Local Alcohol Policy Research Report for the Development of Whanganui District Council’S Local Alcohol Policy

8/11/2016 Local Alcohol Policy Research Report For the development of Whanganui District Council’s Local Alcohol Policy

Stephanie Rose

Contents List of Figures ...... 6 1. EXECUTIVE SUMMARY ...... 8 2. Introduction ...... 10 2.1. Purpose ...... 10 2.2. Scope ...... 10 3. BACKGROUND ...... 10 3.1. Context ...... 10 3.2. Legislative framework ...... 11 3.2.1. Sale and Supply of alcohol 2012 ...... 11 4. METHODOLOGY ...... 11 4.1. Overview ...... 11 4.2. Data collection and specific procedures ...... 11 5. COMMUNITY AND ALCOHOL ...... 13 5.1. Community views on alcohol ...... 13 5.2. Taxi transport and alcohol-related harm ...... 14 5.3. Safer Whanganui Alcohol and Other Drugs Reference Group ...... 16 5.4. Residents perceptions of feeling unsafe due to drunken people ...... 17 6. RESULTS...... 18 6.1. Council’s District Plan ...... 18 6.2. Alcohol Control Bylaw ...... 19 6.3. Licenses held in the District ...... 23 6.3.1. Number of licenses of each kind held for premises in its district ...... 23 6.3.2. Licences to Occupy ...... 23 6.4. Opening hours of each of the premises ...... 24 6.4.1. Off and on-licenced premises ...... 24 6.4.2. Clubs ...... 25 6.5. Location of premises ...... 26 6.5.1. Liquor outlet location versus sensitive sites ...... 27 6.5.2. Liquor outlet locations and socioeconomic deprivation...... 28 6.6. Demography of the district’s residents ...... 32 6.6.1. Population highlights ...... 32 6.6.2. Population ...... 32 6.6.3. Service age groups ...... 34 6.6.4. Ethnicity ...... 34 6.7. Demography of district’s visitors ...... 35

6.8. Overall health indicators of the District’s residents ...... 36 6.9. Alcohol-related problems arising in the District ...... 37 6.9.1. Health ...... 37 6.9.2. Injuries where alcohol is a contributing factor ...... 44 6.9.3. Mental health ...... 45 6.9.4. Alcohol-related disorders ...... 49 6.9.5. Alcohol-related deaths ...... 49 6.9.6. Pre-loading and Side-loading ...... 50 6.9.7. Alcohol and crime ...... 51 6.9.8. Alcohol-related convictions ...... 67 6.9.9. Alcohol-related crashes ...... 68 6.9.10. Social costs of harmful alcohol use ...... 71 6.9.11. Liquor outlet density: violent offences and motor vehicle accidents ...... 71 6.9.12. Other harm: alcohol-related litter ...... 72 7. CONCLUDING COMMENTS ...... 73 References ...... 75 Appendix 1: River City Cabs Alcohol Harm Perception survey report ...... 77 River City Cabs Alcohol Harm Perception survey report ...... 77

List of Tables

Table 1: Location of licensed premises in Whanganui - 2016 ...... 26 Table 2: Socioeconomic deprivation dimensions ...... 29 Table 3: Whanganui District population highlights-2013 ...... 32 Table 4: Whanganui District population- 2013 ...... 32 Table 5: Whanganui District population by census area- 2013...... 33 Table 6: Whanganui District population by service age group - 2013 ...... 34 Table 7: Whanganui District population by ethnicity ...... 34 Table 8: Overall health indicators for Whanganui- 2011/14...... 36 Table 9: Number of hospital discharges and patients from Whanganui Hospital where the reason for admission was an alcohol-related chronic disease - 2013 to 2015...... 41 Table 10: Total number of hospital discharges and patients from Whanganui Hospital who had an alcohol-related chronic disease- 2013 to 2015...... 43 Table 11: CCTV data of alcohol-related harm-December 2015- February 2016 ...... 54 Table 12: Offences attended by Police where alcohol was a factor- Financial years 2011-12 to 2015- 16...... 60 Table 13: Top 7 offences attended by Police where alcohol was a factor- Financial year 2015-16 ..... 61 Table 14: Number of Alcohol-related convictions in Whanganui (2012-2015) ...... 67 Table 15: Whanganui Correction Officer caseloads -2015 ...... 68 Table 16: Fatal and injury crashes in Whanganui District involving alcohol- 2010 to 2014l ...... 70

List of Figures

Figure 1: Taxi operator working hours vs. intoxicated patronage ...... 15 Figure 2: Taxi operator perceptions of safety ...... 15 Figure 3: Taxi operator perceptions of intoxicated patrons negative impact on work ...... 16 Figure 4: Negative experiences as felt by taxi operators by theme ...... 16 Figure 5: Percentage of Residents who felt unsafe from drunken people ...... 18 Figure 6: Original Whanganui alcohol ban area 2004 ...... 19 Figure 7: First addition 30 June 2008 ...... 20 Figure 8: Second addition 3 November 2008 ...... 21 Figure 9: Third addition 17 March 2009 ...... 22 Figure 10: Liquor outlet licences in Whanganui by percentage – 2016...... 23 Figure 11: Whanganui District Off and On licence opening hours- 2016 ...... 24 Figure 12: Whanganui District off and on-licence closing hours- 2016 ...... 25 Figure 13: Whanganui District club licence opening hours- 2016 ...... 25 Figure 14 : Whanganui District Club licence closing hours- 2016 ...... 26 Figure 15: Concentration of liquor premises in Whanganui-2016 ...... 27 Figure 16: Liquor licenced premises proximity to education facilities in Whanganui -2016 ...... 28 Figure 17: Whanganui District’s population by deprivation ...... 29 Figure 18: Socioeconomic deprivation index and liquor licenced premises locations-2016 ...... 30 Figure 19: Socioeconomic deprivation index and liquor licenced premises– Victoria Avenue-2016 ... 31 Figure 20: Comparing licenced liquor premises located in high deprivation areas-2016 ...... 31 Figure 21: Average monthly visitors to Whanganui (May 2015-May 2016) ...... 35 Figure 22: Average alcohol related presentations at Whanganui ED displayed by time and day-2014 ...... 37 Figure 23: Average alcohol-related presentations at Whanganui ED displayed by time for Monday and Sunday-2014 ...... 38 Figure 24: Average alcohol related ED presentations by Age-2014 ...... 39 Figure 25: Discharges and patients- admission ...... 41 Figure 26: Total discharges and patients where admission was an alcohol-related chronic disease- 2013 to 2015...... 42 Figure 27: Total discharges and patients from Whanganui Hospital who had an alcohol-related chronic disease - 2013 to 2015...... 44 Figure 28: Number of injury claims where alcohol was determined to be a factor - 2010-2015 ...... 45 Figure 29: AOD referrals June 2013- June 2014...... 46 Figure 30: AOD referrals June 2014- June 2015...... 46 Figure 31: AOD co-existing referrals June 2013- June 2014 ...... 47 Figure 32: AOD co-existing referrals June 2014- June 2015 ...... 48 Figure 33: Number of clients in Whanganui diagnosed to have alcohol-related disorders- 2012 to 2015...... 49 Figure 34: Deaths where alcohol was a contributing factor- Whanganui DHB region 2012-2015 ...... 50 Figure 35: Number of Intoxicated persons taken into Police custody for financial years 2011/12- 2015/16...... 51 Figure 36: Drunk Custody by location- financial years 2011-12 to 2015-2016 ...... 52 Figure 37: Drunk Custody hotspot locations- financial years 2011-12 to 2015-2016 ...... 53 Figure 38: Drunk custodies by time of occurrence- financial years 2011-12 to 2015-2016 ...... 54

Figure 39: Number of offences under Whanganui District Council’s Liquor Ban Areas Bylaw - 2013 to 2016 ...... 55 Figure 40: Number of Liquor Ban Areas Bylaw offences by age- 2013 to 2016 ...... 56 Figure 41: Number of Liquor Ban Areas Bylaw offences by time- 2013 to 2016 ...... 57 Figure 42: Comparing family violence - financial years 2014-15 & 2015-16 ...... 58 Figure 43: Incidents attended by Police where alcohol was a factor- Financial years 2011/12 to 2015/16...... 59 Figure 44: Alcohol-related traffic offences -financial years 2011/12 to 2015/16...... 59 Figure 45: Offender last drink locations- 1 July 2012 to 30 September 2016 ...... 62 Figure 46: Police attended violence events by financial year-financial years 2011/12 to 2015/16. .... 63 Figure 47: Police attended violence events by suburb-financial years 2011/12 to 2015/16 ...... 64 Figure 48: Police attended violence events by top 5 suburbs-financial years 2011/12 to 2015/16 .... 65 Figure 49: Police attended violence events by temporal analysis-financial years 2011/12 to 2015/16 ...... 66 Figure 50: Percentage of crashes in New Zealand where alcohol/drugs as a contributing factor- 2012 to 2014 ...... 69 Figure 51: Alcohol-related crashes versus total crashes in Whanganui – 2014...... 69 Figure 52: Fatal and injury crashes in Whanganui District involving alcohol- 2010 to 2014 ...... 70

1. EXECUTIVE SUMMARY NUMBER OF OUTLETS  There are a total of 22 off-licences, 46 on-licences, and 31 club licences or one off-licence premises for every 1440 adult residents. There is one on-licence premise for every 689 adults and one club licenced premise for every 1056 adult residents of Whanganui. OPENING HOURS  Most on and off-licences mirror the default opening hours set by the Sale and Supply of Alcohol Act 2012 at 08:00hrs and 07:00hrs respectively. Most on-licences close between the hours of 01:00hrs and 02:00hrs, and off-licences tend to close at 23:00hrs.  For most clubs in Whanganui opening times range between the 8am and 9am throughout the week and they often close on Fridays and Saturdays at 12am. LOCATION OF OUTLETS  Most of our liquor premises are located on Whanganui’s mainstreet and in Whanganui Central. Whanganui East, Aramoho, Gonville, and Castlecliff represent other areas of Whanganui where a concentration of liquor premises is also evident.  There tends to be a high frequency of liquor licences within close proximity to an education facility and/or marae.  Overall, 45% of the total number of licences are located in high deprivation areas. DEMOGRAPHICS  39% of Whanganui’s population have high levels of socioeconomic deprivation and hence may be more likely to be disproportionally affected by alcohol consumption.  2013 the total population of Whanganui was 42,150  7% of Whanganui’s population reside in Gonville South, followed by Fordell-Kakatahi (6%). Kowhai Park, Williams Domain, St Johns Hill, Laird Park, Springvale East, and Castlecliff North all contain 5% of the district’s population respectively.  Most of Whanganui’s population is aged between 35 to 49 years (18.4%) followed by 50 to 59 (14.4%), and 60 to 69 (11.7%), with 77% of residents identifying themselves as European, 21.7% as Māori, and 2.6% as Pacific peoples. VISITORS  Most of our international visitors over the last 12 months originated from the ‘Rest of Europe’.  There were an average of 17,911 visitors from the Manawatu-Wanganui region. HEALTH STATISTICS  In 2014, 18.7% of residents (compared to the New Zealand average of 15.5%) identify themselves as a hazardous drinker.  In 2014, 405 (2.5%) Whanganui Emergency Department (ED) presentations were judged to be alcohol-related.  Alcohol-related ED presentations for all timings throughout Friday, Saturday, and Sunday steadily increased, culminating in the highest number of alcohol-related ED presentations on Sunday.  On a yearly average there are 21 times more alcohol-related ED presentations on Sunday than Monday between the times of 00:00-05:59hrs, with a doubling of alcohol-related ED presentations for the same days between 06:00hrs and 11:59hrs.  20-24 year olds are more likely to present at ED with an alcohol-related health condition, followed by 15-19, 30-34, and 45-49 year olds.  Alcohol related chronic disease admissions for the most part have been relatively steady across 2013 to 2015 for both discharge and patient counts.  Total discharges and patients from Whanganui Hospital who had an alcohol-related chronic disease both declined when comparing 2014 to 2015, but were still higher than 2013 counts. In 2015, one out of every 377 residents was discharged with an alcohol-related chronic disease.

 There has been a steady incline of alcohol-related injuries from 2012/13, with 2014/15 having the highest count of alcohol-related injuries (76).  An assessment of Alcohol and Other Drug referral numbers between March 2015 and March 2016 reveals a total of 897 referrals; 45% of these referrals have a diagnosis of Alcohol Use Disorder.  11 alcohol-related deaths occurred in 2015 and this is currently trending upwards. CRIME STATISTICS  Between 1 July 2011 and 30 June 2016 a total of 2394 persons were taken into drunk custody.  91% of drunk custodies between 2011/12 and 2015/16 occurred in Whanganui Central (1050) – followed by Gonville (389), Castlecliff (257), Whanganui East (191), Aramoho (173), and Springvale (91).  The highest frequency of drunk custodies in the range of financial years 2011/12 to 2015/2016 occurred between 1:00am to 1:59am (at 228 or an average of 57 times per year). From 21:00hrs to 02:29hrs there more than 150 (37 per year) drunk custodies occurring for each hour in this range.  Alcohol-related incidents captured by CCTV show the time range of incidents closely mirror the district’s general closing hours of on and off-licence premises.  A total of 102 ticketed offences have been committed under Council’s Liquor Ban Areas Bylaw since 2013-2015 had the highest number of total offences at 58.  Consumption of alcohol in an alcohol ban area received the highest count of offences under the Council’s Alcohol Ban Areas Bylaw.  16-20 year olds had a higher frequency of bylaw offences at a total of 55; representing more than half the total offences captured across all age groups.  For the years 2013, 2015, and 2016 bylaw offences tended to occur between the hours of 12:00hrs and 01:00hrs  Police data indicates that alcohol was a factor in 19% of all family violence cases attended by police during the financial years 2014/15 and 2015/16.  The financial year 2015/16 had the highest percentage of traffic incidents where alcohol was consumed (54%) for the period presented and this is trending upwards. All other incidents have declined over the years compared to 2011/12.  On average, 10% of all offences dealt with by Whanganui Police for the financial year 2015/16 were committed by an offender who consumed alcohol. This average remains unchanged for the financial year 2014/15 but is down from 2013/14 (15%).  Violence events attended by Police have steadily increased from 2011/12 and 2012/13, dropping in 2013/14, before peaking in 2015/16 to 1902 - a 22% increase in the number of violence events attended by Police in 2011/12.  Friday has a high frequency of violence events between the hours of 21:00hrs and 22:00hrs); Saturday has steadily high frequency of violence events between 18:00hrs and 23:00hrs, peaking around 00:00hrs and 02:00hrs; and Sunday has high frequency of violence events between 00:00hrs and 06:00hrs.  Data indicates a trend of declining alcohol-related offence convictions captured in the Whanganui District.  Nearly three-quarters of offenders had their last alcoholic drink at home or a private residence.  15% of correction officer caseloads are made up of alcohol-related offenders in the Whanganui District.  Of the 105 vehicle crashes recorded for the Whanganui District in 2014, 16 or 15% of total crashes were alcohol-related.  It is estimated in 2005/06 that harmful alcohol use cost the Whanganui District $51.8 million.

