Study finds poorest of us at greater risk of harm from heavy drinking.

Drinking heavily is more harmful to the poorest people in society, who are at greater risk of illness or death because of alcohol consumption, according to a recent medical study. Published in medical journal The Lancet Public Health on Wednesday, it found there is a marked link between socio-economic status and the harm caused by drinking alcohol excessively.

Researchers taking part in the study found increased alcohol consumption was “disproportionately harmful” to the poorest in society. Compared with light drinkers in advantaged areas, excessive drinkers were seven times at risk of an increase in alcohol harm.

This contrasted with excessive drinkers in deprived areas, who were 11 times at risk of an increase. Harmful impacts of alcohol are higher in socio-economically disadvantaged communities. However, until now it was unclear whether those were as a result of
differences in drinking or as a result of other factors.

Lead author Dr Vittal Katikireddi, of the University of Glasgow, said:

“Our study finds that the poorest in society are at greater risk of alcohol’s harmful impacts on health, but this is not because they are drinking more or more often binge drinking.

“Experiencing poverty may impact on health, not only through leading an unhealthy lifestyle but also as a direct consequence of poor material circumstances and psychosocial stresses. Poverty may, therefore, reduce resilience to disease, predisposing people to greater health harms of alcohol.

The authors linked different sets of data to bring together information from Scottish Health Surveys with electronic health records, studying more than 50,000 people.
It suggested that even when other factors are accounted for, including smoking and obesity, living in deprived areas was consistently associated with higher alcohol-related harms. Researchers defined harm from alcohol consumption based on deaths, hospital visits and prescriptions that were attributable to alcohol.

Study co-author Dr Elise Whitley said:

“Heavier drinking is associated with greater alcohol-related harm in all individuals. However, our study suggests that the harm is greater in those living in poorer areas or who have a lower income, fewer qualifications or a manual occupation.

Responding to the study published on Wednesday in The Lancet Public Health which found that drinking heavily is more harmful to the poorest people in society. Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:

“The findings in this study are worrying if not altogether surprising. It is clear that the way alcohol is being sold and promoted in Scotland and elsewhere in the UK is harming some of the most vulnerable people in society. On the other hand, we know what needs to be done, in particular to tackle the scourge of cheap alcohol. In real terms, alcohol is 60% cheaper than it was in 1980 and measures like strength based pricing would disproportionately benefit the poorest groups, in terms of reduced deaths, illness and hospital admissions.

Studies have shown that 82% of the lives saved through minimum unit pricing would come from the lowest income groups. Overall, in the first year alone minimum unit pricing in Scotland is expected to save 60 lives and lead to 1,600 fewer hospital admissions and 3,500 fewer crimes, yet its introduction has been held up for years by alcohol industry legal challenges.

Importantly, minimum unit pricing would leave pub prices untouched, and moderate drinkers would spend only about £2.25 extra per year with a 50p minimum price.”

This is even more evidence of the Alcohol Harm Paradox, which refers to observations that lower socioeconomic status (SES) groups consume less alcohol but experience more alcohol-related problems. However, SES is a complex concept and its observed relationship to social problems often depends on how it is measured and the demographic groups studied. A study published in 2016 hoped to deconstruct this idea and assessed socioeconomic patterns of alcohol consumption and related harm using multiple measures of SES and examined moderation of this patterning by gender and age. You can read the research article here: Deconstructing the Alcohol Harm Paradox: A Population Based Survey of Adults in England



Citation of original research article:

Socioeconomic status as an effect modifier of alcohol consumption and harm: analysis of linked cohort data. 

Dr Srinivasa Vittal Katikireddi, Elise Whitley, Jim Lewsey, Linsay Gray, Prof Alastair H Leyland. Published: 10 May 2017 – Open Access DOI: http://dx.doi.org/10.1016/S2468-2667(17)30078-6


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Alcohol-related Hospital Admissions are at a Record High!

New figures released this week shows that hospital admissions due to alcohol are at their highest ever levels.

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The data, summarised in a release from NHS Digital, shows that alcohol-related hospital admissions in England have increased by 64% over the last decade, with an extra 430,000 people being admitted due to alcohol-related causes in 2015/16 compared with 2005/06.

This takes the total number of alcohol-related hospital admissions to over 1.1 million in 2015/16.

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Alcohol is linked to over 60 illnesses and diseases, including heart disease, liver disease and cancer. Figures from the local alcohol profiles for England show that admissions due to liver disease have gone up 57% over the last decade, and that the number of people diagnosed with alcohol-related cancer has increased 8%.

In contrast, separate data released today by the Office of National Statistics shows that the proportion of adults drinking is at its lowest level since 2005, with younger people more likely to be abstaining from alcohol. However, 7.8 million people admit to binge drinking on their heaviest drinking day.

