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Alcohol a public health issue Day 5 Session 3 Feb 2010 . Overview. Why alcohol is an important public health issue Alcohol data and report available to groups Writing a technical briefing for Director of Public Health. Units of alcohol in common drinks.
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Overview • Why alcohol is an important public health issue • Alcohol data and report available to groups • Writing a technical briefing for Director of Public Health
Units of alcohol in common drinks Source: http://units.nhs.uk/howMany.html
Sensible drinking • men should not regularly drink more than 3–4 units of alcohol per day and women should not regularly drink more than 2–3 units per day • British Liver Trust recommends that individuals should abstain from alcohol for a minimum of two consecutive days a week
Hazardous drinking Regular consumption of: • more than 5 units of alcohol daily for men • more than 3 units of alcohol daily for women • In 2000, around a quarter of adults (38% of men and 15% of women) in Britain were estimated to be hazardous drinkers
Harmful drinking • Women who regularly drink over 6 units a day (or over 35 units a week) and men who regularly drink over 8 units a day (or 50 units a week) are at highest risk of alcohol related harm. • a pattern of drinking that causes damage to physical and mental health
Alcohol dependence • a cluster of physiological, behavioural and cognitive phenomena in which the use of alcohol takes on a much higher priority for the individual than other behaviours that previously had greater value. • The Psychiatric Morbidity Survey reported that 7% of adults in Britain were assessed as being dependent on alcohol in 2000 (mostly ‘mild’). Men were more likely to show dependence than women and younger people were more likely to show dependence than older groups.
Definitions Alcohol specific conditions - thought to be directly attributable to excessive alcohol consumption, such as acute alcohol intoxication and alcoholic liver disease Alcohol-attributable conditions thought to be directly or indirectly attributable to excessive alcohol consumption..
Alcohol in Europe • Global estimates suggest that alcohol misuse harms more people and causes more deaths and serious illness than street drugs • Alcohol is the third highest risk to health in the European Union ahead of health problems related to being overweight or obese, behind only tobacco and raised blood pressure
Alcohol misuse harms more people and causes more deaths and serious illness than street drugs
Age-standardised alcohol related death rate by sex and age-group 1991-2004 Source: ONS
Months of life lost to women through alcohol related conditions 2002-4NWPHO
Months of life lost due to alcohol by Index of Multiple Deprivation quintile, England 2003-5
While there is evidence to suggest that drinking 1–2 units of alcohol per day may reduce the risk of coronary heart disease in middle-aged and older population groups with a history of infrequent lifetime alcohol consumption, the net effect of alcohol on coronary heart disease is negative. • Any further increase in the prevailing (already higher than optimum) levels of alcohol consumption is therefore more likely to result in harm than good
How alcohol affects the lives of drinkers and those around them Street violence Domestic violence (about 40% alcohol related) In 16-64 agegroup 23% are hazardous drinkers and 4% dependent drinkers Police time Child protection 37% of recorded violent crime Drink driving Work days lost Ambulance service Disability benefit Accidents and deaths A&E Many people with mental health problems misuse alcohol Alcohol misuse common among drug misusers Hospital admissions (doubled 2001-5) rate of alcohol-specific deaths is more than five times higher in the most deprived areas compared to the most affluent areas depression
Key effective and cost-effective Interventions • increase in alcohol prices • reduce availability of alcohol, • measures against drunk driving and • Measures against underage drinkingBased on: What are the most effective and cost-effective interventions in alcohol control?, • WHO Regional Office for Europe’s Health Evidence Network (HEN), 2004
Alcohol price relative to retail price index, real households’ disposable income and affordability of alcohol 1980-2005 (Indices 1980 = 100)
Alcohol-specific mortality rates by gender and region, England, 2001–2003 Source: Alcohol-related deaths in England and Wales, 2001 to 2003
Hospital admissions for alcohol-related harm (VSC26) Directly age-standardised rates per 100,000 persons Context Charts show trends, projections and trajectories for alcohol-related admissions by South Central PCT, with ONS area classification group and South Central SHA comparators Source: NCHOD. Compendium of Clinical and Health Indicators. (nww.nchod.nhs.uk) Projection method: Linear projections based on actual rates for 2002-2008 inclusive. Robert Kyffin, Department of Health South East robert.kyffin@dh.gsi.gov.uk 27-Jan-10
References • Indications of Public Health in the English Regions 8: Alcohol • www.apho.org.uk/resource/view.aspx?RID=39296 • Calling Time: Reducing alcohol harm in the South West - a blueprint for joint action • www.swpho.nhs.uk/resource/view.aspx?RID=36940 • Trends and geographical variations in alcohol-related deaths in the United Kingdom, 1991–2004 • www.statistics.gov.uk/downloads/theme_health/hsq33web.pdf • Local Alcohol Profiles for England(www.nwph.net/alcohol/lape)