2. Introduction 2.1. Purpose The purpose of this report is to provide necessary information on alcohol-related trends and harms within the Whanganui District to be considered in determining the contents of Whanganui District Council’s Draft Local Alcohol Policy. 2.2. Scope The scope of this report aligns itself with the requirements made under Section 78(2) of the Sale and Supply of Alcohol Act 2012 (SSAA). Section 78(2) of the SSAA states that when a territorial authority is producing a draft, it must have regard to:

a) the objectives and policies of its district plan; and b) the number of licences of each kind held for premises in its district, and the location and opening hours of each of the premises; and c) any areas in which bylaws prohibiting alcohol in public places are in force; and d) the demography of the district’s residents; and e) the demography of people who visit the district as tourists or holidaymakers; and f) the overall health indicators of the district’s residents; and g) the nature and severity of the alcohol-related problems arising in the district.

3. BACKGROUND 3.1. Context In 2008, the Law Commission was tasked with a first-principles review of the legislative framework under which alcohol was supplied and sold in New Zealand. The Commission released an issues paper: Alcohol in Our Lives: An Issues Paper on the Reform of New Zealand’s Liquor Laws that put forward options for consideration including:

 drafting a new Sale of Liquor Act;  introducing measures to curb harmful drinking, e.g. reduce availability of cheap alcohol products often favoured by young and heavy drinkers;  reducing excise tax on low alcohol products to stimulate consumption;  reducing hours that alcohol can be purchased;  expanding criteria under which a licence can be declined and the range of conditions that could be put on licences; and  introducing a graduated licence fee aimed at benefiting low risk operators.

The issues paper led to the Sale of Liquor Act 1989 being replaced by the SSAA; bringing in a number of new provisions that have significantly impacted on the way territorial authorities can administer their licensing functions.

The SSAA includes greater ability for local communities to influence liquor licensing matters. One of the key ways of achieving this is through the introduction and development of a Local Alcohol Policy (LAP). A LAP is optional for a territorial authority and, where in place, the licensing body will have to consider a LAP when determining licence applications.

At its meeting in January 2014, Council approved a LAP development project plan including a timeframe for its implementation. The project plan was the work of the Whanganui Alcohol Strategy

Group, a joint agency group responsible for promoting safe drinking practices and culture for Whanganui within a Safer Whanganui framework. 3.2. Legislative framework 3.2.1. Sale and Supply of alcohol 2012 The SSAA is a shift from a liberal policy on licensing of alcohol outlets to a stricter regime aimed to reduce the harm to the community from excessive consumption of alcohol, by young persons in particular. Local authorities are specifically empowered by the Act to adopt stronger local alcohol policies.

According to Section 77(1) of SSAA, a local alcohol policy may include policies on any or all of the following matters relating to licensing (and no others):

a) location of licensed premises by reference to broad areas: b) location of licensed premises by reference to proximity to premises of a particular kind or kinds: c) location of licensed premises by reference to proximity to facilities of a particular kind or kinds: d) whether further licences (or licences of a particular kind or kinds) should be issued for premises in the district concerned, or any stated part of the district: e) maximum trading hours: f) the issue of licences, or licences of a particular kind or kinds, subject to discretionary conditions: g) one-way door restrictions. 4. METHODOLOGY 4.1. Overview This section covers methods as utilised by Council officers in the collation of the information presented in this research report. Not included in this report, but forming part of the background work, officers undertook a literature review of international and national research with relation to alcohol trends and harm. 4.2. Data collection and specific procedures Structured around the requirements of Section 78(2) of the SSAA and report headings, this section details how data was collected by Council officers, including the procedures followed and the key stakeholders that data was obtained from.

Report headings Data was obtained from Procedures followed Community and  Research First alcohol  River City Cabs  Versus research Licences held in the  WDC1 Liquor licensing License data was provided in Excel by District team the Liquor licensing team and Opening hours of each  District Licensing accordingly graphed and analysed via of the premises inspector the district’s total population, by Location of premises  WDC GIS

1 Whanganui District Council

 Department of Public location, in comparison to sensitive Health, University of locations and deprivation. Otago Council’s GIS were asked to provide maps illustrating license type locations filtered against deprivation and sensitive sites. Department of Public Health, University of Otago provided socioeconomic deprivation scores and advice in presenting total deprivation for the district. Demography of the  Statistics NZ Demographics of residents were district’s residents  Profile.id collected via StatsNZ’s website, with additional breakdowns of age demographics provided via correspondence with StatsNZ officials and Profile.id. Demography of the  Visit Whanganui Data was collected via a new visitor district’s visitors reporting model that collects anonymous information from mobile phone use and graphed accordingly. Alcohol-related  Whanganui District Trend and frequency analysis was problems arising in the Health Board completed on all data provided. As district: Health  Whanganui Regional more recent 2015 ED presentations Primary Health data was not readily available at the Organisation time of writing, Council officers resorted to 2014 findings. Relationships between ED presentation frequencies and ED presentation timings were examined. Injuries where alcohol  ACC Council officers requested alcohol- is a contributing factor related injury data from ACC for the Whanganui District. A search of key alcohol terms was performed of the free text space of ACC claim forms. Frequency of alcohol reference terms were collated and quantified. Mental health  Whanganui District Trend and frequency analysis was Health Board’s completed on all data provided and (WDHB) Community graphed accordingly. Investigation into Mental Health Service referral clients under the legal drinking  Jigsaw age was requested.

Alcohol-related deaths  Ministry of Justice Trend and frequency analysis was  Whanganui Coroner completed on all data provided and  New Zealand Fire graphed accordingly. Evaluations were Service made between Ministry of Justice and New Zealand Fire Service data. Alcohol and crime  Police NZ Police were asked to provide data covering years 2011 to 2016 to examine any changes pre and post legislative change. Trend and frequency analysis

was completed on all data provided and graphed accordingly. Drunk custodies were analysed by the time they occurred to check if any correlation was present between custodies and current liquor purchasing hours. Drunk custodies and violence events attended were also presented via location and trend analysis was applied for areas experiencing high frequencies. Alcohol-related  Corrections NZ Trend and frequency analysis was convictions  Ministry of Justice completed on all data provided and graphed accordingly. Alcohol-related  Ministry of Transport Trend and frequency analysis was crashes  New Zealand Traffic completed on all data provided and Authority graphed accordingly.

5. COMMUNITY AND ALCOHOL 5.1. Community views on alcohol In July 2013, Whanganui District Council commissioned research consultancy firm Research First to conduct a research project with the aim of capturing resident perceptions around alcohol related issues. The following presents key messages of this project:23

 Interest in drinking outside of Whanganui was limited to young people. Most respondents (87%) were in agreement there were good places to have a drink in Whanganui. In addition, nearly all (89%) saw bars, restaurants and cafes as important for socialising in Whanganui.

 Around a quarter to a third of respondents cited negative aspects associated with alcohol such as unruly gatherings of groups of people who had been drinking alcohol or public disorder related to alcohol.

 In most cases respondents believed that there were the right number of off-licence outlets such as convenience stores, supermarkets, restaurants and cafes, sports clubs and bars. However 60% identified that there were too many liquor outlets.

 Most (83%) respondents indicated that Whanganui should consider the number of nearby places selling alcohol when an application for a new licence is made.

 Many respondents indicated that there should be more control over where alcohol can be purchased in a community. Nearly all (85%+) felt there should be restrictions on the proximity of outlets to schools, parks and playgrounds and drug and alcohol rehabilitation services.

2Research First (2013). Community Views on Alcohol: Research report, Whanganui District Council. 3 The sample including 563 residents and who closely represented the distribution of actual suburbs and ages of the District.

 Opinion was relatively divided as to whether there should be an alcohol precinct (40% agreed, 30% neutral and 30% disagreed), with two thirds indicating there would be problems with too many licensed premises that are close to each other.

 Increasing the number of bars, restaurants and cafes was seen to have positive and negative impact on Whanganui. First and foremost, it was seen to increase employment (60% impact), but over half agreed it could lead to public safety concerns (53% impact). Most (around 70% to 80%) did not feel that more bars, restaurants and cafes would attract more tourists, encourage more business, bring people in the community together or improve the quality of cultural events and performances. Few (less than 10%) indicated that reduced antisocial behaviour and vandalism would result from a reduction in bars, restaurants and cafes.

 Most respondents did not agree that alcohol should be accessible at any time. The most popular time proposed for liquor outlets to open was between 09:00hrs and 11:00hrs, later than the current national default hour of 7:00hrs. Close to half (45%) indicated that liquor outlets should close at either 22:00hrs or 23:00hrs. This is consistent with the national default closing time of 23:00hrs. The most popular time proposed for bars to open was between 10:00hrs or 11:00hrs. This is later than the national default opening time of 8:00hrs. Over half of all respondents indicated a preferred closing time of bars as between midnight and 2:00hrs. This is earlier than the national default closing time for bars of 4:00hrs.

 Half of respondents preferred that a one-way door policy take affect one hour before the closing time of the licensed establishment. A further 38% indicated that a one-way door policy should take effect 30 minutes before closing.

 The effects of the one-way door policy were perceived to be largely positive and respondents felt that this would lead to people sticking to their group at night and reducing public drunkenness.

 Almost two-thirds of respondents thought that an alcohol control ban would reduce alcohol related problems and that an alcohol ban would not negatively affect their ability to enjoy the amenities in the area.

5.2. Taxi transport and alcohol-related harm Between 17 December 2015 to 18 January 2016, Council officers administered a short questionnaire to River City Cab taxi operators as a method of capturing taxi operator perceptions of alcohol related harm experienced during their operational hours. The River City Cabs Alcohol Harm Perception survey (Appendix 1) consisted of 5 multi-choice and open ended questions.

Key findings of the River City Cabs Alcohol Harm Perception survey are as follows4:

 81% of operators said they had transported intoxicated patrons on Saturday night till Sunday morning (Figure 1).

4Full report found in Appendix 1

12 13

10 11

6 7 6 4 5 5 4 4 4 2 3 Numberintoxicated of patrons 1 1 1 2 0 Mon Tues Wed Thurs Fri Sat Sun Mon Tues Wed Thurs Fri Sat Sun 06:00 - 06:00 - 06:00 - 06:00 - 06:00 - 06:00 - 06:00 - 19:00 - 19:00 - 19:00 - 19:00 - 19:00 - 19:00 - 19:00 - 18:00 18:00 18:00 18:00 18:00 18:00 18:00 05:00 05:00 05:00 05:00 05:00 05:00 05:00

Figure 1: Taxi operator working hours vs. intoxicated patronage5

 Close to half of taxi operators surveyed feel unsafe when transporting intoxicated patrons (Figure 2).

25%

44%

31%

Yes No Can't say/ Neutral

Figure 2: Taxi operator perceptions of safety6

 69% of taxi operators said intoxicated patrons negatively impacted their work (Figure 3).

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25% Yes No 6% Can't Say/ neutral 69%

Figure 3: Taxi operator perceptions of intoxicated patrons negative impact on work7

 Almost all taxi operators surveyed have been subjected to negative experiences resulting from interactions with intoxicated patrons (Figure 4).

Verbally abused 81%

Confrontations with passengers 75%

Cleaning (vomit & other) 69%

Fare evasion 69%

Taxi damaged (internal or external) 50%

Physically assaulted/abused 25%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Percentage of taxi operators

Figure 4: Negative experiences as felt by taxi operators by theme8 5.3. Safer Whanganui Alcohol and Other Drugs Reference Group Safer Whanganui Alcohol and Other Drugs Reference Group is represented by the New Zealand Police, Whanganui District Council, Nga Tai O Te Awa, ACC, Whanganui Maori Wardens, NZ Fire Service, Te Oranganui Iwi Health Authority, Whanganui Regional Health Network, Sport Whanganui, Mid Central DHB Health Protection, and Whanganui DHB. The vision of the group is ‘To reduce alcohol and other drug-related harm in the Whanganui community’.

7 Whanganui District Council 2016 8 Whanganui District Council 2016

This section displays the Safer Whanganui Alcohol and Other Drugs (AOD) Reference Group’s achievements; issues identified in Whanganui; and initiatives in reducing alcohol-related harm since its formation.

Achievements since formed – the group:

 Was instrumental in the development of the Local Approved Products Policy (LAPP) – writing policy in partnership with Whanganui District Council, engaging the community in the consultation process and seeing the subsequent adoption of the policy by Council.  Secured funding from the Health Promotion Agency as a trial community to undertake community consultation to inform the development of the draft Local Alcohol Policy (LAP). The group also mobilised community focus groups to understand and have input into the policy development, ensuring community views were reflected in the draft.  Promoted changes to the blood alcohol content (BAC) by holding community events and informing workplaces.  Assisted in the Liquor Licensee workshop; providing an injury prevention and public health perspective.

Issues identified in Whanganui

 Psychoactive substances were identified as an issue for our community. AOD Reference Group worked alongside Nga Tai o Te Awa and Whanganui City College to run a public information forum. While the visible purchase of psychoactive substances has declined since the law change, there is still an underground element to sales which is being monitored.  The group also worked with the WDHB to look at additional support and resources once the law changes came into place.

Initiatives to reduce alcohol related harm

 Promoted the changes in the BAC in December 2014 and strategies to reduce alcohol-related harm.  LAP development.  Safety Week collaboration – focused on reducing alcohol-related harm and engaging the community and businesses.  Health promotion business mail out - letters and information have been posted to employers to encourage effective host responsibility practices whilst hosting staff events and functions over the festive season. The letter also served to remind employees of the lowered BAC drink driving limit and promoted the Police message - If you are going to drink then don’t drive.

5.4. Residents perceptions of feeling unsafe due to drunken people Whanganui District Council’s annual Community Views Survey captures feedback from a representative sample of the District’s population. Every annual survey asks residents their perception of safety and identifies reasons why residents feel unsafe. Figure 5 below represents the percentage of residents who felt unsafe from drunken people from Community Views Surveys ranging from 2010 to 2016.

Residents in 2013 recorded the highest frequency of feeling unsafe from drunken people (29%), whereas residents in 2016 recorded the lowest (15%). 2011(19%) saw a 7% fall from 2010 (27%), that grew again in 2012 (21%) with it peaking in 2013. (29%).

From 2013 to 2016, an oscillating trend occurs, where a high resident perception of unsafety from drunken people (2013 and 2015) is followed by almost a 50% decrease in resident perception (2014 and 2016). Resident perceptions in 2016 are the lowest in the years presented, but given the pattern formed by preceding years, a plausible forecast may depict a raise in residents’ perceptions of feeling unsafe due to drunken people.

Figure 5: Percentage of Residents who felt unsafe from drunken people9 6. RESULTS 6.1. Council’s District Plan The Whanganui District Plan is the key resource management planning document that guides the development and use of land throughout the Whanganui District. The District Plan divides the District into a series of land use zones that recognise significant and distinctive amenity and physical characteristics of different parts of the District. The District Plan provides a rule base for each zone, identifying activities that can be undertaken as of right (permitted) and those that require resource consent.

The District Plan is mandated by the Resource Management Act 1991 (RMA), and is required to give effect to the purpose of the RMA, which is to “promote the sustainable management of natural and physical resources” (set out at section 5 of the RMA).

The District Plan rules do not specifically address the location and trading hours of premises retailing alcohol throughout the District. Food and beverage outlets are identified within the broad definition of commercial activities, which are addressed within the District Plan rule structure.

In general, commercial activities are permitted within identified commercial zones. These zones are focussed on the Whanganui town centre area and the smaller satellite retail centres that serve neighbourhood catchments. This approach seeks to both consolidate the commercial areas of the District and to prevent detrimental impact on the identified amenity of other areas.

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Commercial activities within residential, rural, manufacturing and other minor zones of the District Plan are beyond the scope of identified permitted activities and therefore require resource consent.

