Background
Unhealthy alcohol consumption remains a significant public health concern among U.S. Veterans, yet less is known about recent trends in binge and heavy drinking among this population. This study examines trends in and correlates of binge and heavy alcohol use among Veterans across age and sex.
Methods
This study used nationally representative Behavioral Risk Factor Surveillance System (BRFSS) data from 2016 to 2024. Average annual percent change (AAPC) was estimated using join-point regression. Multivariable logistic regression was used to examine correlates of binge and heavy drinking.
Results
From 2016 to 2024, binge drinking declined modestly overall (15.8% to 14.6%, AAPC = -1.2%, p < .05), with significant decreases among Veterans aged 18-34 and 65-80 (-2.1% and – 2.6%, p < .05, respectively). Heavy drinking remained stable overall but increased among Veterans age 35-49 (7.4% to 9.6%, AAPC = 2.7%, p < .05). Men consistently demonstrated higher binge drinking rates. Women exhibited a notable decline in heavy drinking (8.5% to 6.3%, AAPC = -2.8%, p < .05), converging with men by 2024. Veterans with military-related health insurance were less likely to engage in binge drinking, while those reporting cost-related barriers to care and current tobacco use had higher odds of heavy drinking. A graded relationship was observed between poor mental health and heavy drinking.
Conclusions
Despite overall declines, binge and heavy drinking remain prevalent among Veterans, with emerging midlife risks and sex-specific trajectories. Age- and sex-specific prevention, integrated tobacco and alcohol treatment, and continued efforts to reduce financial barriers to care may reduce alcohol use.