsy cities isn’t necessarily a chronicle of places where alcoholism runs rampant, but where consumption – especially binge consumption – is the highest. 

Binge drinking has no ironclad definition, but the one most go by is the “5/4” rule, which classifies binge drinking as any time a man had five or more standard drinks in a single sitting (four for women). For a lot of people, five drinks over the course of the evening is a lot, but hardly impossible to put away, a point often proven by younger drinkers having a night out with friends or colleagues celebrating a triumph at the office.

However you cut it, though, binge drinking is alcohol abuse, and that alone imposes a significant economic toll on all of us, but especially on the life and health insurance industry, which ultimately gets stuck with the tab for alcohol-related disease, injuries and fatalities. So this makes the list of tipsy cities important to consider, even if the list itself has some serious problems.

For starters, the list itself has only been around for two years, and the criteria for what makes a tipsy city have changed between the years. In both 2010 and 2011, the Daily Beast relied on data from the Centers for Disease Control to deduce how many heavy drinkers and binge drinkers are present in metropolitan statistical areas. Also included was market research data on how many drinks people drank on average each month in those areas. In 2010, it included the deaths per 100,000 residents from alcoholic liver disease. In 2011, however, it didn’t include that and instead included as a criteria populations over the age of 21.

As a result, the cities that ranked as America’s drunkest varied considerably. For example, several states had cities that made one list, but not the other. In Nebraska, Omaha ranked #7 in 2010, but didn’t make the list in 2011. Conversely, Lincoln didn’t make the list in 2010, but ranked #18 in 2011.

There is a similar disconnect in North Dakota, where Fargo ranked #2 in 2010 and didn’t list in 2011 while Bismarck did not list in 2010 but ranked #20 in 2011. In Florida, three cities – Tampa, Tallahassee and Jacksonville ranked #17, #28 and #40 respectively in 2010 but did not list in 2011. Meanwhile, Ft. Myers did not make the list in 2010 but ranked at #15 in 2011. In Ohio, Toledo ranked #15 in 2010 but did not list in 2011, while Cincinnati ranked #35 in 2010 but did not list in 2011. Cleveland, however, made both lists and placed within one spot on both, which suggests that whatever figures you use, the city looks like it’s got some kind of drinking problem. Maybe there are mass migrations of drinkers, but I doubt it. (Unless, of course, if there’s a big spike in drunk driving arrests and alcohol-related motor vehicle accidents between these cities…)

Of the cities that make the list both years, there are plenty of cases where the cities themselves jump significantly on the list. Exactly what the heck happened in 2011 that made Springfield, MA jump 29 slots, up to the second-drunkest city in the union. Chicago, Las Vegas, St. Louis, Tucson AZ and San Antonio TX also have substantial lurches while cities like San Francisco dropped 19 places and Providence, RI dropped 8. If anything, it shows that however the data is being gathered for these admittedly superficial lists, those that appear on it do so under seriously compromised qualifications.

Still, the exercise does point toward regional and urban differences in drinking patterns, and it’s surely worth noting which spots in the country have higher levels of heavy and binge drinking. This is, after all, a major health issue and one that the insurance industry has a vested interest in. Surely a trade group such as the Insurance Information Institute or LIMRA could do the rest of the industry some good by producing a “drunkest cities” list of its own that could withstand the scrutiny of a skeptical statistician. Do that, and the rest of us have a tool for confirming that which the locals usually know well in advance: the people around here like to drink.