The requirement for resource consent for commercial activities beyond the defined commercial zones enables the specific effects arising from proposed activities to be assessed and considered within a decision, along with the relevant District Plan objectives and policies for the subject zone. 6.2. Alcohol Control Bylaw The alcohol ban area of Whanganui District are outlined in Council’s Alcohol Control Bylaw.

The alcohol ban area includes:

 Whanganui town centre, cross the Whanganui Bridge, Durie Hill and including Durie Hill tower.  Victoria Park is split into an alcohol ban area between the designated times of 9pm to 7am the following day and a 24/7 alcohol ban area.  Kowhai Park is included in the alcohol ban area between the designated times of 9pm and 7am the following day.  Mowhanau Beach/Domain is now included in the alcohol ban area for the duration 3pm on 31 December until 3am on 1 January.

Figure 6: Whanganui town centre, cross the Whanganui bridge, Durie Hill and including Durie Hill tower 10

10 Whanganui District Council 2016

Figure 7: Victoria Park11

11 Whanganui District Council 2016

Figure 8: Kai Iwi Beach12

12 Whanganui District Council 2016

Figure 9: Kowhai Park13

13 Whanganui District Council 2016

6.3. Licenses held in the District 6.3.1. Number of licenses of each kind held for premises in its district According to Whanganui District Council records as of August 2016 there were a total of 22 off- licences, 46 on-licences, and 31 club licences.

31% Clubs 46% Off-Licences On-Licences

22%

Figure 10: Liquor outlet licences in Whanganui by percentage – 2016.14

Applying the total adult population of Whanganui District in 201315, the following statements can be made:

 There is one off-licence premise for every 1440 adult residents of Whanganui  There is one on-licence premise for every 689 adult residents of Whanganui  There is one club licence premise for every 1056 adult residents of Whanganui

6.3.2. Licences to Occupy Council grants Licences to Occupy (LTO) permitting premises to allow patrons to consume food and alcoholic beverages at the premise’s outdoor seating. LTOs accompany a premise’s liquor licence. Currently 14 LTOs are currently provided to premises on Victoria Avenue, Taupo Quay and Guyton Street.

14 Whanganui District Council 2016 15 The adult population of Whanganui in 2013 was 28,569 and is defined as people normally residing in Whanganui aged 18 and over.

6.4. Opening hours of each of the premises 6.4.1. Off and on-licenced premises Off and on-licence opening hours

Numberlicences of 7 7 5 3 2 1 1

07:00hrs 07:30hrs 08:00hrs 08:30hrs 09:00hrs 09:30hrs 10:00hrs 10:30hrs 11:00hrs

Off - licence On - licence

Figure 11: Whanganui District Off and On licence opening hours- 201616

Off-licence premises in the District tend to commence business hours at 07:00hrs whereas on-licence premises tend to commence business hours at 08:00hrs, mirroring the maximum trading hours set by the SSAA.

16 Whanganui District Council 2016

Off & On-Licences Closing Hours 16 14 14 14 12 10 8 7 6 5 5 4 Numberlicences of 2 2 1 2 1 3 11 0

Off licence On licence

Figure 12: Whanganui District off and on-licence closing hours- 201617

Most on-licenced premises tend to close at 23:00hrs, followed by 20:00hrs, whereas on-licenced premises mostly closed at 01:00hrs and 02:00hrs, followed next by 00:00hrs. The earliest an on- licenced closed was 22:00hrs, whilst the latest an off-licence closed was 23:00hrs. 6.4.2. Clubs Club opening times 35

Numberlicences of 10

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Figure 13: Whanganui District club licence opening hours- 201618

17 Whanganui District Council 2016 18 Whanganui District Council 2016

For most Clubs in Whanganui opening times range between 08:00hrs and 09:00hrs throughout the week. The next spike in opening hour frequencies is 17:00hrs for Monday to Friday. All Clubs in the weekends are open by 13:00hrs at the latest.

Club closing times 60

20 Numberlicences of

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

Figure 14 : Whanganui District Club licence closing hours- 201619

Except for Fridays and Saturdays, 22:00hrs tends to be the time most Clubs cease operating hours. Clubs are more likely to close on Fridays and Saturdays at 00:00hrs. 6.5. Location of premises The following table presents the total number of premises by licence for corresponding locations in Whanganui.

Location Number of on-licences No. of off-licences No. of club licences Aramoho 1 0 1 Castlecliff 1 3 4 Durie Hill 2 1 1 Fordell 1 0 0 Gonville 2 2 4 Springvale 0 0 1 St Johns Hill 0 1 0 Upokongaro 1 0 0 Westmere 1 1 1 Whanganui 36 10 14 Whanganui East 0 4 4 Table 1: Location of licensed premises in Whanganui - 201620

19 Whanganui District Council 2016 20 Whanganui District Council 2016

Figure 15: Concentration of liquor premises in Whanganui-201621

Liquor premises are concentrated in five key areas of Whanganui. Victoria Avenue (Whanganui’s main street) and Whanganui Central represents one of these concentrated areas and is where the highest concentration of liquor premises are located. Whanganui East, Aramoho, Gonville, and Castlecliff represent other areas of Whanganui where a concentration of liquor premises is evident.

When comparing Whanganui liquor outlets’ licences counts to the national average, the following statements can be made:22

1. Whanganui has above average hotel and sports club licences. 2. Whanganui has below average restaurant and tavern, and “other” on and off licences. 3. Whanganui has about average supermarkets/groceries and chartered clubs.

6.5.1. Liquor outlet location versus sensitive sites The location of liquor outlets can influence alcohol use and related alcohol harm. A systematic review of alcohol availability in communities and the marketing of alcohol concluded that a relationship between outlet density and advertising exposure is linked to alcohol use, particularly by adolescents23.

Sensitive sites locations, including local district schools and Marae have been presented alongside licensed liquor locations in Figure 16.

21 Whanganui District Council 2016 22 Provided by the Medical Officer of Health, Whanganui District Health Board. 23 Bryden, A., Roberts, B., McKee, M., & Petticrew, M. (2012). A systematic review of the influence on alcohol use of community level availability and marketing of alcohol. Health & place, 18(2), 349-357.

24 Figure 16: Liquor licenced premises proximity to education facilities in Whanganui -2016 The close proximity of these locations is common for a district the size of Whanganui.

6.5.2. Liquor outlet locations and socioeconomic deprivation Research indicates a correlation between a person’s access to alcohol outlets in socioeconomically deprived areas. The higher the socioeconomic deprivation the more likely persons living in these areas are to access alcohol outlets.25

What is Socioeconomic Deprivation?

In New Zealand, socioeconomic deprivation is calculated by the Department of Public Health of the University of Otago. This is done by assessing meshblocks against a set of eight variables which are then scaled from 1 to 10, with 10 being the highest and 1 the lowest (through to nil deprivation). The eight variables are tabled below in Table 2.

24 Whanganui District Council 2016 25 Hay, G. C., Whigham, P. A., Kypri, K., & Langley, J. D. (2009). Neighbourhood deprivation and access to alcohol outlets: a national study. Health & place, 15(4), 1086-1093.

Dimension of deprivation Description of variable Communication People aged <65 with no access to the Internet at home Income People aged 18-64 receiving a means tested benefit Income People living in equivalised* households with income below an income threshold Employment People aged 18-64 unemployed Qualifications People aged 18-64 without any qualifications Owned home People not living in own home Support People aged <65 living in a single parent family Living Space People living in equivalised* households below a bedroom occupancy threshold Transport People with no access to a car Table 2: Socioeconomic deprivation dimensions26

*equalivalisation: methods used to control for household composition.

As the New Zealand Deprivation Index is produced at a meshblock level, an overall deprivation score for Whanganui District is not possible. The closest way to understand the extent of socioeconomic deprivation across Whanganui is to study where individuals are represented in both Dep 9 and Dep 10 scores (or fifth quintile) as displayed in Figure 17.

Figure 17: Whanganui District’s population by deprivation27

According to Figure 17, for 2013, Dep 9 (7785) and Dep 10 (9342) represented as a combined total is 17127 (or as a percentage of the total population of Whanganui is 39%28). That is to say that 39% of

26 Adapted from Table 1: Variables included in NZDep2013 found in NZDep2013 Index of Deprivation (May 2014), University of Otago. 27 Provided by June Atkinson, Department of Public Health, University of Otago adapted from Socioeconomic Deprivation Indexes 2013. 28 2013’s population of 42153 was used instead of the more recent 2015 population estimate as the deprivation index is based on Whanganui’s 2013 population.

Whanganui District’s population can be said to be experiencing high levels of socioeconomic deprivation29.

It is well documented and researched that poorer communities are often more likely to be affected by alcohol harms than affluent communities3031.

Supporting this work, a recent UK study found a strong correlation between alcohol consumption and socioeconomically deprived persons. It stated that the associated alcohol harms to a person’s health tend to more likely affect people less well off than their affluent counterparts disproportionally32.

Applying this paradigm to the Whanganui District, it could be said that 39% of Whanganui’s population’s health may be disproportionally affected by alcohol consumption.

Liquor outlet locations and socioeconomic deprivation

Figure 18 represents all registered on-licenced and off-licenced premises and Clubs amongst the backdrop of the social deprivation index for the Whanganui District. Figure 19 displays the same information but centred on Victoria Avenue only.

33 Figure 18: Socioeconomic deprivation index and liquor licenced premises locations-2016

29 NB: this is based on 2013 socioeconomic deprivation indexes 30 Meiklejohn, Jessica, Jennie Connor, and Kypros Kypri. "One in three New Zealand drinkers reports being harmed by their own drinking in the past year." The New Zealand Medical Journal (Online) 125.1360 (2012): 28. 31 Sellman, Doug, and Simon Adamson. "Alcohol harms." The New Zealand medical journal 125.1360 (2012): 5- 8. 32 Bellis, Mark A., et al. "The alcohol harm paradox: using a national survey to explore how alcohol may disproportionately impact health in deprived individuals." BMC public health 16.1 (2016): 1. 33 Whanganui District Council 2016

Figure 19: Socioeconomic deprivation index and liquor licenced premises– Victoria Avenue-2016 34

Figure 20 is a display of registered liquor licensed premises and the amount located in high socioeconomically deprived areas of Whanganui District.

59% 46

45% 26% 27 31 Number licences Number of 22

10 8

On -Licence Off - licence Clubs

Total Licences No. of Licences in High Deprivation

Figure 20: Comparing licenced liquor premises located in high deprivation areas-201635

As displayed in Figure 20, 59% of on-licence liquor outlets and 45% of off-licence liquor outlets are located in high deprivation areas of Whanganui.

Overall, 45% of the total number of licences are located in high deprivation areas.

34 Whanganui District Council 2016 35 Whanganui District Council 2016

6.6. Demography of the district’s residents 6.6.1. Population highlights

2013 Number Median age 42.4 Average household size 2.36 % of total population Couples with children 33% Households with a mortgage 29% Medium and high density housing 11% Households renting 28% Public transport (to work) 0% Walked, jogged, cycled to work 8% Higher degree 3% Māori descent 23% Overseas born 11% Low income households 28% Unemployed 9.60% Table 3: Whanganui District population highlights-201336 6.6.2. Population According to 2013 Census data, the total population of Whanganui is 42150 (Table:4).

% of total Population Number (2013) population

Population (excluding O/S visitors) 42150 100.0

Females 21939 52.0

Males 20214 48.0

Table 4: Whanganui District population- 201337

Area Number (2013) % of total population Otamatea 1284 3% Blueskin 1767 4% Maxwell 1644 4% Castlecliff North 1959 5% Castlecliff South 1257 3% Mosston 1062 3%

36 Statistics New Zealand 2016 37 Ibid.

Balgownie 222 1% Tawhero 1815 4% Gonville South 2988 7% Gonville East 1305 3% Gonville West 1551 4% Springvale West 1359 3% Springvale East 1899 5% Whanganui Collegiate 1146 3% Laird Park 2172 5% Whanganui Central 1215 3% Spriggens Park 306 1% Cooks Gardens 279 1% St Johns Hill 2115 5% Lower Aramoho 1707 4% Upper Aramoho 1989 5% Williams Domain 2136 5% Wembley Park 1587 4% Kowhai Park 2070 5% Bastia Hill 645 2% Durie Hill 1458 3% Putiki 324 1% Marybank-Gordon Park 486 1% Fordell-Kakatahi 2415 6%

Table 5: Whanganui District population by census area- 2013.38

7% of Whanganui’s population normally reside in Gonville South, followed by Fordell-Kakatahi (6%), and Kowhai Park, Williams Domain, St Johns Hill, Laird Park, Springvale East, and Castlecliff North, all of which contain 5% of the District’s population respectively.

38 Statistics New Zealand 2016

6.6.3. Service age groups Whanganui’s population is usually aged between 35 to 49 years (18.4%) followed by 50 to 59 (14.4%), and 60 to 69 (11.7%). 7.4% of Whanganui’s population is aged 18 to 24.

% of total Service age group (years) Number population

Babies and Pre-schoolers (0 to 4 ) 2,808 6.7

Primary Schoolers (5 to 11) 3,912 9.3

Secondary Schoolers (12 to 17 ) 3,729 8.8

Tertiary education and independence (18 to 24) 3,132 7.4

Young workforce (25 to 34) 3,996 9.5

Parents and homebuilders (35 to 49) 7,770 18.4

Older workers and pre-retirees (50 to 59) 6,060 14.4

Empty nesters and retirees (60 to 69) 4,950 11.7

Seniors (70 to 84) 4,641 11.0

Elderly aged (85 and over) 1,152 2.7

Total 42,150 100.0

Table 6: Whanganui District population by service age group - 201339 6.6.4. Ethnicity 77% of residents identified themselves as European, 21.7% as Māori, and 2.6% as Pacific peoples.

% of total Ethnic group - multi-response Number population

European 32,436 77.0

Māori 9,141 21.7

Pacific peoples 1,113 2.6

Asian 1,149 2.7

Middle Eastern/Latin American/African 159 0.4

New Zealander 759 1.8

Other ethnicity 18 0.0

Table 7: Whanganui District population by ethnicity40

39 Statistics New Zealand 2016 40 Statistics New Zealand 2016

6.7. Demography of district’s visitors

Figure 21: Average monthly visitors to Whanganui (May 2015-May 2016) 41

Figure 21 presents average monthly visitors to the Whanganui District between May 2015 and May 2016, with an average total of 17911 total visitors from the Manawatu-Wanganui region, 23756 from the rest of New Zealand, and 8258 total international visitors. The highest average count of domestic visitors over the last 12 months originates from the Manawatu-Wanganui region with an average of 2826 visitors, followed by 6449 visitors from Wellington, and 5253 visitors from Auckland.

The highest average count of international visitors over the last 12 months originate from the ‘rest of Europe’ with an average of 17911 visitors, followed by 2151 visitors from Australia, and 1427 visitors from Germany.

