Sex-dependent predictors of binge drinking among males and females in North Dakota.

Background: North Dakota has one of the highest rates of binge drinking in the United States, but little is known about how the predictors of binge drinking differ between males and females within the state. Therefore, the objective of this study was to identify and compare the sex-dependent predictors of binge drinking in North Dakota. Methods: Data were obtained from the North Dakota Behavioral Risk Factor Surveillance System (BRFSS) for the years 2017-2021. The BRFSS is a population based cross-sectional telephone survey administered annually by the North Dakota Department of Health and Human Services (NDDHHS) in coordination with the Centers for Disease Control and Prevention (CDC). The study population included all males and females aged ≥ 18 years in the North Dakota BRFSS database from 2017 to 2021 who responded to the questions "During the past 30 days, how many days per week or per month did you have at least one drink of any alcoholic beverage such as beer, wine, a malt beverage or liquor?" and "Considering all types of alcoholic beverages, how many times during the past 30 days did you have five or more drinks (for men) or four or more drinks (for women) on an occasion?." Potential predictors of binge drinking were selected using a conceptual model and included: race, age, income, education, urban or rural residence, and frequent physical or mental distress. Separate binary logistic regression models of binge drinking were fitted for males and females. Results: The odds of binge drinking declined with increasing age in both sexes. Males who were Black or other races and ethnicities besides American Indian had lower odds of binge drinking than White males. Additionally, males had significantly higher odds of binge drinking if they lived in a rural county, had a household income ≥ $75,000, or had more than a high school education compared to those who lived in an urban county, had a household income < $75,000, or had no more than a high school education. White females had significantly higher odds of binge drinking than those who were Black, and females with frequent mental distress had significantly higher odds of binge drinking than females without frequent mental distress. Conclusions: The predictors of binge drinking differ between males and females in North Dakota. Geographic and socioeconomic factors were significant predictors in males, but not females, while frequent mental distress was only a significant predictor of binge drinking among females. Efforts to reduce binge drinking in this state should consider potential differences in programmatic needs between the sexes.