After spiking during the pandemic, the rate of alcohol-induced deaths has declined in Wisconsin and nationally. Still, rates of such deaths remain significantly elevated from pre-pandemic years, particularly in Wisconsin. Once on par with the nation, our state’s rate of alcohol-induced mortality is now markedly higher — and that gap has been growing.
Wisconsin’s rate of alcohol-induced deaths has seen major shifts in recent years, mirroring a national trend in which these deaths sharply increased during the COVID-19 pandemic and then gradually declined. The recent drop is welcome news. Yet it should not obscure other, longer-running trends that continue to warrant concern.
In 2024, Wisconsin recorded 1,076 deaths due to alcohol-induced causes, according to provisional data from the Centers for Disease Control’s (CDC) WONDER database. Its alcohol-induced mortality rate was 18.2 per 100,000 residents.
This rate has declined since the pandemic. Yet it remains well above 2019 levels, when it was 14.9 per 100,000, which resulted in 865 such deaths that year.
Far from being a low point, the 2019 rate was, at that time, our state’s highest in more than two decades. In 1999, the first year for which we have data, 356 Wisconsinites died of alcohol-induced causes.
In another alarming trend, Wisconsin’s rate of alcohol-induced deaths has risen well above the national average. Some may find this unsurprising, since our state’s identity has long been linked to the beer and alcohol industry, and rates of binge drinking here are higher than in most states.
Yet as recently as the early 2010s, Wisconsin closely tracked the nation in its rate of alcohol-induced deaths. That is no longer the case: In 2024, the national rate of alcohol-induced deaths was 13.9 per 100,000.
Most alcohol-induced deaths occur among middle-aged and older adults. Wisconsin’s population is older than the nation on average, but when we adjust these rates for age, a similar dynamic remains. In 2024, the national rate of alcohol-induced deaths was 12.2 on an age-adjusted basis, or nearly 21% lower than Wisconsin’s age-adjusted rate of 15.0 per 100,000 (See Figure 1).
Our 50-state review finds several neighboring states have trends similar to Wisconsin’s. Within the statewide numbers, our demographic breakdown also finds other points of concern, especially a rate of alcohol-induced deaths among Black Wisconsinites that far outstrips the rate for all Black Americans.
defining Alcohol-induced deaths
The deaths examined in this report are defined by the CDC as “alcohol-induced deaths.” This CDC definition is narrow, counting only deaths directly attributable to excessive drinking such as alcohol poisoning and certain liver, neurological, digestive, or other diseases. The vast majority of such deaths are from alcoholic liver disease or mental/behavioral disorders caused by the use of alcohol. This narrow definition excludes many deaths to which alcohol use may have contributed, such as motor vehicle accidents, falls, cancers, suicide, or violence.
This report is meant to update our initial research on this topic in 2022, which included CDC data through 2020. At that time, we noted a sharp increase in alcohol-induced deaths nationally and in Wisconsin during the first year of the pandemic. Those deaths rose nearly 25% in Wisconsin in 2020, the biggest one-year increase in more than two decades.
This report draws on four subsequent years of data, running through 2024. In Wisconsin and nationally, age-adjusted alcohol-induced mortality rates peaked in 2021, then declined each of the next three years. However, the state’s long-term trajectory has been one of increasing alcohol-induced mortality, sustained over a period of nearly two decades. So far, the recent declines have not overturned that long-term trend.
higher rates for Black Wisconsinites
When we break down these mortality rates by race and Hispanic origin of the deceased person, we find a broad increase across these groups from 2018 to 2024. (A longer timeframe for comparison, as we use elsewhere in this report, is not possible due to recent changes in the U.S. Census Bureau’s racial classification methods.)
Our analysis breaks the population down into five demographic groups at both the state and national levels: Hispanic (of any race) or non-Hispanic American Indian, Asian, Black, or white. Only one of these groups – American Indians in Wisconsin – have seen a decline in age-adjusted, alcohol-induced mortality since 2018. (It is not possible to calculate the change for Asian Wisconsinites because their rate of alcohol-induced deaths is so low that their data on total deaths and death rates is suppressed for privacy reasons in the CDC WONDER database.)
All other groups saw an increased rate of alcohol-induced mortality during this period. They ranged from 7.2% (American Indians nationally) to 43% (Hispanic Wisconsinites), a modestly larger increase than several other groups.
Figure 2 shows the difference during this period between age-adjusted, alcohol-induced mortality rates for these groups in Wisconsin, compared to rates for those same racial or ethnic groups nationally.
In this comparison, our state’s largest outlier is its Black residents. At a national level, all Black Americans have an age-adjusted alcohol-induced mortality rate, at 8.5 per 100,000 residents in 2024, that was well below the rate for the population overall, which was 12.2. But in Wisconsin, the age-adjusted 2024 rate for Black residents was 19.9, more than double the rate for all Black Americans.
The Forum first highlighted this dynamic in our 2022 report on this topic. Since then, the gap between the mortality rates for Black Wisconsinites and all Black Americans has only widened.
women saw larger increases
In Wisconsin and nationally, men have long been much more likely to die of alcohol-induced causes than women. While that remains the case today – and while both genders are seeing large increases in alcohol-induced mortality — women have seen greater recent increases.
During the period from 1999 to 2024, the age-adjusted rate of such deaths increased 53.0% for all men nationally, to a rate of 17.6 per 100,000, and 125.0% for women, to a rate of 7.2. In Wisconsin, this period brought increases of 102.0% for men, to an age-adjusted rate of 20.6, and 163.9% for women, to a rate of 9.5.