41 Data provided by Visit Whanganui 2016

6.8. Overall health indicators of the District’s residents The Health indicators for Whanganui are based on Whanganui District Health Board42 results taken from the 2011-14: New Zealand Healthy Survey and displayed in Table 8. Unadjusted prevalence (%), 2011-14 Indicator for adults aged 15 years and over Whanganui New Zealand DHB

Excellent, very good or good self-rated health 88.7 90.1

Current smoking 22.0 17.7

Daily smoking 20.5 15.8

Ex-smoker 30.6 25.0

Hazardous drinking 18.7 15.5

Meets vegetable intake guidelines 74.0 66.0

Meets fruit intake guidelines 51.0 57.8

Physically active 48.6 52.4

Obesity 34.5 29.7

Overweight but not obese 36.1 34.7

High blood pressure (medicated) 19.5 15.9

High cholesterol (medicated) 12.4 10.8

Ischaemic heart disease (diagnosed) 6.7 5.0

Stroke (diagnosed) 1.5 1.8

Diabetes (diagnosed) 5.4 5.6

Asthma (medicated) 11.9 11.0

Arthritis (diagnosed) 19.3 15.4

Osteoarthritis (diagnosed) 11.4 9.3

Chronic pain 19.7 17.6

Mood or anxiety disorder (diagnosed) 19.2 17.0

Psychological distress 4.2 5.6

Visited a GP 74.6 78.6

Visited practice nurse 39.9 30.3

Visited after-hours medical centre 14.9 11.9

Unmet need for primary health care 27.8 27.2

Unable to get appointment at usual medical centre within 24 hours 21.9 15.8

Unmet need for GP due to cost 9.7 14.1

Unmet need for GP due to lack of transport 2.2 3.3

Unmet need for after-hours due to cost 4.4 7.0

Unmet need for after-hours due to lack of transport 1.1 1.5

Unfilled prescription due to cost 4.6 6.5

Definitely had confidence and trust in GP 84.2 82.0

Visited a dental health care worker (dentate only) 43.1 48.6

Had one or more teeth removed 7.6 7.1 Usually only visits dental health care worker for dental problems or never visits 65.7 54.2 (dentate only) Table 8: Overall health indicators for Whanganui- 2011/1443.

Whanganui has a higher prevalence of adults aged 15 years and over who partake in hazardous drinking - 3.2% higher than the New Zealand average. Whanganui has a significant difference

42 Whanganui District Health Board serves the populations of Whanganui 42153), Rangitikei (14019), and Ruapehu (11844) Territorial Authority areas, with Whanganui’s population comprising the largest of the three. 43 Ministry of Health 2015. Regional results from the 2011-2014 New Zealand Health Survey accessed from: http://www.health.govt.nz/publication/regional-results-2011-2014-new-zealand-health-survey

compared to the New Zealand average in the prevalence of high blood pressure and a higher prevalence level of obesity, of which both health indicators are associated with long term and excessive alcohol consumption44.

Current, daily, and ex-smoker prevalence is also higher than the national average, with the biggest difference in prevalence being current smoking (Whanganui 22%:NZ 17%). 6.9. Alcohol-related problems arising in the District 6.9.1. Health 6.9.1.1. Emergency Department Presentations In 2014, there were 16431 presentations, age 15 and over, to Whanganui Emergency Department (ED). Of these, 405 (2.5%) were judged to be alcohol-related. When the alcohol-related presentations are analysed in terms of the time and day of presentation, the following patterns are found45.

6.9.1.2. Emergency Department Presentations (timings)

related EDpresentations -

11 30 19 13 15 16 64 8 5 12 18 11 12 5 2 33

Average number of alcohol of Averagenumber 3 8 4 13 14 12 3 3 MONDAY TUESDAY WEDNESDAY THRUSDAY FRIDAY SATURDAY SUNDAY

00:00 - 05:59 06:00 - 11:59 12:00 - 17:59 18:00 - 23:59

Figure 22: Average alcohol related presentations at Whanganui ED displayed by time and day-2014 46

On average, alcohol-related presentations at ED between Monday through to Thursday as found in Figure 22, demonstrates various fluctuations in alcohol-related presentation frequencies. Monday through to Tuesday sees a general reduction of presentations for all timings, there is a general increase

44 Rehm, J., Baliunas, D., Borges, G. L., Graham, K., Irving, H., Kehoe, T., et al. (2010). The relation between different dimensions of alcohol consumption and burden of disease: An overview. Addiction, 105(5), 817–843. 45 It should be noted, Council officer discussions with health representatives have indicated the alcohol-related ED presentations are relatively low and in reality may be understated in this report. Discussions highlighted methods employed to capture this data may not be consistently applied due to prioritisation of emergency staff. 46 Provided by Medical Officer of Health, WDHB 2016.

of alcohol-related presentations across all timing counts between Tuesday and Wednesday through to Thursday with the exception of Thursday 06:00-11:59hrs where a slight dip occurs.

Alcohol-related ED presentations for all timings throughout Friday, Saturday, and Sunday steadily increase, culminating in the highest number of alcohol-related ED presentations on Sunday.

The steep rise in presentation counts for Friday, Saturday, and Sunday, compared to the rest of the week, coincides with Stewart et. al’s (2014)47 research. This studied the enrollment of patients presenting at Christchurch Public Hospital‘s ED over the period of approximately a month and found that higher counts of patients with alcohol-related consumption/medical conditions were presented to the hospital's ED on the weekend than any weekday.48

Comparing Monday and Sunday alcohol-related ED presentations (Figure 23 ) between 00:00 – 11:59hrs there are higher counts of alcohol-related presentations on Sunday than Monday.

related ED

- presentations

19 15 12 13 14

3 8 Average number of alcohol of Averagenumber

00:00-05:59 06:00-11:59 12:00-17:59 18:00-23:59 Axis Title

Monday Sunday Expon. (Monday) Linear (Sunday)

Figure 23: Average alcohol-related presentations at Whanganui ED displayed by time for Monday and Sunday-201449

Comparing average Monday and Sunday alcohol-related ED presentations for 2014 (Figure 23) between 00:00 – 11:59, higher counts of alcohol-related ED presentations are found on Sunday than Monday.

More specifically, asssesing the difference in ED presentation counts between Monday and Sunday 00:00-05:59 and 06:00:11:59, this difference can be represented as ratios <1:21 and 1:2 respectively. That is to say, on a yearly average there are 21 times more alcohol-related ED presentations on Sunday than Monday between the times of 00:00-05:59, and a doubling of alcohol-related ED presentations for the same days between 06:00:11:59.

47 Stewart, Rebecca, et al. "The impact of alcohol-related presentations on a New Zealand hospital emergency department." The New Zealand Medical Journal (Online) 127.1401 (2014): 23. 48 Ibid. 49 Provided by Medical Officer of Health, WDHB 2016.

6.9.1.3. Emergency Department Presentations (age) 20-24 year olds are more likely to present at ED due to an alcohol-related health condition, followed by 15-19, 30-34, and 45-49 year olds. As with ED presentations by timings, these findings are concurrent with the findings of Stewart et. al. (2014).50

relatedED presentation 54 -

41 38 36 33

25 25 19 18

Average number of alcohol of Averagenumber 12 12 7

15- 19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ Age groups

Figure 24: Average alcohol related ED presentations by Age-201451

Average alcohol-related ED presentations – discussion.

A downward trend is present when contrasting 2011 and 2014 average alcohol-related presentations for Whanganui Hospital’s Emergency Department. 2011 audits of ED presentation records performed by WDHB staff assess two aspects important to this discussion, namely has alcohol or drugs been consumed in the last 24 hours and, if alcohol or drug use is associated with Emergency Department presentations.

The following points present 2011 averages of alcohol-related ED presentations taken from audit record reports52:  On average, 28% of persons presented at ED in 2011 said they had consumed alcohol or drugs in the last 24 hours.  On average, 11% of ED presentations were associated with alcohol or drug use.

In 2011, 11% of ED presentations were associated with alcohol or drug use, whereas 2014 alcohol- related presentations were assessed to be 2.5% of total ED presentations.

50 Stewart, Rebecca, et al. "The impact of alcohol-related presentations on a New Zealand hospital emergency department." The New Zealand Medical Journal (Online) 127.1401 (2014): 23. 51 Provided by Medical Officer of Health, WDHB 2016. 52 Whanganui District Health Board, 2016.

Though 2011 data does not differentiate between alcohol or drug use in reporting ED presentations, and factoring in the reported high average count of alcohol-related presentations found nationally53, the decline in alcohol-related ED presentations from 2011 to 2014 raises difficulties in determining the degree of alcohol-related harm when looking at ED presentations.

The 2014 estimate that 2.5% of ED presentations at Whanganui hospital were alcohol-related is less than figures found in other studies. A Christchurch study found that 7.4% of presentations had recently consumed alcohol, and in 5% of cases this contributed directly to their presentation54. Australasian studies55 have found that in studying a weekend night shift that 13.8% of Australian ED presentations and 18% of New Zealand ED presentations were alcohol-related.

Reviewing 2011 and 2014 ED presentations together with other alcohol-related harm indicators presented so far in this report and to follow (mental health, alcohol-related disorders, crime, convictions, and vehicle crashes) highlights no other indicator has experienced such a stark decline in alcohol-related harm.

In addition, in 2011 the average rate a person was screened at ED for alcohol-related presentations was 38%, meaning that there may in fact be more alcohol-related presentations for this year that were not recorded assumingly due to staffing capacity and recording protocols.

With consideration of the lack of evidential logic for the stark decline in alcohol-related ED presentations for 2014, it is recommended to utilise information such as the age of persons and timings they were presented at ED, not the volume of alcohol-related ED presentations when determining the impact of alcohol-related harm for policy development.

It can be assumed recording and auditing protocols may differ for the years presented, brought on by a shift in focus. Staff capacity is also a considerable explanation.

6.9.1.4. Alcohol-related chronic diseases The following sections look at the prevalence of alcohol-related chronic diseases for the Whanganui District as another method of investigating the prevalence of alcohol-related harm.

53 Stewart, Rebecca, et al. "The impact of alcohol-related presentations on a New Zealand hospital emergency department." The New Zealand Medical Journal (Online) 127.1401 (2014): 23. 54 Ibid. 55 Egerton-Warburton, Diana, et al. "Survey of alcohol-related presentations to Australasian emergency departments." Med J Aust 201.10 (2014): 584-587.

WERNICKE'S ENCEPHALOPATHY 1 1 MENTAL AND BEHAVIOURAL DISORDERS DUE TO USE OF 7 8 8 7 8 7 ALCOHOL MALIGNANT NEOPLASM OF LIVER, UNSPECIFIED 2 2

LIVER CELL CARCINOMA 3 2 1 3 2 1

ALCOHOL-INDUCED ACUTE PANCREATITIS 2 3 3 2 3 3

ALCOHOLIC HEPATITIS 1 1

ALCOHOLIC GASTRITIS 1 1

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Discharge 2013 Discharge 2014 Discharge 2015 Patients 2013 Patients 2014 Patients 2015

Figure 25: Discharges and patients- admission56

The ages represented range from 14 to 96 years (seven under 18 years), with alcohol intoxication being prevalent in younger ages.

Discharge Patients Total Total Discharge Patients 2013 2014 2015 2013 2014 2015 ALCOHOLIC 1 1 1 1 GASTRITIS ALCOHOLIC 1 1 1 1 HEPATITIS ALCOHOL- 2 3 3 2 3 3 8 8 INDUCED ACUTE PANCREATITIS LIVER CELL 3 2 1 3 2 1 6 6 CARCINOMA MALIGNANT 2 2 2 2 NEOPLASM OF LIVER, UNSPECIFIED MENTAL AND 7 8 8 7 8 7 23 22 BEHAVIOURAL DISORDERS DUE TO USE OF ALCOHOL WERNICKE'S 1 1 1 1 ENCEPHALOPATHY Grand Total 13 14 15 13 14 14 42 39 Table 9: Number of hospital discharges and patients from Whanganui Hospital where the reason for admission was an alcohol-related chronic disease - 2013 to 2015.57

56 Whanganui District Health Board 2016 57 Whanganui District Health Board 2016

Alcohol-related chronic disease admissions for the most part have been relatively steady across 2013 to 2015 for both discharge and patient counts. Mental and behavioural disorders due to use of alcohol was most prevalent followed by alcohol-induced acute pancreatitis.

Overall, it can be argued that there is no significant change in admissions of alcohol-related chronic diseases over the years 2013 to 2015.

14 14 14

13 13

2013 2014 2015 2013 2014 2015 Discharge Patients

Figure 26: Total discharges and patients where admission was an alcohol-related chronic disease- 2013 to 2015.58

Looking more specifically at each year of admission discharges and patients (Figure 26), 2015 had a higher rate of admission discharges, whilst 2014 had a slight rise in patients. The number of patients remained constant in 2015.

58 Ibid.

Discharge Patients Total Total Discharge Patients 2013 2014 2015 2013 2014 2015 ALCOHOLIC FATTY 1 1 1 1 LIVER ALCOHOLIC 1 1 1 1 2 2 GASTRITIS ALCOHOLIC 1 1 1 1 1 1 3 3 HEPATITIS ALCOHOLIC LIVER 1 1 1 1 DISEASE, UNSPECIFIED ALCOHOL- 2 4 3 2 4 3 9 8 INDUCED ACUTE PANCREATITIS DEGENERATION 1 1 1 1 2 2 OF NERVOUS SYSTEM DUE TO ALCOHOL LIVER CELL 6 3 3 4 2 3 12 8 CARCINOMA MALIGNANT 3 3 3 3 NEOPLASM OF LIVER, UNSPECIFIED MENTAL AND 67 77 71 43 59 50 215 139 BEHAVIOURAL DISORDERS DUE TO USE OF ALCOHOL OESOPHAGEAL 2 1 2 1 VARICES WITHOUT BLEEDING WERNICKE'S 2 2 2 2 ENCEPHALOPATHY Grand Total 79 89 84 48 63 57 252 153 Table 10: Total number of hospital discharges and patients from Whanganui Hospital who had an alcohol-related chronic disease- 2013 to 2015.59

Much like the admissions previously discussed, mental and behavioural disorders due to use of alcohol was the highest category of total hospital discharges and patients.

Counts of persons confirmed as having mental and behavioural disorders due to use of alcohol, liver cell carcinoma, and alcohol-induced acute pancreatitis have steady declined, in turn contributing to a decline of aggregated alcohol-related chronic diseases over 2013 to 2015. According to WDHB officials, this steady decline is assumed to be due to concerted efforts in these areas.

What should be noted is that while the three aforementioned chronic diseases are significantly more prevalent, other alcohol-related chronic diseases have remained relatively unchanged.

59 Whanganui District Health Board 2016

89 84 79

63 57 48

2013 2014 2015 2013 2014 2015 Discharge Patients

Figure 27: Total discharges and patients from Whanganui Hospital who had an alcohol-related chronic disease - 2013 to 2015.60

Overall, total discharges and patients from Whanganui Hospital who had an alcohol-related chronic disease have both declined when comparing 2014 to 2015, but are still higher than 2013 counts.

Using 2013 Census population data6162 and total discharges, the following statements can be made:

 In 2013, one out of every 401 residents was discharged having an alcohol-related chronic disease.  In 2014, one out of every 356 residents was discharged having an alcohol-related chronic disease.  In 2015, one out of every 377 residents was discharged having an alcohol-related chronic disease.

6.9.1.5. Foetal Alcohol syndrome diagnoses There are no Foetal Alcohol syndrome diagnoses for 2013 to 2015. However, there were 11 identified admissions between 2004 and 2012, all (except one aged 10), were younger than three years of age. 6.9.2. Injuries where alcohol is a contributing factor Alcohol-related injuries based on Accident Compensation Corporation (ACC) claims are presented in Figure 28.

Limitations are placed on this data as information collected pertaining to the injury and basis of injury of an individual relies on the claim form lodged by an individual. Not all fields are compulsory to be completed by a claimant. The data received applies to the Whanganui District.

