Alcohol in Coventry – some Insights from the Insight Team Tim Healey, Senior Analyst 18 th March 2015

Contents Alcohol-related Hospital Admissions – Coventrians to UHCW Coventry Household Surveys Statistics on Alcohol: England 2014 (HSCIC) Health Survey for England 2012 Alcohol Focus ONS Family Food (2013) Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Life course trajectories of alcohol consumption in the United Kingdom using longitudinal data from nine cohort studies - BMC Medicine (2015)

Alcohol-related Hospital Admissions – Coventrians to UHCW Alcohol use is the direct cause of a small number of admissions to hospital, but contributory to many more The following conditions are 100% or directly attributable …..

Alcohol-related Hospital Admissions – Coventrians to UHCW Alcohol-induced pseudo-Cushing's syndrome Mental and behavioural disorder due to use of alcohol Degeneration of nervous system due to alcohol Alcoholic polyneuropathy Alcoholic myopathy Alcoholic cardiomyopathy Alcoholic gastritis Alcoholic liver disease Chronic pancreatitis (alcohol induced) Ethanol poisoning Methanol poisoning Toxic effect of alcohol, unspecified Accidental poisoning by and exposure to alcohol

Alcohol-related Hospital Admissions – Coventrians to UHCW Other conditions are considered to have alcohol consumption as a contributory factor

Alcohol-related Hospital Admissions – Coventrians to UHCW Psoriasis Spontaneous abortion Road traffic accidents Pedestrian traffic accidents Water transport accidents Air and space transport accidents Falls Work/machine injuries Firearm injuries Drowning Inhalation of gastric contents/Inhalation and ingestion of food causing obstruction of the respiratory tract Fire injuries Accidental excessive cold Intentional self-harm Assault Malignant neoplasms of lip, oral cavity and pharynx Malignant neoplasm of oesophagus Malignant neoplasm of colon Malignant neoplasm of rectum Malignant neoplasm of liver and intrahepatic bile ducts Malignant neoplasm of larynx Malignant neoplasm of breast Epilepsy Hypertensive diseases Cardiac arrhythmias Heart failure Haemorrhagic stroke Ischaemic stroke Oesophageal varices Unspecified liver cirrhosis Acute and chronic pancreatitis

Alcohol-related Hospital Admissions Coventry Residents at UHCW 2012/13 by Condition Fully and Partially Attributable to Alcohol Count Alcohol-induced pseudo-Cushing's syndrome0 Mental and behavioural disorders due to use of alcohol24 Degeneration of nervous system due to alcohol2 Alcoholic myopathy0 Alcoholic cardiomyopathy1 Alcoholic gastritis0 Alcoholic liver disease10 Chronic pancreatitis (alcohol induced)0 Ethanol poisoning1 Methanol poisoning0 Toxic effect of alcohol, unspecified0 Accidental poisoning by and exposure to alcohol0 Malignant neoplasm of lip, oral cavity and pharynx1 Malignant neoplasm of oesophagus4 Malignant neoplasm of colon5 Malignant neoplasm of rectum7 Malignant neoplasm of liver and intrahepatic bile ducts1 Malignant neoplasm of larynx1 Malignant neoplasm of breast16 Epilepsy and Status epilepticus23 Hypertensive diseases244 Cardiac arrhythmias59 Heart failure47 Haemorrhagic Stroke1 Ischaemic Stroke6 Oesophageal varices2 Gastro-oesophageal laceration-haemorrhage syndrome0 Liver cirrhosis4 Acute and chronic pancreatitis4 Psoriasis0 Spontaneous abortion2

Alcohol-related Hospital Admissions – Coventrians to UHCW Alcohol Attributable Fractions (AAFs) For those conditions where alcohol is contributory, we can look-up what % of admissions for them are due to alcohol – AAFs The table following shows AAFs for conditions – AAFs are necessarily both age and gender dependent

Alcohol-related Hospital Admissions – Coventrians to UHCW Alcohol Attributable Fractions (AAFs) If the group wishes, I can apply the age and gender specific AAFs to the admissions data and bring them to you at a subsequent meeting Were it not for the AAFs, we could do more detailed profiling of the persons attending for these conditions – Ethnicity, where they live, MOSAIC segmentation – but we can add a bit of this kind of insight from our own and other published studies

Alcohol-related Hospital Admissions – Coventrians to UHCW Alcohol Attributable Fractions (AAFs) If the group wishes, I can apply the age and gender specific AAFs to the admissions data and bring them to you at a subsequent meeting Were it not for the AAFs, we could do more detailed profiling of the persons attending for these conditions – Ethnicity, where they live, MOSAIC segmentation – but we can add a bit of this kind of insight from our own and other published studies

Contents Alcohol-related Hospital Admissions – Coventrians to UHCW Coventry Household Surveys Statistics on Alcohol: England 2014 (HSCIC) Health Survey for England 2012 Alcohol Focus ONS Family Food (2013) Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Life course trajectories of alcohol consumption in the United Kingdom using longitudinal data from nine cohort studies - BMC Medicine (2015)

Alcohol Consumption from Coventry Household Surveys Do you drink alcohol on 5+ days in a week?