In response to the figures, alcohol health experts called for more to be done in the UK to tackle the health harm done by alcohol.

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Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:

“These figures show that the UK continues to have a dysfunctional relationship with alcohol. We know that over the long term, rates of binge drinking are falling, and more people are choosing to abstain from alcohol. Worryingly, however, these trends do not appear big enough to stop alcohol harm from continuing to rise, and the sharp increase in alcohol-related hospital admissions over the last few years means hundreds of thousands more people each year are experiencing the misery associated with harmful alcohol consumption.

“The data released today should be sobering reading for whoever wins the upcoming general election, and we would urge the next government to make tackling alcohol harm an immediate priority to save lives, reduce harm, and reduce the pressure on the NHS.”

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 The data is available via the following links.

Research Report | Foul Play? Report highlights how Alcohol industry bent the rules on advertising during UEFA Euro 2016

A new report highlights how alcohol producers worked to circumvent legislation designed to protect children during the UEFA Euro 2016 football tournament. Researchers at the Institute for Social Marketing, University of Stirling, found over 100 alcohol marketing references per televised match programme in three countries – France, the UK and Ireland. Most marketing appeared in highly visible places, such as pitch-side advertising during the matches. This was the case, despite the fact that the tournament was held in France, where alcohol TV advertising and sports sponsorship is banned under the ‘Loi Évin’.

The report, Foul Play? Alcohol marketing during UEFA Euro 2016, will be launched at the European Healthy Stadia conference at Emirates Stadium on Thursday 27th April.

An analysis of broadcast footage found that alcohol marketing appeared, on average, once every other minute. The majority took the form of ‘alibi’ marketing, whereby indirect brand references are used to promote a product, rather than a conventional logo or brand name. Carlsberg was the most featured brand, accounting for almost all references in each of the three countries, using their slogan ‘Probably the best in the world’ while avoiding the mentioning the product name. ‘Alibi’ marketing was a common practice of tobacco companies in sporting events when advertising restrictions were introduced.

Dr. Richard Purves, Principal Investigator, Institute for Social Marketing, University of Stirling said:

“Beamed to audiences across the world, major sporting events such as the UEFA EURO tournament, present a prime opportunity for alcohol companies to market directly to a global audience.  In order to continue to protect children and young people from exposure to alcohol marketing, laws such as those in France need to be upheld and respected by all parties involved and not seen as something to be negotiated.”

Katherine Brown, Director of the Institute of Alcohol Studies said:

‘There is strong evidence that exposure to alcohol marketing encourages children to drink earlier and in greater quantities. The findings of this report show that alcohol companies are following in the footsteps of their tobacco colleagues by bending the rules on marketing restrictions putting children’s health at risk.’

Eric Carlin, Director of Scottish Health Action on Alcohol Problems (SHAAP), said:

‘Sport should be an alcohol-free space. The presence of alcohol marketing during UEFA EURO 2016 highlights that organisers of sporting events need to hold out against tactics of big alcohol companies to flout legal regulations designed to protect children.’

Read the full report here: https://bit.ly/alcfoulplay

The research was carried out by the Institute for Social Marketing, University of Stirling, and funded by the Institute of Alcohol Studies (IAS), Scottish Health Action on Alcohol Problems (SHAAP), and Alcohol Action Ireland.

 

 

Over 200,000 children in England are living with Dependent Drinkers!

New figures released today reveal that over 200,000 children in England are living with dependent drinkers who could benefit from receiving specialist alcohol treatment.

The data from Public Health England estimates that there are 600,000 dependent drinkers who would benefit from treatment, yet only just over 100,000 are currently receiving the help they need.

These figures only cover adults who are most seriously dependent on alcohol. It is currently estimated that around 1.5 million adults in England and Wales have some form of alcohol dependence, and that there are 2.5 million children living with an adult drinking at risky levels.

The PHE data is released alongside a report from the Department for Work and Pensions (DWP) focused on improving the life chances and job prospects of the least well-off. The Department has said it will increase access to grant funding and introduce peer mentors for those in alcohol treatment to help them get back into work.

The report comes at a time when politicians are increasingly recognising the harm cheap alcohol is doing to the most vulnerable in society. The March budget included a consultation on the introduction of a new tax band designed to increase the price of strong white cider, a product which is predominantly consumed by children and heavy drinkers.

And earlier today a report published by the House of Lords Licensing Committee following an enquiry into the operation of the 2003 Licensing Act recognised the damage being done by cheap alcohol. The report calls for the introduction of a minimum unit price (MUP) for alcohol across the UK if it is introduced in Scotland and proves to be successful. Its introduction is being stalled by legal action being taken by sections of the alcohol industry. The report also calls for an end to multi-buy deals such as three for the price of two, a measure which has proved to be successful in Scotland.