A free text search was used in assessing ACC injury claims in the Manawatu-Wanganui region. Terms applied in the free text search included “alcohol”, “intoxicated”, “beer” and “consumption”, with the filter “Whanganui” applied.

60 Whanganui District Health Board 2016 61 Statistics NZ. 62 The figure used here was 31701 as this is the total amount number of Whanganui’s population 18 or over. Considering that only seven individuals identified as under 18, utilising a population count that included 14 to 18 year olds would not be as representative.

The below table provides results of the free text search, providing an indication of the amount of claims found associated with any injuries where alcohol was deemed a factor.

80 74 76

70 65 67 60 60

30 deemed deemed a factor 20

10 Number of claims Numberclaims of where alcohol was

0 2010/11 2011/12 2012/13 2013/14 2014/15

Figure 28: Number of injury claims where alcohol was determined to be a factor - 2010-201563

There was a steady decline in injuries where alcohol was deemed a factor from 2010/11 (74) to 2012/13 (60). A rise in injuries in 2013/14 (67) has continued to 2014/15 (76), the latter of which had the highest count of alcohol-related injuries for the period analysed.

It is important to acknowledge the potential for response bias based on the method of data collection, as claimants may be inclined not to declare consumption of alcohol in case of affecting their claim. This effectively means the data presented in Figure 28 could be lower than actual injury counts where alcohol was a factor. 6.9.3. Mental health The WDHB’s Community Mental Health Service (MHS) works with adults who have severe mental health issues. People accessing MHS services have an assessment, planning, treatment and reviews with an allocated key worker and/or a doctor64. The Alcohol and Other Drug Service works alongside the MHS where referrals to other services are provided.

The following section examines the sources from where Alcohol and Other Drug (AOD) referrals originate, comparing referral counts received from 2013 to 2015.

63 Accident Compensation Corporation (ACC) 2016 64 http://www.wdhb.org.nz/content/page/wdhb-s-mental-health-and-addiction- services/m/2742/#Community%20Mental%20Health

AOD Referrals June 2013 - June 2014

Work Unit Provider - Inpatient 7 Work Unit Provider - Community 25 Social Welfare - eg CYFS, WINZ 4 Self / Tangata Whaiora 380 Police 25 Other Service or Agency not specified elsewhere 43 NZTA 4 Maori Provider or Facility 1 Justice (Courts, Corrections,Youth etc) 40 Hospital Referral (Non Psychiatric) 25 General Practitioner 82 Family / Whanau 14 Emergency department 4 Education Sector 27 Courts 1 Community Probation and Psychological Services 267 Child, Youth and Family Service 30 Child, Adolescent and Family Service (outside of W 1 Accident and Emergency Department 2 0 50 100 150 200 250 300 350 400

Figure 29: AOD referrals June 2013- June 201465

AOD Referrals June 2014 - June 2015

Work Unit Provider - Inpatient 4 Work Unit Provider - Community 13 Work Unit Provider - Alcohol and Other Drug 1 Social Welfare - eg CYFS, WINZ 2 Self / Tangata Whaiora 370 Police 9 Other Service or Agency not specified elsewhere 26 NZTA 5 Mental Health Liaison 1 Maori Provider or Facility 2 Justice (Courts, Corrections,Youth etc) 16 Hospital Referral (Non Psychiatric) 22 General Practitioner 102 Family / Whanau 3 Community Probation and Psychological Services 198 Child, Adolescent and Family Service (outside of W 2 Accident and Emergency Department 4 0 50 100 150 200 250 300 350 400

Figure 30: AOD referrals June 2014- June 201566

65 Whanganui District Health Board 2016 66 Whanganui District Health Board 2016

Examining Figures 29 and 30 above, the highest counts of referrals comes from self/tangata whaiora, followed by Community probation and psychological services.

Total AOD referrals received for the periods of June 2013-June 2014 and June 2014-June 2015 are 982 and 800 respectively. This comparative decrease in referrals between the examined periods can be explained with a general decrease in referrals across all sources, more so from community probation and psychological services (from 267 to 198). Referrals sourced from a general practitioner have comparatively increased.

AOD Co-existing Referrals June 2013 - June 2014

Work Unit Provider - Community 2 Work Unit Provider - Alcohol and Other Drug 1 Self / Tangata Whaiora 19 Public Health - Non MH Comm Provider eg Plunket 2 Police 5 Other Service or Agency not specified elsewhere 3 Maori Provider or Facility 2 Justice (Courts, Corrections,Youth etc) 27 Hospital Referral (Non Psychiatric) 4 General Practitioner 6 Family / Whanau 5 Community Probation and Psychological Services 14 Child, Youth and Family Service 15 Accident and Emergency Department 1

0 5 10 15 20 25 30

Figure 31: AOD co-existing referrals June 2013- June 201467

67 Whanganui District Health Board 2016

AOD Co-existing Referrals June 2014 - June 2015

Work Unit Provider - Community 15 Work Unit Provider - Alcohol and Other Drug 1 Social Welfare - eg CYFS, WINZ 1 Self / Tangata Whaiora 41 Public Health - Non MH Comm Provider eg Plunket 11 Police 11 Other Service or Agency not specified elsewhere 18 Maori Provider or Facility 4 Justice (Courts, Corrections,Youth etc) 40 Hospital Referral (Non Psychiatric) 2 General Practitioner 11 Family / Whanau 13 Education Sector 40 Courts 2 Community Probation and Psychological Services 15 Child, Youth and Family Service 21 Accident and Emergency Department 3

0 5 10 15 20 25 30 35 40 45

Figure 32: AOD co-existing referrals June 2014- June 201568

With regards to AOD co-existing referrals, self/tangata whaiora received the highest counts. Other notable sources providing high counts of referrals include Justice, education sector, and child, youth and family service.

Total AOD co-existing referrals received for the periods of June 2013-June 2014 and June 2014-June 2015 were 106 and 249 respectively. This comparative increase in referrals between the examined periods can be explained with a general increase in referrals from Justice, self/tangata whaiora, and Educator sector.

2015 referral numbers

An assessment of referral numbers between March 2015 – March 2016 accounts for a total of 897 referrals; 45% of these referrals have a diagnosis of Alcohol Use Disorder, 16% have the diagnosis of Cannabis Use Disorder and 6% Amphetamine Use Disorder. The remaining 33% have no diagnosis.

Co-Existing Problems (CEP) Youth Team

As of February 2016, the WDHB has indicated there are 13 clients (17 years old and below) enrolled to the work unit CEP Youth Team.

Furthermore:  Nine out of 13 referrals featured alcohol use and out of these nine clients, eight were males.  Seven were NZ European, one was Samoan and one was Maori.

68 Whanganui District Health Board 2016

 The majority (66%) of the referrals were between the ages of 14 – 15 years.

6.9.4. Alcohol-related disorders The number of Community Mental Health and Addictions Service (WDHB) patients diagnosed to have alcohol-related disorders (Abuse, Dependence, Intoxication, Delirium, Alcohol-Induced Persisting Dementia, Alcohol-Induced Mood, Alcohol Withdrawal and Alcohol-Induced Psychotic Disorder with Hallucinations) is displayed in the figure below. The data was taken from the Community Mental Health and Addictions Service (WDHB) for the last three years minus rural (Raetihi, Ohakune, Taihape and Marton) and is specific to the Whanganui area.

300 247 250 213 204 195 182 200 171 153 150 128 121 94 100 76 61 50 34 No. patients of diagnosed 25 5 0 Total patients Male Female Patients under the Patients 25 years and age of 25 years older

2013 2014 2015

Figure 33: Number of clients in Whanganui diagnosed to have alcohol-related disorders- 2012 to 2015. 69

Total patients in 2015 were up from 2014 by 65 and up by 43 compared to 2013. A trend appears across all categories presented in Figure 33 in that a decline in patients diagnosed with alcohol- related disorders occurs between 2013 and 2014, and then increases again for 2015, reaching a count higher than the baseline presented by 2013 counts.

The bigger change in patients is presented in the category Patients under the age of 25 years where a 34% increase of patient counts occurs contrasting 2013 and 2015 counts for this category. 6.9.5. Alcohol-related deaths For the period from 1 January 2012 to 31 December 2015 there were a total of 245 deaths within the Whanganui DHB region, of which 35 deaths had alcohol noted as being a factor70. This means that between 2012 and 2015, 14% of deaths within the Whanganui DHB region occurred with alcohol being a factor. Figure 34 below provides a breakdown of alcohol-related deaths for this period.

69 Community Mental Health and Addictions Service (WDHB) 70 Ministry of Justice

11 10

8 related related deaths

- 6 Numberalcohol of

2012 2013 2014 2015

Figure 34: Deaths where alcohol was a contributing factor- Whanganui DHB region 2012-201571

Figure 34 indicates an increase of deaths where alcohol was a noted factor from 2012 onwards. Another trend captured was that low alcohol related deaths in one year (2012 and 2014) were proceeded by higher counts of alcohol related deaths the preceding year (2013 and 2015). Forecasting on current alcohol related deaths, 2016 may likely have a decrease in alcohol related deaths when compared to 2015. However, there has been no demonstrably lower count than 2012, meaning, that considering current trends, the future number of alcohol-related deaths would only be greater on average.

6.9.5.1. Deaths caused by fire where alcohol was a contributing factor Collating figures from the Ministry of Justice and New Zealand Fire Service, three deaths in 201372, one death in 201473, and one death in 201574 were caused by fires where alcohol was a contributing factor. 6.9.6. Pre-loading and Side-loading Pre-loading(also know as side-loading) is defined as the act of consuming alcohol outside and prior to entering a licensed premises that sells alcohol.75 Using Gorden et al.’s (2012) framework, reasons for persons to participate in pre-loading can be categorised as follows: “price” (the relatively cheaper cost of alcohol at an off-licensed than on-licensed premises), “social dimensions” (better quality social interactions), and “limits” (legal and operating hour limitations).76

There are no statistics specific to Whanganui on this subject. Given that 76% of alcohol (by volume) sold in New Zealand is via off-licence, and that this is cheaper than via on-licences, it is likely that pre- loading is a significant feature of local drinking patterns. Regionally speaking, a study of pre-loading in

71 Ministry of Justice 2016 72 Ibid. 73 Ibid. 74 New Zealand Fire Service 75 McCreanor, T., et al. "‘Drink a 12 box before you go’: pre-loading among young people in Aotearoa New Zealand." Kotuitui: New Zealand Journal of Social Sciences Online (2015): 1-11. 76 Gordon R, Heim D, MacAskill S 2012. Rethinking drinking cultures: a review of drinking cultures and a reconstructed dimensional approach. Public Health 126: 3–11.

Palmerston North found that 77% of respondents sampled said that they pre-load before travelling to town.77

6.9.7. Alcohol and crime 6.9.7.1. Drunk custody: Intoxicated persons taken into Police custody

Figure 35 displays the amount of intoxicated persons taken into custody in Whanganui for each financial year from 1 July 2011 to 30 June 2016. Between this period a total of 2394 persons were taken into drunk custody. Drunk custody here refers to police having taken action one way or another when responding to an incident involving an intoxicated person. Actions can include transporting the intoxicated person home, arrest, detaining the person for detox, and placing the person in the care of someone else.

486 495 500 469 475 469 450

400

350

300

250

200

150

100

50 No. intoxicated of persons takeninto custody 0 FY2011/12 FY2012/13 FY2013/14 FY2014/15 FY2015/16 Financial years

Figure 35: Number of Intoxicated persons taken into Police custody for financial years 2011/12-2015/16.78

Between 2011 until mid-2013, there was a slight incline of police custodies where intoxicated persons were involved. The drop in custodies after 30 June 2013 can be generally attributed to the stricter alcohol controls taking affect via the recent introduction of the Sale and Supply of Alcohol Act 2012. Financial years 2013/14 and 2015/16 reported the same number of intoxicated persons taken into Police custody.

6.9.7.2. Drunk Custody by location When viewing the amount of drunk custodies by location (Figure 36), the six areas of Whanganui where the highest amount of drunk custodies occurred are Whanganui Central (1050), Gonville (389),

77 UMR Research. “Pre-loading of alcohol and associated harm in Palmerston North” on behalf of Palmerston North City Council (2013). 78 Police NZ 2016

Castlecliff (257), Whanganui East (191), Aramoho (173), and Springvale (91). These six areas, or drunk custody hot spots, account for 91% of drunk custodies between financial years 2011-12 and 2015-16.

WHANGANUI AIRPORT WESTMERE SAINT JOHNS HILL PARIKINO PAPAITI OKOIA MARYBANK MANGAMAHU LAKE VIRGINIA KAI IWI FORDELL BRUNSWICK OTAMATEA KAITOKE BASTIA HILL PUTIKI DURIE HILL COLLEGE ESTATE TAWHERO SPRINGVALE WHANGANUI EAST ARAMOHO CASTLECLIFF GONVILLE WHANGANUI CENTRAL

0 200 400 600 800 1000 1200 Number of drunk custodies

FY2011-12 FY2012-13 FY2013-14 FY2014-15 FY2015-16

Figure 36: Drunk Custody by location- financial years 2011-12 to 2015-201679

Specifically looking at these drunk custody hot spots within the last financial year 2015/16, 50% of drunk custodies can be credited to Whanganui Central, 18% to Gonville, 14% to Castlecliff, 4% to Whanganui East , 4% to Aramoho, and 3% to Springvale.

79 Police NZ 2016

250

200

WHANGANUI CENTRAL 150 GONVILLE CASTLECLIFF ARAMOHO 100 WHANGANUI EAST

SPRINGVALE Numberdrunk of custodies

0 FY2011-12 FY2012-13 FY2013-14 FY2014-15 FY2015-16

Figure 37: Drunk Custody hotspot locations- financial years 2011-12 to 2015-201680

The following presents a summary of findings as depicted in Figure 37:

 Drunk custodies in Whanganui Central have trended upwards since mid-2013 reaching a high point of 233 in the financial year 2015/16.  A steep incline of drunk custodies in Castlecliff for 2015/16 (64) – this was close to the highest number of drunk custodies recorded for the period analysed in 2012/13 (68).  Gonville drunk custody counts have remained steady between 2014/15 (88) and 2015/ 16 (87). Counts for this period are higher than previous financial years despite improved changes to alcohol harm controls (i.e. Sale and Supply of Alcohol Act 2012).  Aramoho and Whanganui East, besides 2012/13 where custody counts were respectively lower (31) and higher (46), have mirrored each other’s declining custody counts.  Springvale drunk custodies have declined since 2012/13 (27), but seem to be on the rise again with an increase of four custodies between 2014/15 and 2015/16.

The decline in drunk custodies for the whole of Whanganui from 2012/13 onwards (Figure 35) can be attributed to a decrease in drunk custody occurrences across Springvale, Whanganui East, and Aramoho. Also contributing to this decline in drunk custodies were other areas of Whanganui that generally retained low drunk custody counts – these had no custodies recorded for the financial year 2015/16.

80 Police NZ 2016

6.9.7.3. Drunk Custody by timings

250

200

150

100

No. drunk of custodies 50

Hours

Figure 38: Drunk custodies by time of occurrence- financial years 2011-12 to 2015-2016 81

Depicted in Figure 38, the highest frequency of drunk custodies occurring in the range of financial years 2011/12 to 2015/16 was between 01:00hrs to 01:59hrs (228 or an average of 57 times per year). The lowest frequency occurred between 08:00hrs to 08:59hrs (13 or an average of 3 times per year). Looking more broadly at the findings, the range 21:00hrs to 02:29hrs shows that more than 150 (37 per year) drunk custodies occurred for each hour in this range.

