A profile of alcohol and health in Wales Andrea Gartner, Health Information and Intelligence Analyst, Wales Centre for Health, Cardiff

Overview Introduction Use of survey data Alcohol-related and alcohol-attributable indicators Socio-economic patterns Dissemination/feedback

Introduction Joint WCfH/NPHS health intelligence publication Provides information on consumption patterns and harm relating to alcohol Target audience: public health professionals and interested public Origin: WCfH project, NPHS data requests (HNA update) Investigation into available data/new methods

Authors/contributors Main author: Andrea Gartner Contributing authors: Hugo Cosh, Rhys Gibbon, Nathan Lester NWPHO colleagues Communications team colleagues for dissemination/media Su Mably and many other colleagues

Use of survey data From self-reported surveys Binge drinking (>8 units males, >6 females on heaviest drinking day in past week) Above guidelines (>4 males, >3 females) Results differ (GHS 2006 binge 22% males, WHS 2007 28%, females similar)

Weekly UK sales versus weekly consumption from surveys, 1996-2007 Source: BBPA, GHS, WHS

Survey data: Percentage who reported binge drinking in the past week in Wales, 2007 Source: WHS 2007

‘Alcohol-related’ or ‘alcohol-attributable’ indicators of harm? ‘Alcohol-related’ indicators ONS definition of disease groups most directly linked to alcohol ‘Alcohol-attributable’ indicators Method of estimating outcomes both entirely and in part attributable to alcohol Using alcohol-attributable fractions (AAFs) ‘Alcohol-specific’ indicators entirely attributable to alcohol (AAF=1) Definitions, first two

Alcohol-attributable fractions NWPHO/Liverpool University (commissioned by Department of Health) Calculated for conditions with evidence in literature on causal relationship Applicable to mortality and hospital admissions Fractions for 49 disease groups by sex and age band Disease group ICD-10 M 16-24 F 16-24 M 25-34 F 25-34 … M 75+ F 75+ Alcoholic liver disease K70 1.00 Cancer of lip, oral cavity and pharynx C00-C14 0.50 0.40 0.35 0.36 0.20 Fall injuries W00-W19 0.22 0.14 0.12 0.04 Alcoholic liver disease: fraction of 1

Average annual deaths in Wales Alcohol-related deaths (ONS) Alcohol-attributable deaths (NWPHO) All causes Male 260 (1.7%) 670 (4.3%) 15,422 Female 146 (0.9%) 344 (2%) 17,154 Source: ONS ADDE average 2002-2006

Average annual hospital admissions (episodes) in Wales Alcohol-related (ONS) Alcohol-attributable (NWPHO) All admissions Male 8,400 (3.0%) 27,300 (9.7%) 281,800 Female 4,500 (1.3%) 17,600 (4.9%) 361,700 Source: PEDW 2002-2006, rounded

Trend in alcohol-attributable hospital admissions for Wales, 1999-2006 Source: PEDW, ONS MYE 1999-2006

Socio-economic patterns Alcohol-related mortality by WIMD, persons, 2002-06 Percentage of reported binge drinking or drinking above guidelines by WIMD, persons, 2007 Source: ONS ADDE, MYE, 2002-2006 Source: WHS 2007

Key findings Alcohol is major preventable cause of death and illness in Wales Consumption amongst children of concern Survey data likely to underestimate consumption Trend in alcohol-related and alcohol-attributable mortality rates levelling out, hospital admissions upward Socio-economic inequalities

Dissemination/Feedback Published 6th April 2009 on WCfH and NPHS websites (Profile and supporting data files) 270 printed copies sent out Press release and media coverage Positive informal feedback from stakeholders Request from WAG for update Alcohol-attributable indicators to be used in new lifestyle profile Alcoholic liver disease: fraction of 1

Media coverage Radio Wales interview BBC website: “1000 die from alcohol in Wales” Western Mail front page + full page article: “Quarter of 13-year-olds in Wales have been drunk more than once” Daily Post articles: “Booze binge obsession risks health time bomb” and “The statistics are as clear as the bottom of a vodka glass” BBC one in four deaths attributed to alcohol -> 4% changed to “under 1 in 25”