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Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Trends in alcohol-related admissions to hospital by age, sex and socioeconomic deprivation in England, 2002/03 to 2013/14

Authors: Mark A Green, Mark Strong, Lucy Conway, Ravi Maheswaran

Published in: BMC Public Health | Issue 1/2017

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Abstract

Background

Prevalence of alcohol-related harms in England are among the highest in Europe and represents an important policy issue. Understanding how alcohol-related trends vary by demographic factors is important for informing policy debates. The aim of our study was to examine trends in alcohol-related admissions to hospital in England, with a focus on variations by sex, age and socioeconomic deprivation.

Methods

We used data on hospital admissions for England for the financial years 2002/03 to 2013/14. Our four main outcome variables were acute and chronic conditions wholly and partially attributable to alcohol consumption. We also looked at four specific conditions wholly attributable to alcohol. Socioeconomic deprivation was measured using the English Indices of Deprivation of a patient’s residence (categorised by quintile). We calculated crude rates, age-specific rates (visualised by Lexis plots) and directly standardised rates by deprivation category, separately for males and females.

Results

Total admissions for all alcohol-attributable admissions increased from 201,398 in 2002/03 to 303,716 in 2013/14. The relative increase of these admissions was larger than compared to non-alcohol attributable admissions. Acute admissions wholly attributable to alcohol had the largest relative increase of our outcome measures, and displayed a bimodal distribution with higher rates in adolescence/young adults and middle age. Chronic conditions wholly attributable to alcohol were concentrated in middle age (particularly males). While admission rates were generally higher for males, females had higher rates of hospitalisations due to ‘Intentional self-poisoning due to alcohol’. We also found evidence of wide social inequalities by level of deprivation, which were wider for men than compared to women across all of our outcome measures other than ‘Intentional self-poisoning due to alcohol’.

