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

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

3. 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

4. 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

5. 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 %, females similar)

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

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

8. ‘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

9. 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

10. 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

11. 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 , rounded

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

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

14. 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

15. 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

16. 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”