Alcohol in the East Midlands
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Alcohol in the East Midlands Alcohol in the East Midlands August 2017 1 Alcohol in the East Midlands About Public Health England Public Health England exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. We do this through world-leading science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services. We are an executive agency of the Department of Health and Social Care, and a distinct delivery organisation with operational autonomy. We provide government, local government, the NHS, Parliament, industry and the public with evidence-based professional, scientific and delivery expertise and support. Public Health England Wellington House 133-155 Waterloo Road London SE1 8UG Tel: 020 7654 8000 www.gov.uk/phe Twitter: @PHE_uk Facebook: www.facebook.com/PublicHealthEngland Prepared by: Stephen Spreadborough, Public Health Analyst, Natalie Cantillon, Principal Public Health Intelligence Analyst, Tracy Carr, Health and Wellbeing Manager, PHE East Midlands For queries relating to this document, please contact: [email protected] © Crown copyright 2018 You may re-use this information (excluding logos) free of charge in any format or medium, under the terms of the Open Government Licence v3.0. To view this licence, visit OGL. Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned. Published March 2018 PHE publications PHE supports the UN gateway number: 2017827 Sustainable Development Goals 2 Alcohol in the East Midlands Foreword Many of us enjoy alcohol, and there’s nothing wrong with that. However, alcohol is a powerful drug that kills someone nearly every hour in the UK, the vast majority of them men. In the East Midlands, 1 in 4 adults drink over the recommended units of alcohol per week and 1 in 6 binge drink. We also have significantly higher rates of admission for alcohol related conditions when compared to England. There are higher rates of admission in the more deprived areas in the East Midlands. We know that, because of its effects on the wider determinants of health, tackling alcohol-related harm is an important route to reducing health inequalities in general. Alcohol is a depressant which in low doses causes euphoria, reduced anxiety, and sociability and in higher doses causes intoxication (drunkenness), stupor and unconsciousness. Long-term use can lead to alcohol abuse, physical dependence, and alcoholism as well as: accidents and injuries requiring hospital treatment violent behaviour and being a victim of violence unprotected sex that could potentially lead to unplanned pregnancy or sexually transmitted infections (STIs) loss of personal possessions, such as wallets, keys or mobile phones alcohol poisoning – this may lead to vomiting, seizures (fits) and falling unconscious What we need for the East Midlands is a broad range of alcohol policies and interventions, including treatment for harmful and dependent drinkers, as part of collective action to keep alcohol high on the public health agenda. Local authorities will need to continue, and strengthen, their work with the NHS, police, schools, businesses and local communities to understand local needs, agree local priorities and take determined action to tackle these problems. This report reviews the level of harm related to alcohol use across the East Midlands. It explores inequalties in health outcomes linked to alcohol. The report includes a series of recommendations that will support the alcohol agenda for the East Midlands and lead to improved health outcomes. Ann Crawford Deputy Director Health and Wellbeing Public Health England East Midlands 3 Alcohol in the East Midlands Contents Alcohol in the East Midlands 1 About Public Health England East Midlands 2 Foreword 3 Key findings 5 Place 5 Recommendations 6 Background 8 Overview of alcohol in the East Midlands 11 Local Alcohol Profiles 14 Reasons for admission 17 Inequalities 19 Treatment 27 Bibliography 28 4 Alcohol in the East Midlands Key findings 1 in 4 adults in the East Midlands drink over the recommended units of alcohol per week and 1 in 6 binge drink The East Midlands has significantly higher rates of admission for alcohol-related conditions (narrow definition) when compared to England for both males and females 1,562 adults died from alcohol-specific conditions in the East Midlands in 2013 to 2015 and an additional 2,146 from alcohol-related conditions In 2015/16 there were 686 hospital admissions per 100,000 population where an alcohol-related disease, injury or condition was the primary reason for admission or there was an alcohol-related external cause. This equates to 31,280 admissions and was significantly higher than England (647 per 100,000) Alcohol-related mortality is twice as high in males than females (68.2 per 100,000 in males and 30.6 in females) There are inequalities in terms of deprivation in the East Midlands with the higher rates of admission in the more deprived areas. For alcohol-specific conditions the rate of admission within the most deprived quintile in the East Midlands is almost 3.5 times greater than the least deprived quintile There are specific areas of concern around Nottingham City, which is significantly worse than England for a number of health outcomes relating to alcohol. There are also poorer health outcomes in the city areas of Derby and Leicester Place There are specific areas of concern around Nottingham city, which is significantly higher than England for: Alcohol-specific mortality Years of life lost due to alcohol-related conditions Mortality from chronic liver disease Admission episodes for alcohol-specific conditions and alcohol-related conditions Admissions for alcohol-related unintentional injuries Admissions for intentional self-poisoning by exposure to alcohol Admissions for mental and behavioural disorders due to the use of alcohol Admissions for alcohol-related cardiovascular disease conditions Admissions for alcoholic liver disease Claimants of benefits due to alcoholism The city areas of Derby, Nottingham and Leicester show a high number of significantly worse outcomes linked to alcohol when compared to England, however when we compare to statistical neighbours, Derbyshire compares less favourably. 5 Alcohol in the East Midlands Recommendations It is recommended that: PHE East Midlands supports the local system to raise awareness and support the use of tools that and evidence have been developed to improve health outcomes linked to alcohol by: continuing to promote and support the use of the Alcohol CleAR toolkit. The centre will focus initially on Lincoln, Nottingham and Northampton as pilot areas. supporting and promote the use of the Recovery Diagnostic Tool (RDT). The centre will focus on Nottingham and Nottinghamshire as pilot areas. working with local partners to disseminate and promote the use of the alcohol evidence review working with local partners to support understanding and implementation of the interventions included in the Strategic Transformation Plan (STP) menu of preventative interventions. This includes initiatives such as “Identification and Brief Advice (IBA)” for alcohol. supporting the local application of national marketing campaigns in the East Midlands. This includes promoting initiatives such as the OneYou campaign. Will developing the SHAPE tool to incorporate local alcohol data and data on licenced premises to provide a more comprehensive view of local alcohol issues PHE East Midlands will support the local system to share learning and disseminate good practice by: Sharing best practice across the East Midlands and with other centres and partners Providing support for local authority public health teams to raise the profile of alcohol with elected members Development of the East Midlands liver health network PHE East Midlands will support the local system with a number of specific local projects relating to alcohol. The centre will: deliver Making Every Contact Count (MECC) and Identification and Brief Advice (IBA) presentations with the wider workforce, for example with dental health trainees. support the local area action area in Nottinghamshire which has been designated as a phase 2 LAAA2 area 6 Alcohol in the East Midlands support local authorities in the development of service specifications for alcohol – for example the review of service specifications across Leicester, Leicestershire and Rutland promote cross agency “blue light” projects and schemes and share learning across the schemes atht are in place in Lincoln, Nottingham and Northampton Support the development a survey on alcohol consumption in Nottinghamshire and Lincoln PHE East Midlands targets additional support at the areas of greatest risk with respect to alcohol by: Targeting activity with Nottingham to highlight the population needs in this area as this is the local authority with the greatest level of need Working with system partners to support the prevention messages in the STP’s i.e. coordinate/fund MECC and IBA training. Developing a programme of targeted work with other stakeholders, for example Police and Crime Commissioners (PCC) to raise awareness and protect investment in this agenda 7 Alcohol in the East Midlands Background The effects of harmful drinking on individuals, their families and communities are wide- ranging and require a response at a national and local level (1). It is estimated that 10.8 million adults