Alcohol health experts welcomed the measures announced by the DWP today and the focus on the most vulnerable and lowest paid, pointing to studies which have shown that the least well off are around five times more likely to die from alcohol-related causes than those at the top of the income bracket.

Experts also called, however, for a wider, population-level approach to improving life and employment opportunities for dependent drinkers alongside greater support for individuals.

Liver physician Professor Sir Ian Gilmore, chair of the Alcohol Health Alliance UK (AHA), said:

“We welcome the Government’s recognition that cheap alcohol is damaging some of the most vulnerable groups in society. The revelation that 200,000 children in England are living with adults in need of specialist help is deeply worrying. We need to make sure people get the support they need once they have a problem with alcohol, for their own sakes and for the sake of their children. But people don’t set out to become dependent drinkers and we need to stop more people from reaching that stage.

“For the greatest impact, the measures announced today should be combined with
measures like minimum unit pricing of alcohol. Studies have shown that setting a minimum price for alcohol would reduce unemployment and bring substantial numbers of unemployed drinkers back into the workforce.

“The government is already taking steps to tackle alcohol dependence in this broader way, with the recent announcement that it will be consulting on increasing the tax on high- strength ciders, drinks which are known to be drunk by the most vulnerable and do disproportionate harm.

“Studies also indicate that MUP would help address health inequalities, with over 80 per cent of lives saved coming from the lowest income groups. At the same time, the measure would not increase the price of alcohol sold in pubs and clubs.”

The Public Health England figures can be found here.
The DWP report, entitled Improving Lives: helping workless families, is available here.


About the Alcohol Health Alliance UK
The Alcohol Health Alliance UK (AHA) is a group of 50 organisations including the Royal College of Physicians, Royal College of GPs, British Medical Association, Alcohol Concern and the Institute of Alcohol Studies. The AHA works together to:
– Highlight the rising levels of alcohol-related health harm
– Propose evidence-based solutions to reduce this harm
– Influence decision makers to take positive action to address the damage caused by alcohol misuse

“Government has ‘no sense of direction’ in reducing devastating alcohol harm” | Lord Brooke

After Welfare, the cost of Health is the second biggest charge which Chancellors of the Exchequer have to deal with. Yet if one examines Budget speeches it rarely gets a mention, although in fairness to Phillip Hammond it did this year because of the crisis in Care which is directly linked to Health.

Health costs continue to grow at around 4% per annum but the economy is down around 2%. So with an aging population,the ‘health service car crash’ as one recent ex health service minister described it, every action must be taken or at least explored to avoid further injury or collapse.

That is what is at the heart of my debate – seeking changes that will reduce not only burgeoning public health costs but lead to healthier, happier and longer lives. As part of that, the Government must confront the stark challenge that alcohol abuse presents for the NHS in terms of financial costs, resources and impact on staff time and welfare.

Alcohol is estimated to cost the NHS around £3.5bn per year, which amounts to £120 for every taxpayer!

Even though drinking has declined marginally, there is a growing burden of alcohol related admissions and “activity” as our NHS tries to deal with the consequences of harmful drinking. This is not surprising when Public Health (England) recently reported:-

  • Alcohol is now the leading cause of death among 15 to 49 year olds.
  • There are now more than a million alcohol-related hospital admissions a year.
  • Alcohol caused more years of life lost to the workforce than from the 10 most cancers.
  • In England more than 10 million are drinking at levels that increase the risk of harming health.

There are 23,000 deaths related to alcohol in England each year, meaning that alcohol accounts for 10% of the UK burden of disease and death and is one of the three biggest avoidable risk factors of them.

Evidence indicates that the ease of access, availability and persistently cheap alcohol perpetuates these problems with deprivation and health inequalities particularly prevalent amongst men from lower socio-economic groups.

Alcohol is 60% more affordable today than it was in 1980. Affordability is one of the key drivers of consumption and harm: cheaper alcohol invariably leads to higher rates of death and disease.

David Cameron and the Coalition Government recognised this back in 2012 when they produced their progressive Alcohol Strategy. In its foreword he wrote”..and a real effort to get to grips with the root cause of the problem.That means coming down hard on cheap alcohol”

That hasn’t happened. Other aspects of the strategy have disappeared. There seems to be a vacuum with no discernible sense of direction. I will be pressing for one – the NHS certainly needs it.

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Lord Brooke of Alverthorpe is a Labour peer in the House of Lords.

Original post here: Politics Home

Women & Alcohol | Edinburgh and London-Based Seminar Series | 2017

The Institute of Alcohol Studies (IAS) and the Scottish Health Action on Alcohol Problems (SHAAP) are co-hosting a four part seminar series to discuss issues relating to women and alcohol.