6.9.7.4. Closed Circuit Television (CCTV) and alcohol-related harm Data provided from CCTV operators focuses on the period of December 2015 to February 2016, as is summarised in the following table.

Month Number of No. of Time range of No. of % of No. of nights events events alcohol events times incidents alcohol police incidents attended December 7 nights 22 23:00hrs – 12 55% 12 2015 02:57hrs January 2016 10 nights 20 23:22hrs – 13 65% 5 03:15hrs February 2016 7 nights 12 23:00hrs – 5 42% 6 02:00hrs Table 11: CCTV data of alcohol-related harm-December 2015- February 201682

All events captured by CCTV occurred on a Friday or Saturday night for all months. January 2016 (65%) and December 2015 (55%) had the highest percentage of events identified as alcohol incidents. The high amount of events, including alcohol incidents, decreases as the generally accepted holiday period ceases.

81 Police NZ 2016 82 Police NZ 2016

Alcohol incidents recorded included breaches of the Liquor Ban Bylaw, patrons drinking outside on- license premises, and intoxicated patrons observed partaking in violent activities/altercations.

The time range of the events that occurred closely mirrored the closing hours of on and off-licence premises.

6.9.7.5. Breaches of Liquor Ban Areas Bylaw Under Section 147 of the Local Government Act 2002, a Local Authority can make bylaws for alcohol control purposes. Whanganui District Council’s Liquor Ban Areas Bylaw requires83 no alcohol to be consumed, brought, or possessed in specified public areas (Figures 6-9, Section 6.2 Liquor Ban Areas Bylaw).

A total of 102 ticketed offences have been committed under Council’s Liquor Ban Areas Bylaw since 2013. 2015 had the highest amount of total offences at 58; this includes Police issuing infringements for consumption, bringing, and possession of alcohol in a public place. 2014 had the next highest tally of total ban offences at 24 followed by 13 for 2016 and 7 for 2013.

2016 6 7

2015 34 1 23

2014 12 3 9

2013 5 2

0 10 20 30 40 50 60 70 No. of offences

Consumed Alcohol Brought Alcohol Possessed Alcohol

Figure 39: Number of offences under Whanganui District Council’s Liquor Ban Areas Bylaw - 2013 to 201684

With the exception of 2016, the offence most committed under Council’s Liquor Bylaw was consumption in a public place.

83 Council’s Liquor Control Bylaw was replaced with the current Alcohol Control bylaw 2016. 84 Police NZ 2016

60 52

30 24

No. offences of 20 10 10 7 4 2 1 1 1 0 0 16-20 21-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61+ Age groups

Figure 40: Number of Liquor Ban Areas Bylaw offences by age- 2013 to 201685

Offences were generally committed by younger persons. 76% of offences were committed by persons 25 and under, and 84% of offences were committed by persons 30 years and under.

16-20 year olds had a higher frequency of offences at a total of 52, representing more than half the total offences captured across all age groups.

85 Police NZ 2016

04:00 to 04:59

03:00 to 03:59

02:00 to 02:59

01:00 to 01:59

00:00 to 00:59

23:00 to 23:59

22:00 to 22:59

21:00 to 21:59

20:00 to 20:59

19:00 to 19:59

18:00 to 18:59

17:00 to 17:59

16:00 to 16:59

15:00 to 15:59 Time Time day of (24hrs) 14:00 to 14:59

13:00 to 13:59

12:00 to 12:59

11:00 to 11:59

10:00 to 10:59

09:00 to 09:59

08:00 to 08:59

07:00 to 07:59

06:00 to 06:59

05:00 to 05:59

0 5 10 15 20 25 30 Number of offences

2013 2014 2015 2016

Figure 41: Number of Liquor Ban Areas Bylaw offences by time- 2013 to 2016 86

For years 2013, 2015, and 2016, bylaw offences tended to occur between the hours of 00:00hrs and 01:00hrs. 2014 had higher offences between the hours of 02:00hrs and 03:00hrs.

86 Police NZ 2016

6.9.7.6. Family violence Studies indicate the risk of being a victim or perpetrator of family violence rises with the amount of alcohol consumed87. Supporting international evidence, a Christchurch longitudinal study found a causal association between alcohol use disorder and family violence88.

Police data indicates that it was determined that alcohol was a factor in 19% of all family violence cases attended by Police during the financial years 2014/15 and 2015/16 (Figure 41).

100% 90% 19% 19% 80% 70% 60% 50% 40% 30%

20% Percent Percent family of violence 10% 0% FY2014/15 FY2015/16

no alcohol involved alcohol involved

Figure 42: Comparing family violence - financial years 2014-15 & 2015-1689

6.9.7.7. Incidents and alcohol Figure 43 displays the percentage of incidents where Police have determined alcohol was consumed. The financial year 2015/16 had the highest percentage of traffic incidents where alcohol was consumed (54%) for the period presented and is trending upwards. All other incidents have relatively declined over the years compared to 2011/12.

87 Wells, Samantha, Kathryn Graham, and Paulette West. "Alcohol-related aggression in the general population." Journal of studies on alcohol 61.4 (2000): 626-632. 88 Boden, J., Fergusson, D. and Horwood, L. 2012. Alcohol Misuse and violent behaviour: Findings from a 30- year longitudinal study. , Drug and Alcohol Dependence, Vols. 122(1-2), pp. 135-141. 89 Police NZ 2016

Domestic Dispute 42% FY2015/16 17% 54% 31% 20% Sudden Death

71% FY2014/15 48% Traffic Incident 50% 26% 42% 14% Vehicle Collision 50% FY2013/14 37% 31% Bail Breach 26% 100%

80% 13% Forbidden To Drive FY2012/13 32% 29% 45% 61% 100% Other Incident

75% FY2011/12 20% 50% 53% Juvenile Complaint (Action Taken 44% 100% Under Cyp & F Act)

Figure 43: Incidents attended by Police where alcohol was a factor- Financial years 2011/12 to 2015/16.90

6.9.7.8. Traffic related offences Traffic offences where it was determined alcohol was involved have declined in recent years. Traffic offences for the financial years 2014/15 and 2015/16 have remained at a steady high at 90%, down from 2013/14 (95%), 2012/13(96%), and 2011/12 (97%). Though there has been a decline, alcohol as a factor is still overrepresented in traffic offences.

98% 97% 96% 96% 95%

94%

92%

90% 90% 90%

88% Percent Percent alcohol of related traffic offences 86% FY2011/12 FY2012/13 FY2013/14 FY2014/15 FY2015/16 Financial year

Figure 44: Alcohol-related traffic offences -financial years 2011/12 to 2015/16.91

90 Police NZ 2016 91 Police NZ 2016

6.9.7.9. Offences and alcohol Presented in Table 12 are the percentage of offence categories where alcohol was consumed.

FY2011/12 FY2012/13 FY2013/14 FY2014/15 FY2015/16 Homicide 33% 0% 0% 0% 0% Kidnapping and Abduction 0% 0% 0% 0% 0% Robbery 11% 10% 20% 11% 4% Grievous Assaults 29% 33% 29% 16% 19% Serious Assaults 37% 33% 35% 18% 24% Minor Assaults 31% 32% 34% 21% 19% Intimidation and Threats 28% 31% 24% 20% 13% Group Assemblies 75% 0% 0% 0% 0% Sexual Affronts 20% 0% 25% 0% 0% Sexual Attacks 16% 13% 15% 7% 5% Immoral Behaviour 8% 0% 29% 0% 0% Drugs (Not Cannabis) 6% 0% 3% 12% 0% Drugs (Cannabis Only) 14% 6% 6% 10% 8% Disorder 55% 63% 53% 52% 53% Family Offences 25% 20% 24% 15% 9% Burglary 19% 14% 11% 8% 4% Car Conversion 20% 22% 16% 9% 9% Theft 8% 6% 6% 4% 3% Receiving 0% 3% 0% 8% 0% Fraud 6% 0% 2% 3% 2% Destruction of Property 40% 34% 22% 26% 23% Trespass 26% 27% 19% 12% 26% Animals 17% 0% 0% 0% 0% Postal/rail/fire Service Abuses 0% 0% 14% 0% 0% Arms Act Offences 11% 11% 3% 5% 3% Endangering 0% 0% 0% 0% 25% Table 12: Offences attended by Police where alcohol was a factor- Financial years 2011-12 to 2015-16.92

Examining Table 12, the following statements can be made:

 Alcohol has not been associated with any homicide offences since 2012/13.  Robbery offences had a substantial rise in 2013/14 (20%), slowly declining to 11% and 4% for 2014/15 and 2015/16 respectively.  A slight rise of Grievous Assault offences in 2015/16 (19%) from 2014/15 (16%).  Minor assaults committed for 2015/16 are down from previous years (19%).  Intimidation and threats committed for 2015/16 are down from previous years (19%).  Alcohol has not been associated with any group assembly offences since 2012/13.  There have been no Sexual Affronts for 2014/15 and 2015/16.  2015/16 had the lowest percentage of Sexual Attack offences (5%) committed  Immoral Behaviour offences have remained at zero since 2012/13.  Drugs (Not Cannabis) offences are down to zero for 2015/16 from 12% in 2014/15.  Drugs (Cannabis Only) offences were relatively high for 2014/15 (10% and 2015/16 (8%) considering the highest percentage of alcohol related drug offences occurred in 2012/13 at 14%.

92 Police NZ 2016

 Disorder offences have remained high throughout the time range studied. Last financial year saw a 1% increase in alcohol related disorder offences at 53% from 52% in 2014/15. 2012/13 had the highest percentage of alcohol related disorder offences at 63%.  Family offences where alcohol was determined to be consumed have progressively reduced from 24% in 2013/14, 15% in 2014/15, and 9% in 2015/16.  4% of Burglary offences occurring in 2015/16 involved the consumption of alcohol and this represents the lowest result for this category over the measured timeframe.  Car Conversion offences have remained relatively low in 2014/15 and 2015/16 (9%).  3% of Theft offences occurring in 2015/16 involved the consumption of alcohol and this represents the lowest result for this category over the measured timeframe.  Receiving offences where alcohol was involved had peaked in 2014/15 (8%) but have retained zero instances in 2015/16.  Fraud offences have remained relatively low (2% for 2015/16).  23% of Destruction of Property offences in 2015/16 have been attributed to alcohol consumption. The percentage of this offence that can be attributed to alcohol consumption is still high, but is lower than previous years.  Trespass offences where alcohol was consumed are at 26% for 2015/16 and 2011/12.  Animal offences where alcohol was involved have remained at zero since 2011/12.  Postal/rail/fire Service Abuses where alcohol was involved had a rise in 2013/14 (14%), otherwise remaining at zero.  Arms Act offences where alcohol was consumed are at 3% for 2015/16 and 2013/14, the lowest result for the timeframe measured.  25% of Endangering offences in 2015/16 were linked to alcohol being consumed. This was the only financial year where the offence was related to alcohol consumption.

Most offences presented have remained relatively stable with regard to the percentage that have occurred where it was determined alcohol was consumed.

Of the list of 26 offences tabled, seven of these offences for the financial year 2015/16 have been determined to be linked to alcohol consumption in at least 19% of cases (Table 13), with one offence (Disorder) attributed to alcohol consumption in 53% of cases.

Offence Fy2015-16 Grievous Assaults 19% Minor Assaults 19% Destruction of Property 23% Serious Assaults 24% Endangering 25% Trespass 26% Disorder 53% Table 13: Top 7 offences attended by Police where alcohol was a factor- Financial year 2015-1693

On average, 10% of all offences dealt with by Whanganui Police for the financial year 2015/16 were committed by an offender who consumed alcohol. This average remains unchanged for the financial year 2014/15, and is down from 2013/14 (15%).

93 Police NZ 2016

6.9.7.10. Offender last drink location Figure 45 is taken from Police New Zealand’s Alco-link database that records the location of an offender’s last drink for the period 1 July 2012 to 30 September 2016. The figure omits data where offenders were unable to provide a response to the last drink survey nor is the type of offence detailed.

Special license only Venue (n=15) 1%

Public Place (n=246) 13%

Licensed Premises (n=236) 12% Location last of drink Location

Home/Private residence (n=1404) 74%

0% 10% 20% 30% 40% 50% 60% 70% 80%

Figure 45: Offender last drink locations- 1 July 2012 to 30 September 201694

From 1 July 2012 to 30 September 2016 a total of 1901 persons completed the last drink survey. Nearly three-quarters of offenders had their last alcoholic drink at home or a private residence. This is followed by an almost identical representative of licensed premises (12%) and public place (13%) as last drink location.

Assessing these findings it can be said most offenders had their last drink in a home/private residence prior to committing an offence, reducing the biggest share of offences would mean implementing initiatives that target private residences. These findings should be read in conjunction with the data’s limitations in that focusing only on the last place of alcohol consumption prior to an offence removes the influence other locations had leading up to the last location, nor does the data compare the intensity of alcohol consumption.

94 Police NZ 2016

6.9.7.11. Violence events The link between violence and alcohol consumption is well represented in international research. According to the World Health Organisation (WHO), alcohol has a direct effect on physical and cognitive functioning, contributing to violence through, for example, reducing self-control and the ability to recognize warning signs.95

2000 1902

1800 1662 1557 1593 1600 1513

1400

1200

1000

800

600 No. of violence No. violence of events 400

200

0 FY2011/12 FY2012/13 FY2013/14 FY2014/15 FY2015/16 Financial year

Figure 46: Police attended violence events by financial year-financial years 2011/12 to 2015/16.96

Violence events attended by Police have steadily increased from 2011/12 and 2012/13, dropping in 2013/14, before peaking in 2015/16 to 1902 events. This represents a 22% increase in the number of violence events attended by Police in 2011/12.

95 World Health Organization. (2009). Preventing violence by reducing the availability and harmful use of alcohol. 96 Police NZ 2016

FORDELL WAITOTARA UPOKONGARO KAIWHAIKI PAPARANGI PARIKINO WHANGANUI AIRPORT KAI IWI WAIINU BEACH MAXWELL MANGAMAHU BASTIA HILL PAPAITI OKOIA BRUNSWICK WESTMERE KAITOKE PUTIKI OTAMATEA SAINT JOHNS HILL DURIE HILL COLLEGE ESTATE SPRINGVALE TAWHERO ARAMOHO WHANGANUI EAST CASTLECLIFF GONVILLE WHANGANUI CENTRAL 0 500 1000 1500 2000 2500 No. of violence events attended by police

FY2011/12 FY2012/13 FY2013/14 FY2014/15 FY2015/16

Figure 47: Police attended violence events by suburb-financial years 2011/12 to 2015/16 97

The five areas of Whanganui where the highest amount of violence events attended by Police occurred are Whanganui Central (2229), Gonville (1587), Castlecliff (1524), Whanganui East (1071), and Aramoho (702).

97 Police NZ 2016

600

500

400 WHANGANUI CENTRAL GONVILLE 300 CASTLECLIFF WHANGANUI EAST 200 ARAMOHO

100

0 FY2011-12 FY2012-13 FY2013-14 FY2014-15 FY2015-16

Figure 48: Police attended violence events by top 5 suburbs-financial years 2011/12 to 2015/16 98

The following presents a summary of findings as depicted in Figure 48:

 A general increase in violence events for all hotspots between 2014/15 and 2015/16.  Castlecliff has had the steepest increase of violence events between financial years 2014/15 and 2015/16 than other areas.  Aramoho has seen a steady increase of violence events since 2013/14.