Our 2022 report also examined alcohol-induced mortality by age group from 1999 through 2020. Analyzing three 20-year age cohorts – young adults ages 25-44, middle-aged adults ages 45-64, and older adults ages 65-84 – we found significant mortality-rate increases in each group. However, in our previous research, middle-aged Wisconsinites saw the largest increase for the period ending in 2020.
For this updated analysis, we compare changes from the most recent pre-pandemic year, 2019, through 2024. Again, at a national level and in Wisconsin, all three age cohorts saw large mortality increases during the pandemic, followed by modest declines that still left them above pre-pandemic rates.
Middle-aged adults have long had the highest rates of alcohol-induced mortality, as many such deaths result from conditions that often develop after many years of heavy drinking. That still was the case in 2024.
However, in Wisconsin and nationally, it was young adults (25-44) who saw the largest proportional increases in alcohol deaths during the period from 2019 to 2024.
neighboring states had similar rates
A broader perspective can be found by zooming out to a 50-state view of alcohol-induced mortality rates. As the map in Figure 3 shows, there are significant regional differences in this metric across the country.
States on the East Coast and in the South tend to have lower rates of alcohol-induced mortality. Every state in the top 10, meanwhile, is located in the western United States.
Wisconsin is part of a cluster of Upper Midwest states with rates above the national average, though not in the top 10. Two of its neighbors, Iowa and Minnesota, had higher rates of age-adjusted, alcohol-induced mortality in 2024 (15.9 and 16.2, respectively, compared to 15.0 for Wisconsin).
These figures suggest that our state’s higher-than-average mortality rates in this area may be linked to regional factors that don’t end at our state’s borders.
A broader perspective
As previously noted, the metric on which we base the bulk of our analysis for this report is alcohol-induced deaths – a narrowly defined category that excludes many deaths in which excessive alcohol use plays a role. More expansive definitions of deaths attributable to alcohol are available, but this report focuses on alcohol-induced mortality.
That said, looking at a broader category of deaths for which alcohol was one of multiple causes – rather than the single underlying cause – can give us a fuller picture. In 2024, Wisconsin saw an estimated 2,316 deaths for which alcohol was one of multiple causes.
The rate for these types of deaths follows a similar pattern as the alcohol-induced deaths, with a significant increase that peaked during the pandemic, declined modestly since, but remained elevated as of 2024.
conclusion
The trends highlighted in this report pose several critical questions. Alcohol has long been readily available and widely consumed in the United States. So, what has changed in recent years, particularly in Wisconsin, to affect such a significant increase in alcohol-induced deaths? And why have our state’s Black residents and women seen particularly pronounced impacts? Answers to these questions are not fully apparent, but some clear themes do emerge.
Even before the pandemic, there was evidence pointing to increased levels of alcohol consumption. Consumption appears to have further increased in 2020 and 2021, when alcohol deaths saw a pronounced increase.
It seems possible that the unusual social conditions that accompanied the sharp rise in alcohol deaths during the pandemic may also have contributed to it. If so, this may contribute to our understanding of what happened then, and what may be continuing to occur in the post-pandemic era.
For many Americans, the pandemic period was marked by high levels of anxiety and social isolation. There are signs that social disconnection and loneliness, and rates of depression and anxiety, which were rising prior to the pandemic, increased further during it, and remain elevated. These factors may continue to be connected to our elevated levels of alcohol-induced deaths.
At a national level, there also is reason to believe that broader changes in the health of the U.S. population may play a role. As the prevalence of health conditions such as obesity and diabetes have increased, they may make individuals who also drink excessively more vulnerable to dying from alcohol-induced causes.
Here in Wisconsin, the even larger increase in alcohol-induced deaths may warrant action by state and local policymakers. There is evidence that the measures we outline below, if implemented, might help to reduce alcohol abuse in general in our state, though it is less clear the extent to which they would reduce alcohol-induced mortality.
Research consistently has shown that higher rates of taxation on alcohol can reduce overall consumption. Policymakers may wish to consider such a step in Wisconsin, due in part to our state’s comparatively low rates of alcohol taxation. Policymakers could use those revenues to lower other taxes or to support treatment programs for alcohol abuse.
Other potential policy actions could include reducing the hours during which alcohol may be legally purchased, or reducing the density of establishments at which it may be purchased. There is research to show that such measures may decrease alcohol consumption at the population level. It is less clear if such measures have similar effects among high-risk individuals at risk of alcohol-induced death.
We acknowledge that increasing taxation or regulation of alcohol sales likely would be politically fraught, or simply unappealing to some policymakers for principled reasons. An alternate course of action, or a potentially complementary one as noted above, could involve increasing state or local investments into prevention, intervention, and treatment for alcohol abuse.
Reducing underage alcohol consumption could be a key part of a broader prevention strategy. For example, if state policymakers chose, they could begin to provide state funding for law enforcement agencies to conduct alcohol age compliance checks on retailers.
Ultimately, while the number of Wisconsinites dying of alcohol-induced causes has decreased in recent years, it remains far above levels seen in the not-too-distant past. Appropriate policy responses to this trend are open for debate, with one option being to maintain the status quo. While perhaps the safest choice in some respects, recent trends also suggest that Wisconsinites’ lives are at stake. Whatever course they choose, policymakers should take this into consideration.