Each session will be chaired by an eminent academic, who will invite three guest speakers to present their personal responses to three pre-set questions, which are relevant to the topic.

These events will provide an opportunity for policy makers, academics, activists, and media representatives to critically discuss topics related to women and alcohol use. The intention is to stimulate thinking, challenge some attitudes and perceptions, and to think about future research and policy priorities.

Seminar 1: Friday, 10th March 2017

Women, Alcohol, and Globalisation.
Royal College of Physicians, London, 2 – 4pm

Chair: Dr. Cecile Knai, Associate Professor of Public Health Policy, London School of Hygiene and Tropical Medicine.

  • How does alcohol marketing influence women’s behaviours?
  • How does alcohol marketing influence attitudes towards women?
  • How does alcohol affect women in different social and cultural contexts?

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Healthier central England or North–South divide? Analysis of national survey data on smoking and high-risk drinking

In England, around 20% of the population are smokers and 13% drink excessively. These behaviours are leading risk factors for several non-communicable diseases, including cancer, diabetes and chronic respiratory and cardiovascular conditions. It is estimated that around 8000 deaths/year are alcohol-related and 80 000 deaths of adults aged 35 and over are attributed to smoking annually. The prevalence and adverse effects of high-risk drinking and tobacco use are not equally distributed across the country, with large regional variations.

A North–South divide exists for smoking, with higher rates of tobacco use, smoking-related deaths and smoking-related harm in northern regions. 

In contrast, excessive alcohol consumption tends to be lowest in central and eastern regions, while an East versus West divide is seen in the prevalence of alcohol dependency and alcohol sales. These regional variations in consumption do not always map onto experienced harm, a phenomenon known as the Alcohol Harm Paradox. In 2014, alcohol-related death rates were significantly higher among regions in the north of England compared with those in the south.

Objectives: This paper compares patterns of smoking and high-risk alcohol use across regions in England, and assesses the impact on these of adjusting for sociodemographic characteristics.

Design: Population survey of 53 922 adults in England aged 16+ taking part in the Alcohol and Smoking Toolkit Studies.

Measures: Participants answered questions regarding their socioeconomic status (SES), gender, age, ethnicity, Government Office Region, smoking status and completed the Alcohol Use Disorders Identification Test (AUDIT). High-risk drinkers were defined as those with a score of 8 or more (7 or more for women) on the AUDIT.

Results: In unadjusted analyses, relative to the South West, those in the North of England were more likely to smoke, while those from the East of England, South East and London were less likely. After adjustment for sociodemographics, smoking prevalence was no higher in North East (RR 0.97, p>0.05), North West (RR 0.98, p>0.05) or Yorkshire and the Humber (RR 1.03, p>0.05) but was less common in the East and West Midlands (RR 0.86, p<0.001; RR 0.91, p<0.05), East of England (RR 0.86, p<0.001), South East (RR 0.92, p<0.05) and London (RR 0.85, p<0.001). High-risk drinking was more common in the North but was less common in the Midlands, London and East of England. Adjustment for sociodemographics had little effect. There was a higher prevalence in the North East (RR 1.67, p<0.001), North West (RR 1.42, p<0.001) and Yorkshire and the Humber (RR 1.35, p<0.001); lower prevalence in the East Midlands (RR 0.69, p<0.001), West Midlands (RR 0.77, p<0.001), East of England (RR 0.72, p<0.001) and London (RR 0.71, p<0.001); and a similar prevalence in the South East (RR 1.10, p>0.05)

Figure 2Figure 2: Association between Government Office Region and high-risk drinking: (A) unadjusted;
(B) adjusted for gender, age, ethnicity and socioeconomic status (reference region: South West). Note: this shows the relative risk difference for each region relative to the South West (dotted reference region). Increasing red tones reflect increasingly higher significant risk and increasing blue tones reflect increasingly lower significant risk. Regions shaded white have a similar risk to the South West. Online supplementary figure S9 labels the Government Office Regions in England.
Expand Image – More diagrams in the main report

Conclusions: In adjusted analyses, smoking and high-risk drinking appear less common in ‘central England’ than in the rest of the country. Regional differences in smoking, but not those in high-risk drinking, appear to be explained to some extent by sociodemographic disparities.

Strengths and limitations of this study

  • Used a representative survey about smoking and drinking conducted on a large sample of the adult population in England.

  • Based on the most up-to-date information in England on regional differences in smoking and high-risk drinking accounting for disparities in gender, socioeconomic status (SES), ethnicity and age.

  • Respondents may have underestimated or failed to report their drinking and smoking.

  • Patterns of smoking and alcohol use were only available at the Government Office Region level, whereas important variation may occur at a more micro-geographical level.

bmj

Copyright information:
Published by the BMJ Publishing Group Limited.

 

Read the full report here!