Until recently, data on the differences between rural and urban populations around substance abuse and related traffic offenses has been sparse. Much of it was gathered as secondary to the primary topic, meaning the majority was gathered under other research projects, such as those examining patterns of substance abuse in rural versus urban areas. The assumption had been that urban areas would have at least as great a problem with substance abuse and related traffic offenses, if not more, compared to rural areas. This assumption likely stems from the significant difference in population between cities and the countryside; only 19 percent of the US population lived in a rural area in 2010.

However, more recent studies have shown that rural areas have a much larger problem with intoxicated driving, particularly drunk driving, compared to urban areas. In fact, rural areas account for the majority of traffic fatalities in the nation, regardless of level of intoxication, although the overall national rates of traffic fatalities and drunk driving are declining.

Drunk Driving in Rural Areas

Alcohol-Impaired Driving Crashes in the US

Alcohol-impaired driving, more commonly known as drunk driving, legally begins when the driver’s blood alcohol content (BAC) is 0.08 grams per deciliter (g/dL) or higher. The Insurance Institute for Highway Safety (IIHS) Highway Loss Data Institute (HLDI) reports that, beginning in 1982, the number of fatally injured drivers who were intoxicated due to alcohol began to decline. By 1982, 49 percent of intoxicated drivers who were fatally injured had a BAC above the legal limit of 0.08; by 1994, rural areas saw a decline to 34 percent, and urban areas saw a decline to 32 percent. Since 1994, about one-third of drivers who are fatally injured have a BAC above 0.08.

The Centers for Disease Control and Prevention (CDC) has recent data from 2014, noting that drunk driving and related fatal accidents are still a large problem in the United States. The CDC found that:

  • Alcohol impairment contributed to crashes that killed 9,967 people.
  • Alcohol-impaired crashes accounted for 31 percent of all traffic-related deaths in the US.
  • About 19 percent of traffic deaths of children between the ages of 0 and 14 were caused by a drunk driver.
  • Approximately 1.1 million drivers were arrested for being intoxicated on either alcohol or narcotics.
  • About 121 million people self-reported driving while intoxicated, either on alcohol or drugs.

Every day, 28 people die in a vehicle accident caused by a drunk driver; this is one death every 53 minutes. About one-third of drivers involved in DUI accidents have a previous conviction for a DUI; repeat offenders tend to be white, male, younger than 30 years old, and unmarried. The Department of Transportation (DOT) found that 81 percent of intoxicated drivers were men. Far more people are injured, perhaps in a life-changing way, by these accidents.

Rates of drunk driving and fatal accidents vary by state, but the states in the top five are largely rural or non-urban. In 2008, the reported top five worst states for fatal drunk driving were:

  • Montana
  • South Carolina
  • Mississippi
  • Wyoming
  • Louisiana

Dangers on Rural Roads

Drivers in rural areas are more likely to experience traffic accidents, in general, compared to urban populations. In part, this is due to a higher incidence of collisions with wildlife, including elk, deer, and even moose. People driving on rural roads tend to drive faster. More people in rural areas fail to wear seatbelts, making accidents deadlier. They are less likely to get emergency medical treatment in a timely fashion because it takes longer for emergency responders to arrive. But, most shockingly, more rural drivers drive while intoxicated, cause accidents while drunk, and die because of these accidents.

Traffic accidents in rural areas accounted for 55 percent of all the traffic fatalities in the United States in 2010, according to the National Highway Traffic Safety Administration (NHTSA), although these areas account for only 19 percent of the population of the country. Although traffic fatalities decreased between 2001 and 2010 by 28 percent, there are still far more fatal traffic accidents in rural areas compared to urban areas, and more of them are due to intoxication, usually from alcohol.

Dangers on Rural Roads

In 2013, reports showed that rural roads were deadlier than urban roads based on miles driven; the death rate for traffic accidents was 2.6 times higher in rural areas compared to urban areas. By 2015, little improvement had been made in rural traffic fatalities; there were 35,093 car accident deaths on rural roads, although these roads were home to less than half of the nation’s traffic, according to the National Conference of State Legislatures (NCSL).

The University of Michigan’s Transportation Research Institute (UMTRI) found in a comprehensive study that the safest places in the nation were the most densely populated: along the Pacific Coast and in the North Atlantic Seaboard.

Deadly Drunk Driving Statistics from Rural Areas

The NHTSA reported that, in 2010:

In 2013, rural areas still struggled with drunk driving accidents and fatalities, although all traffic fatalities were declining across the nation. Between 2004 and 2013, NHTSA reported, traffic fatalities involving alcohol in rural areas declined 29 percent; from 7,661 deaths in 2004 to 5,473 in 2013. Urban drunk driving fatalities declined by only 14 percent, but the number of deaths overall remained lower than in rural areas. In 2004, there were 5,415 deaths caused by drunk driving in urban areas, which declined to 4,590 in 2013. In both rural and urban areas, those ages 21-24 continue to make up the largest percentage of intoxicated drivers in fatal accidents.

A thorough study published in 2013 on the US National Library of Medicine (NLM), managed by the National Institutes of Health (NIH), examined the idea that there was a difference in intoxicated driving between rural and urban populations. First, the group corrected for ideas around substance abuse in general and found that urban and rural populations had similar rates of drug abuse and addiction, including alcohol use disorder and alcoholism. Data gathered from the National Survey on Drug Use and Health (NSDUH) found that rates of binge drinking and underage drinking were comparable between urban and rural populations while illicit drug use was about 2 percent higher among rural populations.

The study found that there are no significant demographic differences between rural and urban DUI offenders, including those involved in fatal crashes; the main difference is that rural drivers are more likely to cause or be involved in a drunk driving accident compared to urban populations. With so few people living in these areas, this finding is very unsettling. People who live in rural areas typically earn less money and have less access to healthcare compared to urban populations; this means they have less access to drug and alcohol prevention programs, less access to intervention through a medical professional, and less access to quality rehabilitation programs.