Alcohol Consumption from Coventry Household Surveys Do you drink alcohol on 5+ days in a week?

Alcohol Consumption from Coventry Household Surveys Do you drink more than Recommended Amounts on 4+ Days a week

Alcohol Consumption from Coventry Household Surveys Do you drink more than recommended amounts on 4+ days week?

Contents Alcohol-related Hospital Admissions – Coventrians to UHCW Coventry Household Surveys Statistics on Alcohol: England 2014 (HSCIC) Health Survey for England 2012 Alcohol Focus ONS Family Food (2013) Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Life course trajectories of alcohol consumption in the United Kingdom using longitudinal data from nine cohort studies - BMC Medicine (2015)

Statistics on Alcohol: England 2014 (HSCIC) Alcohol consumption - Drinking in the last week Nationally, between 2005 and 2012 there was a fall from 22% to 14% in the proportion of men who were frequent drinkers (those who drank alcohol on at least five days in the week before being interviewed), and from 13% to 9% in the proportion of women. In 2012 people aged 65 and over were most likely to have drunk frequently, both for men (23%) and women (14%). In Coventry, between 2009 and 2013 there was a fall from 12% to 6% in the proportion of men who were frequent drinkers (those who drank alcohol on at least five days in the week before being interviewed), and from 5% to 3% in the proportion of women. In 2013 people aged 65 and over were most likely to have drunk frequently – 21% overall.

Statistics on Alcohol: England 2014 (HSCIC) Alcohol consumption - Maximum daily consumption in the last week Nationally, 67% of men had drunk alcohol in the last week; this included 30% of men who did not exceed 4 units on any day that they drank, 17% who drank between 4 and 8 units, and 21% who drank more than 8 units on at least one day in the last week. 53% of women had drunk alcohol in the last week, including 25% who drank 3 units or less on the day drank most, 16% who had drunk between 3 and 6 units and 13% who had drunk more than 6 units on at least one day. In Coventry, 62% of men had drunk alcohol in the last week; this included 45% of men who did not exceed 4 units on any day that they drank. 38% of women had drunk alcohol in the last week. 55% of Coventry women did not exceed 2-3 units on any day that they drank.

Contents Alcohol-related Hospital Admissions – Coventrians to UHCW Coventry Household Surveys Statistics on Alcohol: England 2014 (HSCIC) Health Survey for England 2012 Alcohol Focus ONS Family Food (2013) Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Life course trajectories of alcohol consumption in the United Kingdom using longitudinal data from nine cohort studies - BMC Medicine (2015)

Health Survey for England 2012 Alcohol Focus Men Drink Normal Strength Beer etc. (62%) – this drops as age increases Wine (33%) – increases with age Spirits (22%) – most likely in 16-34s and particularly younger ages – but increasing % of 16-24s drink alcopops In the West Midlands 73% drink up to 21 units per week – but this doesn’t vary by age 27% in West Midlands (35,700 Men in Coventry) drink over this and 7% (9,250) more than 50 Units Nationally and looking at those who drink units, 18% of the highest quintile of household incomes drink at this level – reducing to 10% of the lowest Nationally and looking at those who drink 50+ units 6% of the highest AND the lowest household incomes drink at this level Nationally and looking at those who drink units, 16% of the least deprived quintile of IMD 2010 drink at this level – reducing to 10% of the most deprived quintile Nationally and looking at those who drink 50+ units 5% of the least deprived quintile of IMD 2010 AND of the most deprived quintile drink at this level

Health Survey for England 2012 Alcohol Focus Women Drink Wine (64%) – increases with age but levels out at and drops past this Sprits (26%) – most likely in 16-34s and particularly younger ages – but increasing 75+ Normal Strength Beer etc. (19%) – this drops as age increases 10% of 16-24s drink alcopops In the West Midlands 83% drink up to 14 units per week – but this doesn’t vary by age 17% (22,700 in Coventry) drink over this and 6% (8,000) more than 35 Units Nationally and looking at those who drink units, 9% of the highest quintile of household incomes drink at this level – reducing to 4% of the lowest Nationally and looking at those who drink 35+ units 5% of the highest household incomes drink at this level and 4% of the lowest Nationally and looking at those who drink units, 9% of the least deprived quintile of IMD 2010 drink at this level – reducing to 4% of the most deprived quintile Nationally and looking at those who drink 35+ units 6% of the highest household incomes drink at this level and 4% of the lowest

