Alcohol-impaired driving deaths

Percentage of driving deaths with alcohol involvement.

The 2021 County Health Rankings used data from 2015-2019 for this measure.

Reason for Ranking

Alcohol-impaired driving deaths directly measures the relationship between alcohol and motor vehicle crash deaths. Alcohol is a substance that reduces the function of the brain, impairing thinking, reasoning, and muscle coordination which are essential to operating a vehicle safely.[1] In 2018, approximately 10,500 Americans were killed in alcohol-related motor vehicle crashes.[2] The annual cost of alcohol-related crashes totals more than $44 billion. Drivers between the ages of 21 and 24 cause 27% of all alcohol-impaired deaths.[2]

Key Measure Methods

Alcohol-Impaired Driving Deaths is a Percentage

Alcohol-Impaired Driving Deaths is the percentage of motor vehicle crash deaths with alcohol involvement.

Alcohol-Impaired Driving Deaths are Measured in the County of Occurrence

Alcohol-Impaired Driving Deaths are reported for the county of occurrence. This is because it is more likely that the drinking behavior that led to the driving crash happened where the accident occurred rather than in the county where the people involved in the crash reside.

Measure Limitations

This measure considers the percentage of crash deaths involving alcohol, not the number of total crashes or the number of total crashes involving alcohol. Another limitation of this measure is that not all fatal motor vehicle traffic accidents have a valid blood alcohol test, so these data are likely an undercount of actual alcohol involvement. A final limitation is that even though alcohol is involved in all cases of alcohol-impaired driving, there can be a large difference in the degree to which it was responsible for the crash (e.g. someone with a 0.01 BAC vs. 0.35 BAC).


The numerator is the total number of alcohol-impaired motor vehicle crash deaths in the 5-year period. The National Highway Traffic Safety Administration defines a fatal crash as alcohol-related or alcohol-involved if either a driver or a non-motorist (usually a pedestrian or bicyclist) had a measurable or estimated blood alcohol concentration of 0.01 grams per deciliter or above.


The denominator is the total number of motor vehicle crash deaths in the 5-year period.

Can This Measure Be Used to Track Progress

This measure can be used to measure progress with some caveats. It is important to note that the estimate provided in the County Health Rankings is a 5-year average. However, in most counties, it is relatively simple to obtain single year estimates from the resource included below. In addition, Alcohol-impaired driving deaths is a percentage whereas using a rate per population or the total number of crashes might be better to measure progress.

Data Source

Years of Data Used


Fatality Analysis Reporting System

FARS is a census of fatal motor vehicle crashes with a set of data files documenting all qualifying fatalities that occurred within the 50 States, the District of Columbia, and Puerto Rico since 1975. To qualify as a FARS case, the crash had to involve a motor vehicle traveling on a trafficway customarily open to the public, and must have resulted in the death of a motorist or a non-motorist within 30 days of the crash.

Digging Deeper
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We recommend starting with the Fatality Analysis Reporting System, which contains information on crashes by race, ethnicity, age, gender, and more for cities, counties, states, and the nation. In addition, most states produce traffic statistics called “Crash Facts”. You can find links to these reports in State-Specific Data Sources.


[1] National Highway Traffic Safety Administration. (2019). Drunk Driving. Washington, DC: US Department of Transportation. Available at: Accessed 3 December 2019.

[2] National Center for Statistics and Analysis. (2019, December). Alcohol-impaired driving: 2018 data (Traffic Safety Facts. Report No. DOT HS 812 864). Washington, DC: National Highway Traffic Safety Administration. Available at: Accessed 3 January 2020.

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When it comes to developing and implementing solutions to problems that affect communities, evidence matters. The strategies below give some ideas of ways communities can harness evidence to make a difference locally. You can learn more about these and other strategies in What Works for Health, which summarizes and rates evidence for policies, programs, and systems changes.

Provide information and increase motivation to change or prevent problematic alcohol consumption in a short session; also called alcohol screening & brief intervention
Increase the price of alcohol via regular adjustments to taxes levied for beer, wine, and liquor purchases
Implement checkpoints where law enforcement officers can stop drivers suspected of drinking and driving and assess their level of alcohol impairment; also called sobriety checkpoints
Hold alcohol retailers legally responsible for injuries or damage caused by providing alcohol to intoxicated or underage customers; also called commercial host liability laws
Use specialized courts to offer criminal offenders with drug dependency problems an alternative to adjudication or incarceration

The County Health Rankings provide a snapshot of a community’s health and a starting point for investigating and discussing ways to improve health. Select a state and a measure below to see what’s happening locally.