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Alcohol: Notes & Sources


Alcohol use terms

  • Note about adults drinking categories: Because binge drinkers may (or may not) qualify as heavy drinkers, and both would be considered excessive drinkers, the rates of binge drinking, heavy drinking, and excessive drinking are not mutually exclusive and cannot be combined.
  • Among adults, binge drinking is defined for males as having 5 or more drinks on 1 occasion in the past 30 days; females meet the definition if they have 4 or more drinks on 1 occasion. 
  • Among adults, heavy drinking is defined differently by gender: for males, an average of more than 2 drinks per day; for females, an average of more than 1 drink per day.
  • Excessive drinking: Either binge drinking or heavy drinking are considered excessive alcohol use.
  • Youth binge drinking is defined as having 5 or more drinks on one occasion in the past two weeks.
  • For youth, current alcohol use is defined as any alcohol use in the past 30 days.

Confidence interval (also called "error bar") is the range of values that includes the true value 95% of the time. If the confidence intervals of two groups do not overlap, the difference between groups is statistically significant (meaning that chance or random variation is unlikely to explain the difference).   

King County regions: The geographic boundaries of the four King County sub-regions (North, Seattle, East, and South) are defined by the aggregation of ZIP codes for adults, and by the aggregation of school districts for teens.

Race/Ethnicity: Federal standards mandate that race and ethnicity (Hispanic origin) are distinct concepts requiring 2 separate questions when collecting data from an individual. "Hispanic origin" is meant to capture the heritage, nationality group, lineage, or country of birth of an individual (or his/her parents) before arriving in the United States. Persons of Hispanic ethnicity can be of any race. Communities Count's terms for racial/ethnic groups are derived from those used by the U.S Census Bureau in 2010.

  • Communities Count terms:  Hispanic, Non-Hispanic, White Non-Hispanic, Black, American Indian/Alaska Native (AIAN), Asian, Native Hawaiian/Pacific Islander (NHPI), White, and Multiple Race (Multiple). Persons of Hispanic ethnicity can be of any race and are included in other racial categories. Racial/ethnic groups are sometimes combined when sample sizes are too small for valid statistical comparisons of more discrete groups. 
  • 2010 Census terms: Hispanic or Latino, Not Hispanic or Latino, White alone (Not Hispanic or Latino),  Black or African American, American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, White, Some Other Race, and Two or More Races.
  • Surveys collecting data on teens do not follow the above convention of asking separate questions about race and ethnicity. Categories are therefore mutually exclusive, so teens are considered White non-Hispanic, Black non-Hispanic, etc.  Teens who choose multiple categories are considered multiple race.


Adult data have been averaged over 3 or 5 years to enable comparisons across groups that would otherwise be too small for detection of statistically significant results.

Adult trend data are not shown because the trend lines were too tightly clustered for clear visual discrimination.

Excessive drinking was related to drunk driving and tobacco use.

  • Among adults who reported excessive drinking, 12% also reported driving while drunk.  In contrast, among adults who did not report binge drinking, fewer than 1% reported driving while drunk (data not shown).
  • Among excessive drinkers, 19% were current smokers compared to the 9% smoking rate among adults who did not report excessive drinking (data not shown).

Policies related to alcohol consumption:  Based on strong evidence that privatization of alcohol sales results in increased per capita alcohol consumption, the Community Preventive Services Task Force recommended against privatization of alcohol in states that currently control retail alcohol sales. Liquor sales have increased in Washington State since the new privatization law went into effect on June 1, 2012 (WA State Department of Revenue).

Statistical Significance: Unless otherwise noted, any difference mentioned in the text is statistically significant (unlikely to have occurred by chance).

Too few respondents to report:  Survey data with 50 or fewer responses are not reported.

Data Sources

Data on adult excessive and binge drinking are from the Washington State and national Behavioral Risk Factor Surveillance System (BRFSS). The BRFSS is a random telephone interview survey of non-institutionalized adults ages 18 and older that has been conducted in King County every year since 1987. Starting in 2003, the BRFSS was administered in English and Spanish. The limitations of an English-and-Spanish-only telephone survey include the following: a) people who do not have a land line telephone or who do not speak English or Spanish are excluded, and b) people who have less education and lower incomes are underrepresented.

  • For additional information on the Washington State BRFSS, see here
  • For additional information on the national BRFSS, see

Local and state data on youth alcohol use and binge drinking are from the Washington State Healthy Youth Survey (, a survey of public school students in grades 6, 8, 10, and 12.  National data are from the 2009 National Youth Risk Behavior Surveillance System ( Data from local and national surveys are not directly comparable due to differences in ages/grades of students surveyed, survey questions, and other methodological differences.

Other Sources

City Health Profiles provide demographic and health information for 25 geographic areas in King County – mostly large cities (e.g., Seattle, Bellevue), groups of small cities (Bothell/Woodinville), or combinations of cities with nearby unincorporated areas (e.g., Renton/Fairwood). Each report has seven sections:
  • Demographics
  • General health status
  • Leading causes of death
  • Health risk factors and chronic diseases
  • Injury and violence-related mortality
  • Maternal and infant health
  • Access to care and preventive services

School District Health Profiles provide demographic and health information for several school districts in King County.  The profiles were developed by Public Health-Seattle and King County in collaboration with school districts for the purpose of informing school policy-makers and administrators, health and wellness planners, and the public about student health indicators at the district level. The data come from the Healthy Youth Survey, which is administered every 2 years to students in grades 6, 8, 10, and 12.  Each profile report has 6 sections: 

  • Demographics of survey respondents
  • Obesity, physical activity, and dietary behaviors
  • Mental health
  • Personal safety and violence
  • Alcohol, tobacco, and other drug use and second-hand smoke exposure
  • 3 additional indicators, selected by each district (examples: adults to turn to for help when feeling sad or hopeless; family skipped meals in past 12 months due to finances; bullied in the past 30 days because of face, ethnicity, or national origin) 

Community Guide to Preventing Excessive Alcohol Consumption: One of many free guides available to help communities choose effective program and policy interventions. The Community Guide is based on rigorous systematic reviews of programs and policies designed to improve public health and well-being.

Health problems related to excessive drinking: Centers for Disease Control and Prevention:

Maps of King County covering a wide range of topics can be accessed at  Maps most immediately relevant to Communities Count are under the headings of Community data & demographics, Public health, and Environment & natural resources, but other maps should be useful as well (farmers markets, transit routes, walking and biking routes, parks, traffic counts, etc.).

Quotes:  Communities Count interviewed 32 King County parents or guardians raising at least one child younger than 6 years of age.  We reached out to communities of color, recent immigrants, and residents with limited English proficiency to achieve a broad range of racial, cultural, and socioeconomic diversity. We interviewed both families with very low household income and those who earned up to median income (about $68,000 for a family of four in 2010). Family structures included single-parent households, couples living in consensual unions, married couples, and extended families. We also interviewed social service providers from agencies such as Crisis Clinic, Hopelink, Multi-Service Center, and Child Care Resources, as well as staff from community colleges that offer worker retraining or similar programs to help King County residents find jobs. We use fictional names to ensure confidentiality.