98 Police NZ 2016

Figure 49: Police attended violence events by temporal analysis-financial years 2011/12 to 2015/1699

As research makes a clear link between violence and alcohol consumption, when examining the times violence events are attended to by Police (Figure 49) it can be inferred that times with high levels of violence coincide with commonly thought of drinking times such as Friday, Saturday and Sunday nights.

Friday has a high frequency of violence events between the hours of 21:00hrs and 22:00hrs; Saturday has a steadily high frequency of violence events between 18:00hrs and 23:00hrs, peaking around 00:00hrs and 02:00hrs; and Sunday has high frequency of violence events between 00:00hrs and 06:00hrs.

99 Police NZ 2016

6.9.8. Alcohol-related convictions 6.9.8.1. Number of Alcohol-related convictions in Whanganui Provided by the Ministry of Justice, Table 14 presents the number of convictions for alcohol-related offences in the Whanganui District for the last three years, ending 30 June.

Table 14: Number of Alcohol-related convictions in Whanganui (2012-2015) 100

Breath Alcohol Level over 400 Mcgs/Litre of Breath is recorded as having the highest offence count committed under the ANZOC Group Driving under the influence of alcohol or other substance. This category’s high count of convictions only represents offenders intercepted by enforcement units and it is quite plausible, as in most cases of reported crime, that a higher count of offences occur than are actually captured and processed through to conviction.

The data indicates a trend of declining alcohol-related offence convictions captured in the Whanganui District, bar Person under 20 Breath contained alcohol –over 150 mcgs.

The pervasiveness of alcohol-related convictions can be demonstrated as a percentage of the District’s total population. In 2013, according to census data, 42,153 people are recorded as usually residing in Whanganui, meaning that for the same year almost 1% of the population was convicted for an alcohol- related offence.

6.9.8.2. Snapshot of correction officer caseload Drug and alcohol abuse is a major driver of crime, with at least 30% of crime committed in New Zealand by people under the influence of drugs or alcohol101.

As at 31 October 2015, there were 23 probation officers working in the Whanganui area. Of the 629 offenders probation officers manage, 92 were sentenced for alcohol-related offences. As a percentage, 15% of correction officer caseloads consist of alcohol-related offenders in the Whanganui District.

100 Ministry of Justice 2015 101 New Zealand Police. 2010. National Alcohol Assessment. Wellington: New Zealand Police.

Table 15 provides a breakdown of offence type and offender cases by service unit.

Table 15: Whanganui Correction Officer caseloads -2015102

Table 15 highlights that service units are experiencing a higher frequency in persons with excessive blood alcohol level as an offence type.

6.9.8.3. Alcohol programmes- Department of Corrections Approximately 500 participants went through Alcohol and other Drugs (AoD) programmes (whether ‘brief’ or ‘intermediate’ interventions) during 2015/2016. A single facilitator delivers to six participants or two facilitators to 12 participants. Session durations are between 2 to 2.5 hours over a week for brief interventions and 2-3 weeks for intermediate interventions

The drug treatment programme in the Maori Focus Unit (MFU-Te Tirohanga) provides drug and alcohol treatment primarily as phase three of the MFU national programme for men who meet the pre-requisite level of drug and alcohol need; currently there are 12 participants per three month cycle.

6.9.9. Alcohol-related crashes On a national scale, 28% of Fatal crashes103, 20 %104 injury crashes and 12% of Minor105 injury crashes occurred over the years of 2012-2014 where alcohol/drugs were a contributing factor.106

102 Department of Corrections 2016 103 Defined as injuries that result in death within 30 days of the crash. 104 Defined as injuries such as fractures, concussions, crushings, internal injuries, severe cuts, and lacerations 105 Injuries of a minor natures such as sprains or bruises 106 Ministry of Transport. (2015). Alcohol and Drugs 2015. Accessed from: http://www.transport.govt.nz/assets/Uploads/Research/Documents/Alcohol-drugs-2015.pdfn

Figure 50: Percentage of crashes in New Zealand where alcohol/drugs as a contributing factor- 2012 to 2014107

6.9.9.1. Total crashes versus alcohol-related In 2014, a total of 105 vehicle crashes was recorded for Whanganui District. Of these 105 crashes, 16 or 15% of total crashes were alcohol-related. 66% of Fatal crashes, 33% of Serious crashes, and 9.5% of Minor crashes occurred where alcohol was a contributing factor.

120 105 100 84 80

40 Totalnumber crashes of 18 20 16 6 8 2 3 0 Fatal Serious Minor Total

Alcohol All Crashes

Figure 51: Alcohol-related crashes versus total crashes in Whanganui – 2014.108

6.9.9.2. Alcohol-related crashes Table 16 presents the amount of Fatal and Injury crashes in Whanganui District involving alcohol109. The figures in this table show a steady decline of total injuries due to a reduction in Minor injury

107 Ministry of Transport. (2015). Alcohol and Drugs 2015. Accessed from: http://www.transport.govt.nz/assets/Uploads/Research/Documents/Alcohol-drugs-2015.pdfn 108 Ibid. 109 Due to the nature of non-fatal crashes it is believed that these are under-reported, with the level of under- reporting decreasing with the severity of the crash

crashes. Fatal and Serious injuries have remained relatively high, benchmarking against 2010 crash counts.

Fatal and injury crashes in Whanganui District involving alcohol

Year Fatal Serious Minor Total

2010 3 6 17 26

2011 1 7 22 30

2012 0 3 17 20

2013 2 2 15 19

2014 2 6 8 16

Total 8 24 79 111 Table 16: Fatal and injury crashes in Whanganui District involving alcohol- 2010 to 2014l110

25 22

20 17 17 Fatal 15 15 Serious Minor

10 Linear (Fatal) 8 7 Linear (Serious) 6 6 Linear (Minor) 5 3 3 2 2 2 1 0 0 2010 2011 2012 2013 2014

Figure 52: Fatal and injury crashes in Whanganui District involving alcohol- 2010 to 2014111

Figure 52 displays the tabled information from Table 15 into a graph for added comparison. Mirroring the previous discussion, since 2010, Fatal crashes have remained relatively stable, Serious crashes have declined and returned to 2010 counts, and Minor crashes have been reduced by 53%.

The steady decline of Minor injury crashes where alcohol was a contributing factor in Whanganui could be estimated as the downstream effect of changes in alcohol-regulating legislation.

A brief history of legislation changes corresponding to a reduction of Minor crashes in Whanganui 2012 onwards are as follows112:

110 New Zealand Traffic Authority 2015 111 Ibid. 112 Ministry of Transport. (2015). Alcohol and Drugs 2015. Accessed from: http://www.transport.govt.nz/assets/Uploads/Research/Documents/Alcohol-drugs-2015.pdfn

 7 August 2011 the legal breath and blood limit for those under 20 years was lowered to zero.  10 September 2012, section 65A of the Land Transport Act 1998 came into force. New provisions available to the courts where repeat drink drive offenders and first time offenders convicted of driving with blood alcohol levels double the current adult limit could be given an alcohol interlock disqualification.  On 1 December 2014, the legal breath alcohol limit for adult drivers (aged 20 and over) reduced from 400 to 250 micrograms of alcohol per litre of breath, and the blood alcohol limit from 80 to 50 milligrams of alcohol per 100 millilitres of blood.

6.9.10. Social costs of harmful alcohol use A 2009 study applying a methodology, endorsed by the World Health Organisation, where a broad range of personal, economic, and social impacts were used, estimated that harmful alcohol use cost New Zealand $4.9 billion in 2005/06.113 Extrapolating this figure to apply to the Whanganui District, it is estimated in 2005/06 harmful alcohol use cost Whanganui District $51.8 million.114 6.9.11. Liquor outlet density: violent offences and motor vehicle accidents In Michael P. Cameron et al.’s (2013) study, commissioned on behalf of the Health Promotion Agency, investigated the relationship between liquor outlet density, violent offences and motor vehicle accidents across the North Island from 2006-2011.

The findings for the Whanganui District in relation to violent offences and outlet density are:115

 0.00 – 1.26 violent offences for every additional licensed club (low).  6-9 additional violent offences for every additional bar and nightclub (high).  1.30-1.70 additional violent offences for every additional other on-licence outlet (i.e. on- licence density excluding bars and nightclubs) (high).  Statistically insignificant relationship between supermarket and grocery store density and violent offences.  Additional other off-licensed premises (i.e. off-licence density excluding supermarkets and grocery stores) are associated with fewer violent offences.

The findings for the Whanganui District in relation to motor vehicle accidents and outlet density are:

 Statistically insignificant relationship between licensed club density and motor vehicle accidents.  Statistically insignificant relationship between bar and nightclub density and motor vehicle accidents.  0.40 – 0.45 additional motor vehicle accidents for every additional other on-licence outlet (i.e. on-licence density excluding bars and nightclubs) (med).  Statistically insignificant relationship between off-licence supermarket and grocery store density and motor vehicle accidents.

113 Slack, A., Nana, G., Webster, M., Stokes, F., & Wu, J. (2009). Costs of harmful alcohol and other drug use. BERL Economics, 40. 114 This estimate was developed by calculating Whanganui’s population size proportionally against New Zealand’s population in 2006 and applying this proportion to the estimated social costs developed by Berl. 115 Cameron, M.P., Cochrane, W., Gordon, C., & Livingston, M. (2013). The locally-specific impacts of alcohol outlet density in the North Island of New Zealand, 2006-2011. Research report commissioned by the Health Promotion Agency. Wellington: Health Promotion Agency.

 Additional other off-licenced premises (i.e. off-licence density excluding supermarkets and grocery stores) are associated with fewer motor vehicle accidents.

For violent offences, Whanganui had higher additional violent offences for on-licence outlets other than licensed clubs. No statistical relationship was evident between supermarket and grocery store density, whereas additional other off-licensed premises were associated with fewer violent offences. Motor vehicle accidents were mildly affected by additional other on-licence outlets, with the only other significant finding being that additional other off-licenced premises are associated with fewer motor vehicle accidents.

In summary, the research supports that Whanganui bar, nightclub, and other on-licence (not supermarket or grocery store) density correlates with a higher frequency of violent offences and a medium frequency of motor vehicle accidents.

As stated by the researchers, it is highly problematic, and probably incorrect, to assume outlet density and alcohol-harm relationships are constant, that the same outlet density may be statistically insignificant relating to alcohol-harm in one area, could in fact positively or negatively relate to alcohol-related harm in another area.116 It should also be noted that only two types of alcohol harm were utilised in the research (accidents and violence) and is in no way a holistic representation of alcohol harm. Likewise, the study focused on the years 2006 to 2011 before the introduction of the Sale and Supply of Alcohol Act and the lowering of the legal breath alcohol limit for adult drivers. 6.9.12. Other harm: alcohol-related litter A by-product of alcohol consumption includes harms such as property damage, sound pollution, and the littering of public areas with alcohol-related litter, causing unsafe and unhealthy environments117. As sound pollution is not solely caused by intoxicated individuals, the research focuses instead on alcohol-related litter. Council has two methods of collecting related harms with relation to litter; via Council’s Customer Records Management (CRM) tool which collates feedback reported on by the community and by Council’s Parks officers in day to day operations.

Customer Record Management

Using key alcohol-related search terms including “alcohol, beer, bottles, glass, and drink”, a scan of Council’s Customer Record Management (CRM) database from 2011 to January 2016 found 10 accounts of alcohol-related litter by Whanganui residents. Of these 10 cases, broken alcohol bottles (8 cases) received the highest counts of reported alcohol-related litter.

The location of broken alcohol glass was reportedly found by residents at public parks, Castlecliff Beach, Aramoho cemetery, the Peace memorial, and the kid’s playground located at Meuli St and Swiss Ave.

The frequency of broken alcohol glass reported fluctuates between the current review years. Three cases were reported in 2015, with two cases reported in 2014 and 2013, one case in 2011 and no cases reported in 2012. As the CRM database keyword search was performed in February 2016, it can be estimated that between two - four cases could be reported in 2016.

116 Ibid. 117 Wechsler H, Lee JE, Hall J, Wagenaar AC, Lee H: Secondhand effects of student alcohol use reported by neighbours of colleges: the role of alcohol outlets. Soc Sci Med. 2002, 55: 425-435. 10.1016/S0277- 9536(01)00259-3

Council officers have determined alcohol-related litter occurs on a periodic basis. More specifically, alcohol-related litter is evident and at times correlates with seasonal events within the District. The Officer’s findings are as follows:

 Springvale Park will sometimes have alcohol-related litter left on the field after a bigger event, along with other litter such as plastic water bottles.  Periodically there is more alcohol-related litter at Castlecliff Domain top carpark, Mosquito Point, under the bridge at Kowhai Park, under the Dublin Street Bridge and at the carpark along the riverfront where the train sculpture is.  The bigger issue is bottles are left on the sports grounds and then broken, there is potentially an unseen health and safety risk.  Random events and end of school tend to have higher frequencies of litter and vandalism.

Summarising Council’s CRMs and Council’s Parks and Reserves team feedback, the community is experiencing related harm through the litter of public spaces with alcohol bottles. However, as the evidence suggests, the occurrence is infrequent and not a major alert for concern at the present time.

91 cases of glass sustained injuries were presented to Whanganui Hospital’s Emergency Department since 1996118. Records of injuries do not reference any alcohol-related litter as a cause and supports the low risk of alcohol-related rubbish.

7. CONCLUDING COMMENTS The findings of this research report indicate that Whanganui District has a sufficient prevalence of alcohol-related harm to warrant a local alcohol policy that is more restrictive than permissive in nature.

Whanganui’s population profile increases the likelihood for the community to experience or be subjected to alcohol-related harm. For instance, 22% of the population identify themselves as Māori who are twice as likely to as non- Māori to consume large quantities of alcohol119; 7.4% are aged 18 to 24; and 39% of the population experience high degrees of deprivation and hence are more prone to alcohol-related harm.

With regard to the District’s health, the average number of people presenting at the Whanganui hospital ED with alcohol-related harm is relatively low when compared to overall presentations. These figures are quite uncommon and sit outside the context of other categories of alcohol-harm presented in this report. Average alcohol-related ED presentations are dissimilar to the findings of national and international studies which echo higher levels of alcohol-related ED presentations.

Aside from this, when contrasting on and off-licence closing hours to ED presentations, a higher frequency of alcohol-related ED presentations occurs in conjunction with the availability of alcohol and the closing times of on and off-licence outlets.

As shown in Figure 22, Saturday and Sunday mornings have the highest number, on average, of alcohol-related ED presentations than any other period across any given week. The assumption here is that people presenting at ED have consumed alcohol the night before and during the early morning

118 Obtained from Whanganui District Health Board (2016). 119 2013/14 New Zealand Health Survey, Ministry of Health

hours prior to presentation. The high peak in alcohol-related ED presentations between 18:00- 23:59hrs on Fridays also relates to the accessibility of alcohol provided by current operating times of on and off-licenced outlets.

These findings support research that indicate a direct relationship between the accessiblity of alcohol provided by liquor licensed premises’ business hours and alcohol-related impacts to health.120

Discharges and patients from Whanganui hospital having an alcohol-related chronic disease seems to be on the decline. Recent figures from 2015 show one out of every 377 residents was discharged having an alcohol-related chronic disease which is seemingly high for a district the population size of Whanganui.

Deaths and injuries where alcohol was deemed a contributing factor are low in total, yet are on the increase.