Conclusions

Our study expands the evidence base to help understand population level trends in alcohol-related admissions by age, sex and socioeconomic deprivation. There have been increasing hospital admissions attributable to alcohol between 2002/03 and 2013/14, particularly concentrated in middle aged males and deprived areas. However, the increase in young females being admitted for ‘Intentional self-poisoning due to alcohol’ raises additional concerns.
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Literature
1.
go back to reference Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and Total mortality in men and women. Arch Intern Med. 2014;166:2437–45.CrossRef Di Castelnuovo A, Costanzo S, Bagnardi V, Donati MB, Iacoviello L, de Gaetano G. Alcohol dosing and Total mortality in men and women. Arch Intern Med. 2014;166:2437–45.CrossRef
2.
go back to reference Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011;342:d671.CrossRefPubMedPubMedCentral Ronksley PE, Brien SE, Turner BJ, Mukamal KJ, Ghali WA. Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ. 2011;342:d671.CrossRefPubMedPubMedCentral
4.
go back to reference Newton JN, Briggs ADM, Murray CJL, Dicker D, Foreman KJ, Wang H, et al. Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;386:2257–74.CrossRefPubMedPubMedCentral Newton JN, Briggs ADM, Murray CJL, Dicker D, Foreman KJ, Wang H, et al. Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2015;386:2257–74.CrossRefPubMedPubMedCentral
8.
go back to reference Siegler V, Al-Hamad A, Johnson B, Wells C, Sheron N. Social inequalities in alcohol-related adult mortality by National Statistics Socio-Economic Classifications, England and Wales 2001-03. Health Stat Q. 2011;50:1–36.CrossRef Siegler V, Al-Hamad A, Johnson B, Wells C, Sheron N. Social inequalities in alcohol-related adult mortality by National Statistics Socio-Economic Classifications, England and Wales 2001-03. Health Stat Q. 2011;50:1–36.CrossRef
9.
go back to reference Erskine S, Maheswaran R, Pearson T, Gleeson D. Socioeconomic deprivation, urban-rural location and alcohol-related mortality in England and Wales. BMC Public Health. 2010;10:99. Erskine S, Maheswaran R, Pearson T, Gleeson D. Socioeconomic deprivation, urban-rural location and alcohol-related mortality in England and Wales. BMC Public Health. 2010;10:99.
10.
go back to reference Williams R, Aspinall R, Bellis M, Camps-Walsh G, Cramp M, Dhawan A, et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet. 2014;384:1953–97.CrossRefPubMed Williams R, Aspinall R, Bellis M, Camps-Walsh G, Cramp M, Dhawan A, et al. Addressing liver disease in the UK: a blueprint for attaining excellence in health care and reducing premature mortality from lifestyle issues of excess consumption of alcohol, obesity, and viral hepatitis. Lancet. 2014;384:1953–97.CrossRefPubMed
11.
go back to reference Bellis MA, Hughes K, Nicholls J, Sheron N, Gilmore I, Jones L. The alcohol harm paradox: using a national survey to explore how alcohol may disproportionately impact health in deprived individuals. BMC Public Health. 2015;16:111.CrossRef Bellis MA, Hughes K, Nicholls J, Sheron N, Gilmore I, Jones L. The alcohol harm paradox: using a national survey to explore how alcohol may disproportionately impact health in deprived individuals. BMC Public Health. 2015;16:111.CrossRef
12.
go back to reference Jones L, Bates G, McCoy E, Bellis MA. Relationship between alcohol-attributable disease and socioeconomic status, and the role of alcohol consumption in this relationship: a systematic review and meta-analysis. BMC Public Health. 2015;15:400.CrossRefPubMedPubMedCentral Jones L, Bates G, McCoy E, Bellis MA. Relationship between alcohol-attributable disease and socioeconomic status, and the role of alcohol consumption in this relationship: a systematic review and meta-analysis. BMC Public Health. 2015;15:400.CrossRefPubMedPubMedCentral
13.
go back to reference Thomson SJ, Westlake S, Rahman TM, Cowan ML, Majeed A, Maxwell JD, et al. Chronic liver disease - an increasing problem: a study of hospital admission and mortality rates in England, 1979-2005, with particular reference to alcoholic liver disease. Alcohol Alcohol. 2008;43:416–22.CrossRefPubMed Thomson SJ, Westlake S, Rahman TM, Cowan ML, Majeed A, Maxwell JD, et al. Chronic liver disease - an increasing problem: a study of hospital admission and mortality rates in England, 1979-2005, with particular reference to alcoholic liver disease. Alcohol Alcohol. 2008;43:416–22.CrossRefPubMed
15.
go back to reference Mäkelä P, Paljärvi T. Do consequences of a given pattern of drinking vary by socioeconomic status? A mortality and hospitalisation follow-up for alcohol-related causes of the Finnish drinking habits surveys. J Epidemiol Community Heal. 2008;62:728–33.CrossRef Mäkelä P, Paljärvi T. Do consequences of a given pattern of drinking vary by socioeconomic status? A mortality and hospitalisation follow-up for alcohol-related causes of the Finnish drinking habits surveys. J Epidemiol Community Heal. 2008;62:728–33.CrossRef
16.
go back to reference Breakwell C, Baker A, Griffiths C, Jackson G, Fegan G, Marshall D. Trends and geographical variations in alcohol-related deaths in the United Kingdom, 1991-2004. Health Stat Q. 2007;33:6–24. Breakwell C, Baker A, Griffiths C, Jackson G, Fegan G, Marshall D. Trends and geographical variations in alcohol-related deaths in the United Kingdom, 1991-2004. Health Stat Q. 2007;33:6–24.
