By MATT BLOIS
By most measures people in Williamson County are some of the healthiest in the state, but the area consistently ranks among the heaviest drinking counties in Tennessee.
In its County Health Rankings, the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation estimated that about 17 percent of people in Williamson County drink excessively in 2018, second to Davidson and Rutherford Counties at 18 percent.
Excessive drinkers are people who drink more than four or five drinks in a single occasion or more than one to two drinks a day on average.
Another study from a health research center at the University of Washington found that Williamson County, Davidson County and Shelby County had the highest proportion of binge drinkers in Tennessee between 2002 and 2012.
Both studies used data collected by the Centers for Disease Control through phone surveys. All of the data is self-reported.
The County Health Rankings ranked Williamson County as the healthiest county in the state overall in 2018. The county has relatively low rates of obesity and smoking, as well as good access to doctors and healthy food.
Catherine Montgomery, the director of the Williamson County Health Department, said the county has had a high number of excessive drinkers for at least the last eight years.
“We’ve got educated folks in Williamson County. We’ve got folks with the means to purchase, whether it’s wine or liquor,” she said. “I think people socially look at it as an OK thing to do.”
According to the Centers for Disease Control binge drinking is more common among people with higher education levels and household incomes of $75,000 or more. Although, people with low incomes are more likely to be alcohol dependent.
That means people in wealthy areas like Williamson County are likely to drink a little too much, but not way too much.
The risks of drinking way too much are obvious: alcohol poisoning, car crashes, injuries. The County Health Rankings show that Williamson County has relatively few of those problems.
It has the lowest rate of deaths from injuries in the state, and it’s on the lower end of the spectrum for violent crime, car crashes involving alcohol and drug overdoses.
The risks of drinking a little too much look more like the risks of eating too many french fries. The Centers for Disease Control reports that excessive drinking can increase the likelihood of heart disease, cancer and mental health problems.
Chapman Sledge, the Chief Medical Officer of the substance abuse recovery center Cumberland Heights, said that people who drink excessively aren’t always alcoholics.
“If someone drinks a six pack a day are they an alcoholic? My answer is I don’t know,” he said. “Let’s ask his wife or let’s ask his boss. Let’s look at his arrest record and look at his medical records. It’s not how much and it’s not how often.”
He said the true measure of alcohol dependency is whether or not someone can stop drinking to avoid bad consequences. When a man can’t stop drinking even though his marriage is falling apart that’s alcoholism.
Studies have shown that increased alcohol consumption often leads to a higher divorce rate (and conversely a higher divorce rate drives more people to drink). But Williamson County has had a slightly lower divorce rate than the rest of the state since 2009.
Even though Williamson County has one of the highest levels of excessive drinking, it also has the lowest unemployment rate in the state.
Sledge said there are plenty of people from Williamson County who come to Cumberland Heights for substance abuse treatment, but most excessive drinkers aren’t alcoholics. The Centers for Disease Control reports that 90 percent of excessive drinkers don’t qualify as an alcohol dependent.
Still, Sledge said drinking too much is a big problem.
“There are some health problems that even with moderate use… over a longer period of time can be an issue,” he said. “It doesn’t take much to be considered at risk. It used to be that for a glass of red wine the cardiovascular benefits outweighs the risk, but you don’t hear that much anymore.”
Another study published in 2015 found that excessive drinking has an enormous economic cost. Researchers calculated that excessive drinking cost the U.S. more than $240 billion in 2010, and binge drinking was responsible for the vast majority of that cost.
Those costs resulted from the loss of productivity at work, spending on health care and spending on the criminal justice system.
Montgomery said the county’s health department is attacking the problem by focusing on youth. The county has educational programs focused on keeping teenagers from drinking on prom night and stopping parents from hosting parties with alcohol for teenagers.
She said it seems to be working. Williamson County Schools collects data about student drinking each year, and the results for youth are promising.
“It’s really low for alcohol, which is a good thing. It’s decreased,” she said. “Maybe what we’re doing out there is working, or maybe it’s not a cool thing to do.”