Data provided by Police strongly supports Whanganui having a need to address alcohol-related problems. Drunk custodies are mildly lower compared to previous years, with the highest frequency of drunk custodies occurring between 01:00hrs to 01:59hrs. Offences under Council’s Alcohol Control Bylaw are up compared to previous years and are perpetrated usually by persons aged between 16- 20 years.

Findings gathered from Police collated data indicates there is a correlation between the timings of alcohol-related offences and incidences with the accessibility of alcohol:

 Drunk custodies between 21:00hrs and 03:00hrs (peaking between 01:00hrs and 02:00hrs)  Bylaw offences between 23:00hrs and 03:00hrs (peaking between 00:00hrs and 01:00hrs)

Given the link between alcohol and violence, violence events recorded by Police present the flow-on effect of alcohol availability with average Saturday violence events reaching maximum counts between 00:00hrs and 02:00hrs; and Sunday experiencing high counts of violence events between 00:00hrs and 06:00hrs.

This report suggests where there is a concentration of licensed premises, and the relatively higher availability of alcohol (Central Whanganui, Whanganui East, Aramoho, Gonville, and Castlecliff), then there is also a higher frequency of violence events and drunk custodies than areas where there is a lesser concentration of licenses and relatively less availability of alcohol.

Feedback provided by Taxi operators also indicates a relationship between the times operators transport intoxicated patrons, and the accessibility of on and off-licence outlets. Friday, Saturday, and Sunday between the times of 19:00hrs – 05:00hrs is when Taxi operators experienced higher patronage from intoxicated patrons and a higher level of abuse.

In conclusion, this report has focused on the prevalence of alcohol-related harm in the Whanganui District and based solely on its findings, it is recommended the default provisions of the SSAA for the purposes to minimise alcohol-related harm are strengthen by a Local Alcohol Policy.

120 Miller, Peter, et al. "Changes in injury‐related hospital emergency department presentations associated with the imposition of regulatory versus voluntary licensing conditions on licensed venues in two cities." Drug and alcohol review 33.3 (2014): 314-322; & Zeisser, Cornelia, et al. "A Systematic Review and Meta‐Analysis of Alcohol Consumption and Injury Risk as a Function of Study Design and Recall Period." Alcoholism: Clinical and Experimental Research 37.s1 (2013): E1-E8.

References Bellis, Mark A., et al. (2016) "The alcohol harm paradox: using a national survey to explore how alcohol may disproportionately impact health in deprived individuals." BMC public health 16.1: 1.

Boden, J., Fergusson, D. and Horwood, L. (2012). Alcohol Misuse and violent behaviour: Findings from a 30-year longitudinal study. , Drug and Alcohol Dependence, Vols. 122(1-2), pp. 135-141.

Bryden, A., Roberts, B., McKee, M., & Petticrew, M. (2012). A systematic review of the influence on alcohol use of community level availability and marketing of alcohol. Health & place, 18(2), 349-357.

Cameron, M.P., Cochrane, W., Gordon, C., & Livingston, M. (2013). The locally-specific impacts of alcohol outlet density in the North Island of New Zealand, 2006-2011. Research report commissioned by the Health Promotion Agency. Wellington: Health Promotion Agency

Department of Public Health. (2014). NZDep2013 Index of Deprivation, University of Otago.

Egerton-Warburton, D., Gosbell, A., Wadsworth, A., Fatovich, D. M., & Richardson, D. B. (2014). Survey of alcohol-related presentations to Australasian emergency departments. Med J Aust, 201(10), 584- 587.

Gordon R, Heim D, MacAskill S. (2012). Rethinking drinking cultures: a review of drinking cultures and a reconstructed dimensional approach. Public Health 126: 3–11.

Hay, G. C., Whigham, P. A., Kypri, K., & Langley, J. D. (2009). Neighbourhood deprivation and access to alcohol outlets: a national study. Health & place, 15(4), 1086-1093.

McCreanor, T., et al. (2015). ‘Drink a 12 box before you go’: pre-loading among young people in Aotearoa New Zealand." Kotuitui: New Zealand Journal of Social Sciences Online: 1-11.

Meiklejohn, Jessica, Jennie Connor, and Kypros Kypri. (2012). "One in three New Zealand drinkers reports being harmed by their own drinking in the past year." The New Zealand Medical Journal (Online) 125.1360: 28.

Miller, Peter, et al. (2014). "Changes in injury‐related hospital emergency department presentations associated with the imposition of regulatory versus voluntary licensing conditions on licensed venues in two cities." Drug and alcohol review 33.3: 314-322;

Ministry of Health (2015). Regional results from the 2011-2014 New Zealand Health Survey. Accessed from: http://www.health.govt.nz/publication/regional-results-2011-2014-new-zealand-health- survey

Ministry of Transport. (2015). Alcohol and Drugs 2015. Accessed from: http://www.transport.govt.nz/assets/Uploads/Research/Documents/Alcohol-drugs-2015.pdfn

New Zealand Police. (2010). National Alcohol Assessment. Wellington: New Zealand Police.

Rehm, J., Baliunas, D., Borges, G. L., Graham, K., Irving, H., Kehoe, T., et al. (2010). The relation between different dimensions of alcohol consumption and burden of disease: An overview. Addiction, 105(5), 817–843.

Research First (2013). Community Views on Alcohol: Research report, Whanganui District Council.

Sellman, Doug, and Simon Adamson. (2012). "Alcohol harms." The New Zealand medical journal 125.1360: 5-8. Slack, A., Nana, G., Webster, M., Stokes, F., & Wu, J. (2009). Costs of harmful alcohol and other drug use. BERL Economics, 40.

Stewart, Rebecca, et al. (2014). "The impact of alcohol-related presentations on a New Zealand hospital emergency department." The New Zealand Medical Journal (Online) 127.1401: 23.

UMR Research. (2013. “Pre-loading of alcohol and associated harm in Palmerston North”, Palmerston North City Council.

Wechsler H, Lee JE, Hall J, Wagenaar AC, Lee H. (2002). Secondhand effects of student alcohol use reported by neighbours of colleges: the role of alcohol outlets. Soc Sci Med. 2002, 55: 425-435. 10.1016/S0277-9536(01)00259-3

Wells, Samantha, Kathryn Graham, and Paulette West. (2000). "Alcohol-related aggression in the general population." Journal of studies on alcohol 61.4: 626-632.

World Health Organization. (2009). Preventing violence by reducing the availability and harmful use of alcohol.

Zeisser, Cornelia, et al. (2013). "A Systematic Review and Meta‐Analysis of Alcohol Consumption and Injury Risk as a Function of Study Design and Recall Period." Alcoholism: Clinical and Experimental Research 37.s1: E1-E8.

Appendix 1: River City Cabs Alcohol Harm Perception survey report

River City Cabs Alcohol Harm Perception survey report

Executive summary Key findings of the River City Cabs Alcohol Harm Perception survey is as follows:

 81%of operators said they had transported intoxicated patrons on Saturday night till Sunday morning.  Close to half of taxi operators surveyed feel unsafe when transporting intoxicated patrons.  Nearly 70% of taxi operators said intoxicated patrons negatively impacted their work.  Almost all taxi operators surveyed have been subjected to negative experiences resulting from interactions with intoxicated patrons.

Introduction The following report details the findings of the River City Cabs Alcohol Harm perception survey. The survey was designed to capture alcohol related harm as experienced by taxi operators in the Whanganui district. Feedback provided by River City Cabs’ taxi operators form part of Council’s research into alcohol related harms within the Whanganui District.

Background The discussed research found within this report was commissioned as part of the Council’s on-going gathering of alcohol related harm within the District for the purposes of informing, evaluating, and reviewing current and future Council policy.

During its scoping stage, Council officers developed an inventory of stakeholders negatively impacted by alcohol harm based on initial assumptions and evidence. Taxi operators were identified as a group of stakeholders requiring further engagement for the purposes of gathering statistical information to support Council’s evidence based policy stance.

Methodology A survey questionnaire was designed by Council officers which was provided to the Manager of River City Cabs Ltd for administration.

The questionnaire (appendix 1) consisted of 5 questions consisting of multi-choice and open ended questions. The survey’s design focused on balancing the need for capturing any alcohol related harm experienced by taxi operators and minimising disruption to operator work capacity.

Surveys were distributed for completion to taxi operators from 17 December 2015 to 18 January 2016.

16 out of 33 (48%) taxi operators employed by River City Cabs Ltd responded to the survey.

Results Question 1: How do you know a passenger is intoxicated (drunk/tipsy)?

As indicated in Graph 1, the majority of taxi operators responded with the manner of speaking, alcohol smell, and difficulty in walking as reliable signals patrons were intoxicated.

Recognising intoxicated patron

94% 94% 100% 75%

31%

How they speak Alcohol smell Difficulty in walking Glossy appearance in Slow reaction eyes

Graph 1: Taxi operator recognition signs of intoxicated patrons

Operators provided additional responses with other indicatives of intoxicated patrons; these are as follows:

 repetitious  abusive  sometimes stroppy  flinging/waving their arms about.

Question 2: On what days do you believe you pick up intoxicated (drunk/tipsy) passengers?

Unsurprisingly, Friday and Saturday nights were reported by taxi operators to contain the highest transportation of intoxicated patrons. Graph 2 shows 13 taxi operators (81%) had signalled encountering intoxicated patrons on Saturdays from 19:00hrs onwards up till 05:00hrs Sunday morning the following day.

Graph 2 also indicates taxi operators experiencing a steady rise of intoxicated patrons from Thursday evening (19:00hrs onwards) peaking Saturday evening (19:00hrs onwards), and then declining slightly below the beginning of the graph’s initial rise.

12 13

10 11

Graph 2: Taxi operator working hours versus intoxicated patrons

It should be considered that a small proportion of taxi operators (<35%) had assumingly noted on the questionnaire the entirety of their working shifts. It is not clear when comparing this small proportion with the total respondent group if the former actually encountered intoxicated patrons or if the response captures total working shifts. The former scenario should not be devalued as responses from this group show accurate completion and observance of survey logic.

Question 3: Do you feel unsafe transporting intoxicated passengers?

25%

44%

31%

Yes No Can't say/ Neutral

Graph 3: Taxi operators and perceptions of safety when transporting intoxicated patrons

44% of taxi operators felt unsafe due to intoxicated patrons. An analysis of respondents who answered No or Can’t say/ neutral with responses provided by the same respondents found elsewhere in this report signal a slight contradiction. The contradiction being that the respondent has said they don’t feel unsafe in their response to question 3, but have indicated elsewhere in the survey occurrences, such as abuse, that are associated with risks to general safety.

It is quite feasible to argue all taxi operators who responded have been subjected to incidents that are considered as a risk to the operator’s safety, though at an individual level, the perception of safety will differ.

Verbatim comments

Verbatim comments provided by respondents who had answered Yes are as follows:

 They have a tendency to change without warning and can become violent for no apparent reason.  Just depends on situation. sometimes- if they are males a lot of them tend to speak sexually at times making it uncomfortable.  Only some, mainly younger people. Does not apply to all jobs.  Need to be taking more notice of what passenger is doing and can’t concentrate fully on driving.  Yes, because you never know what their reaction is going to be. Some passengers can’t handle alcohol and can be aggressive.  Personal security- possible car damage- runners.  They are very argumentative and abusive. Threaten to stab and kill.

Question 4: Do you feel transporting intoxicated passengers negatively impacts your work? (Needed to go to A&E, damaged car (including vomit) unable to use for the whole/part of shift etc)

Do intoxicated patrons negatively impact work?

25% Yes No 6% Can't Say/ neutral 69%

Graph 4: Taxi operators negatively impacted by intoxicated patrons

69 percent of taxi operators said intoxicated patrons negatively impacted their work.

Only one taxi operator (6%) provided the response of No to question 4. This may have been an oversight or misinterpretation on the part of the operator as other responses collated in Question 5

indicated that the operator’s taxi was damaged, the operator endured verbal abuse, and incurred fare invasion.

Verbatim comments

Additional comments from operators are as follows:

 Just depends on the person at the time!!  Vomit occasionally, damage. Fear of the worst to come.  Drunk after drunk depletes your energy and patience. Also they tend to take longer making the payment hence slowing down the work pattern.  Cleaning up someone else’s mess is not nice and losing part of shift affects revenue.  Loss of income and vehicle is out of service.  Intoxicated people are very loud. After midnight a headache sometimes occurs due to the volume of noise and the stress.  Down time spent cleaning up and extra time spent on days off making sure car is up to standard- is all added stress.  Can be very upsetting if they verbally abusive and can ruin your evenings work.  Off the road stress.  Health and safety on edge. Are they going to carry out their threats.  Be positive and makes them relax instead of agro.  They are just a pain in the arse.

Question 5: In the last year, have you experienced the following from intoxicated (drunk/tipsy) passengers?

Verbally abused 81%

Confrontations with passengers 75%

Cleaning (vomit & other) 69%

Fare evasion 69%

Taxi damaged (internal or external) 50%

Physically assaulted/abused 25%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% Percentage of taxi operators

Graph 5: Experiences of taxi operators subjected to intoxicated patrons.

81% of taxi operators experienced verbal abuse from intoxicated patrons, followed by confrontations with passengers (75%), fare evasion (69%), and cleaning (69%)

Only one taxi operator did not complete this question, with most operators signally at least 2 out of the maximum of 6 responses. Surveying the results, a few points can be made:

 Almost all taxi operators surveyed have been subjected to negative experiences caused by interactions with intoxicated patrons.  Verbal abuse was experienced by nearly all operators.  Some operators experienced a higher amount of negative impact types than others. 63% of operators said they were subjected to between 4-6 negative impacts caused by intoxicated patrons.

Conclusion

This report summarises the extent to which a sample of taxi operators are subjected to transgressions, abuse, and a loss of income as a result of transporting intoxicated patrons within the Whanganui District during working hours.

The general finding that can be derived from operator responses is that intoxicated patrons present an often hidden health and safety risk to taxi operators.

River City Cabs Alcohol Harm Perception survey If yes, please tell us why?

We need to hear from you

We need to hear from you and how intoxicated members of the public impact your health, safety, and general ability to complete your work.

QUESTIONS Q 4). Do you feel transporting intoxicated passengers negatively impacts Q1). How do you know a passenger is intoxicated (drunk/tipsy)? your work? (Needed to go A&E, damaged car (including vomit) unable to use for the whole/part of shift etc) (Tick as many as you want) o Yes o No o Can’t o How they speak o Glossy appearance in eyes say/neutral o Alcohol smell o Slow reaction If yes, please tell us why? o Difficulty in walking o Other actions (please name)

Q2). On what days do you believe you pick up intoxicated (drunk/tipsy) passengers? (You may tick more than one box below)

Mon Tues Wed Thurs Fri Sat Sun Q5). In the last year, have you experienced the following from intoxicated 6am - 6am - 6am - 6am - 6am - 6am - 6am - 6pm 6pm 6pm 6pm 6pm 6pm 6pm (drunk/tipsy) passengers? 7pm- 7pm- 7pm- 7pm- 7pm- 7pm- 7pm- 5am 5am 5am 5am 5am 5am 5am o Verbally abused o Fare evasion o Physically assaulted/ abused o Confrontations with passengers Q3). Do you feel unsafe transporting intoxicated passengers? (Circle one) o Taxi damaged (internal or external) o Cleaning (vomit & other)

o Yes o No o Can’t say/neutral

Thank you for your time in completing this survey.