Trends in incidence and risk markers of student emergency department visits with alcohol intoxication in a U.S. public university—A longitudinal data linkage study

•First longitudinal study documenting incidence of student alcohol intoxication.•There was a rising trend in incidence of ED visits with alcohol intoxication.•Student characteristics at enrollment were predictive of this problem drinking.•Campus related factors significantly attenuated socioeconomic gradients. To examine the trends in incidence and socio-demographic, organizational, academic, and clinical risk markers of student alcohol intoxication associated with emergency department (ED) visits. Student admission data from 2009 to 2015 were linked to primary healthcare data and subsequent ED visits with alcohol intoxication identified using ICD-9 codes within one year following the first (index) enrollment each year. Incidence rate per 10,000 person-years was calculated. Cox proportional hazard regression provided adjusted hazard ratios (HR) (95 % CIs) for the association between student characteristics and subsequent ED visits with alcohol intoxication. Of 177,128 students aged 16–49 enrolled, 889 had at least one ED visit with alcohol intoxication, resulting in an incidence rate of 59/10,000 person-years. Incidence increased linearly from 45/10,000 person-years in 2009–10 to 71/10,000 person-years in the 2014–15 academic year (p