Contents Alcohol-related Hospital Admissions – Coventrians to UHCW Coventry Household Surveys Statistics on Alcohol: England 2014 (HSCIC) Health Survey for England 2012 Alcohol Focus ONS Family Food (2013) Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Life course trajectories of alcohol consumption in the United Kingdom using longitudinal data from nine cohort studies - BMC Medicine (2015)

ONS Family Food (2013) The quantity of alcohol purchased for home consumption has fallen nationally since Alcoholic drinks (ml) The quantity of alcohol purchased for home consumption varies geographically and West Midlands 2013 figures are higher at 740ml The quantity of alcohol purchased out of the home has also fallen nationally since average excluding under 14's (ml) West Midlands 2013 figures are higher at 398ml In real terms, between 2010 and 2013 household spending on food and drink fell by 3.2 per cent and eating out expenditure by 5.6 per cent. Household spending on alcoholic drinks fell by 5.7 per cent over the same period, whilst that bought for consumption outside the home fell by 13.4 per cent.

Contents Alcohol-related Hospital Admissions – Coventrians to UHCW Coventry Household Surveys Statistics on Alcohol: England 2014 (HSCIC) Health Survey for England 2012 Alcohol Focus ONS Family Food (2013) Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Life course trajectories of alcohol consumption in the United Kingdom using longitudinal data from nine cohort studies - BMC Medicine (2015)

Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) All persons aged 16 and over, Great Britain Percentages MenWomenAll Drank alcohol in the last week In Employment ILO Unemployed Economically Inactive All Drank alcohol on five or more days in the last week In Employment ILO Unemployed Economically Inactive All14911

Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Fewer of the people who drank alcohol in the last week were Unemployed (-18%) or Economically Inactive (-17%) Looking at Regular drinkers (5+ days) the pattern is reversed with 13% of regular drinkers being Economically Inactive people and 10% of regular drinkers being Unemployed compared to 10% in Employment. In Coventry, 7.9% of 16-64’s are Unemployed compared to 6.5% for Great Britain. The rate of unemployment in Coventry has been on a downward trajectory since a peak of 10% in January In Coventry, 31% of 16-64’s are Economically Inactive compared to 22% for Great Britain. This has risen steadily since 2004 (25%)

Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Drinking Habits by Ethnicity, 2012 All persons aged 16 and over, Great Britain Non-White ethnic groups White All Non- White Mixed Asian or Asian British Black or Black British Chinese or any other ethnic group All All Persons Drank alcohol last week Drank alcohol on five or more occasions last week All persons who drank alcohol last week - units consumed on heaviest drinking day last week Up to 4/3 units More than 4/3 units, up to 8/6 units More than 8/6 units, up to 12/9 units More than 12/9 units

Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Nationally, the White ethnic group drinks both more often and more regularly than all non-white groupings and 4% more of the white ethnicity drank in the previous week than the population overall. However, at high levels of consumption (e.g. more than More than 12/9 units per day) the differences are more nuanced – 14% for White is the same as the overall figure, but markedly higher than for the all non-white grouping (5%). Coventry is an ethnically diverse City and these figures are mirrored in local Household Surveys which show greater % of drinkers who drink 5+ times per week as White – although the trend is falling and the gap is closing.

Contents Alcohol-related Hospital Admissions – Coventrians to UHCW Coventry Household Surveys Statistics on Alcohol: England 2014 (HSCIC) Health Survey for England 2012 Alcohol Focus ONS Family Food (2013) Opinions & Lifestyle Survey, Drinking Habits Amongst Adults (2012) Life course trajectories of alcohol consumption in the United Kingdom using longitudinal data from nine cohort studies - BMC Medicine (2015)

Alcohol consumption patterns change across life and for men, mean consumption rose sharply during adolescence, peaked at around 25 years at 20 units per week, and then declined and plateaued during mid-life, before declining from around 60 years. A similar trajectory was seen for women, but with lower overall consumption (peak of around 7 to 8 units per week). Frequent drinking (daily or most days of the week) became more common during mid to older age, most notably among men, reaching above 50% of men. Population projections for Men over 65 rises annually from 21,000 in 2012 to 33,000 in 2037.