Rural states, even with more heavily-regulated alcohol marketplaces, tend to have higher death rates from alcohol-related car crashes.

Conversely, states with more of their population in urban areas and less heavily regulated alcohol marketplaces tend to be on the lower end of the scale when it comes to alcohol-related car crashes. This is according to an analysis of data from the Mississippi Center for Public Policy.

Using data from the Centers for Disease Control and the National Highway Traffic Safety Administration, rural states tend to have higher overall driving death rates than more urban ones, because of a variety of factors including a smaller number of trauma centers, higher rates of texting while driving and lower seatbelt usage rates. 

Of the top five states for alcohol-impaired driving deaths from 2004 to 2014, three are control states for alcohol and all but one (Mississippi allows the sale of wine in liquor stores) permit the sale of wine in grocery stores. All three average about 1.963 million in population.

A control state is one where states are in charge of the sale of distilled spirits and sometimes even wine and beer through state agencies at the wholesale level. 

The Mississippi Department of Revenue regulates the sale of alcohol in Mississippi through the licensing of retailers, taxation at both the wholesale and retail levels and wholesaling of both liquor and wine. The Magnolia State is one of five states that wholesale both wine and distilled spirits.

State Alcohol-Impaired Driving Deaths 2005 to 2014State population (2010 census)Alcohol related deaths per 100,000 residents Control state (Y/N)Wine sales in grocery stores
Montana                         897 989,415                           91 YY
Wyoming                         484 563,626                           86 YY
South Carolina                     3,723 4,625,364                           80 NY
North Dakota                         539 672,591                           80 NY
Mississippi                     2,367 2,967,297                           80 YN

The states with the lowest death rates from alcohol-related incidents are more heavily populated (8.5 million average population) and all but one (Utah) are non-control states, which means private distributors handle the wholesaling of distilled spirits, wine and beer.

State Alcohol-Impaired Driving Deaths 2005 to 2014State population (2010 census)Alcohol related deaths per 100,000 residents Control state (Y/N)Wine sales in grocery stores
 Minnesota                     1,274 5,303,925                           24 NN
Massachusetts                     1,309 6,547,629                           20 NY
New Jersey                     1,747 8,791,894                           20 NY
New York                     3,605 19,378,102                           19 NY
Utah                         456 2,763,885                           16 YN

Parsing the data further, the average alcohol-related traffic deaths per 100,000 residents was 40 for the 43 states that are non-control states and 45 for the 17 that are.

In 2017, the Arkansas legislature allowed the sale of wine in grocery stores via the passage of Act 508. In 2018, there were 516 traffic fatalities in the state, up from 493 the year before the legislation passed but considerably less than the 10-year average of 528.

YearFatalities 
2018516
2017493
2016545
2015531
2014466
2013483
2012552
2011549
2010563
2009585