17.
go back to reference Baker A, Rooney C. Recent trends in alcoholrelated mortality, and the impact of ICD-10 on the monitoring of these deaths in England and Wales. Health Stat Q. 2003;17:5–14. Baker A, Rooney C. Recent trends in alcoholrelated mortality, and the impact of ICD-10 on the monitoring of these deaths in England and Wales. Health Stat Q. 2003;17:5–14.
18.
go back to reference McCartney G, Bouttell J, Craig N, Craig P, Graham L, Lakha F, et al. Explaining trends in alcohol-related harms in Scotland, 1991-2011 (I): the role of incomes, effects of socio-economic and political adversity and demographic change. Public Health. 2016;132:13–23.CrossRefPubMed McCartney G, Bouttell J, Craig N, Craig P, Graham L, Lakha F, et al. Explaining trends in alcohol-related harms in Scotland, 1991-2011 (I): the role of incomes, effects of socio-economic and political adversity and demographic change. Public Health. 2016;132:13–23.CrossRefPubMed
20.
21.
go back to reference Welch C, Harrison D, Short A, Rowan K. The increasing burden of alcoholic liver disease on United Kingdom critical care units : secondary analysis of a high quality clinical database. J Heal Serv Res Policy. 2016;13:40–4.CrossRef Welch C, Harrison D, Short A, Rowan K. The increasing burden of alcoholic liver disease on United Kingdom critical care units : secondary analysis of a high quality clinical database. J Heal Serv Res Policy. 2016;13:40–4.CrossRef
23.
go back to reference Sheron N, Hawkey C, Gilmore I. Projections of alcohol deaths--a wake-up call. Lancet. 2011;377:1297–9.CrossRefPubMed Sheron N, Hawkey C, Gilmore I. Projections of alcohol deaths--a wake-up call. Lancet. 2011;377:1297–9.CrossRefPubMed
24.
go back to reference Grittner U, Kuntsche S, Gmel G, Bloomfield K. Alcohol consumption and social inequality at the individual and country levels — results from an international study. Eur J Pub Health. 2012;23:332–9.CrossRef Grittner U, Kuntsche S, Gmel G, Bloomfield K. Alcohol consumption and social inequality at the individual and country levels — results from an international study. Eur J Pub Health. 2012;23:332–9.CrossRef
27.
go back to reference Stockwell T, Zhao J, Martin G, Macdonald S, Vallance K, Treno A, et al. Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions. Am J Public Health. 2014;103:2014–20.CrossRef Stockwell T, Zhao J, Martin G, Macdonald S, Vallance K, Treno A, et al. Minimum alcohol prices and outlet densities in British Columbia, Canada: estimated impacts on alcohol-attributable hospital admissions. Am J Public Health. 2014;103:2014–20.CrossRef
28.
go back to reference Department for Communities and Local Government. The English Indices of deprivation 2010. London: DCLG; 2011. Department for Communities and Local Government. The English Indices of deprivation 2010. London: DCLG; 2011.
30.
go back to reference Burns EM, Rigby E, Mamidanna R, Bottle A, Faiz OD. Systematic review of discharge coding accuracy. J Public Health. 2011;34:138–48.CrossRef Burns EM, Rigby E, Mamidanna R, Bottle A, Faiz OD. Systematic review of discharge coding accuracy. J Public Health. 2011;34:138–48.CrossRef
31.
go back to reference Livingston M, Matthews S, Barratt MJ, Lloyd B, Room R. Diverging trends in alcohol consumption and alcohol-related harm in Victoria. Aust N Z J Public Health. 2010;34:368–73.CrossRefPubMed Livingston M, Matthews S, Barratt MJ, Lloyd B, Room R. Diverging trends in alcohol consumption and alcohol-related harm in Victoria. Aust N Z J Public Health. 2010;34:368–73.CrossRefPubMed
32.
go back to reference Callaghan R, Macdonald S. Changes in the rates of alcohol- and drug-related hospital separations for Canadian provinces: 1996 to 2005. Can J Public Heal. 2009;100:393–6. Callaghan R, Macdonald S. Changes in the rates of alcohol- and drug-related hospital separations for Canadian provinces: 1996 to 2005. Can J Public Heal. 2009;100:393–6.
33.
go back to reference Engdahl B, Ramstedt M. Is the population level link between drinking and harm similar for women and men? — a time series analysis with focus on gender-specific drinking and alcohol-related hospitalizations in Sweden. Eur J Pub Health. 2010;21:432–7.CrossRef Engdahl B, Ramstedt M. Is the population level link between drinking and harm similar for women and men? — a time series analysis with focus on gender-specific drinking and alcohol-related hospitalizations in Sweden. Eur J Pub Health. 2010;21:432–7.CrossRef
34.
go back to reference Yang A, Vadhavkar S, Singh G, Omary M. Epidemiology of alcohol-related liver and pancreatic disease in the United States. Arch Intern Med. 2008;168:649–56.CrossRefPubMed Yang A, Vadhavkar S, Singh G, Omary M. Epidemiology of alcohol-related liver and pancreatic disease in the United States. Arch Intern Med. 2008;168:649–56.CrossRefPubMed
35.
go back to reference Pascal R, Liang W, Gilmore W, Chikritzhs T, Gilmore W. Risks of alcohol-attributable hospitalisation and death in Australia over time: evidence of divergence by region, age and sex. Australas Med J. 2013;6:134–51.CrossRefPubMedPubMedCentral Pascal R, Liang W, Gilmore W, Chikritzhs T, Gilmore W. Risks of alcohol-attributable hospitalisation and death in Australia over time: evidence of divergence by region, age and sex. Australas Med J. 2013;6:134–51.CrossRefPubMedPubMedCentral
36.
go back to reference Mäkelä P, Österberg E. Weakening of one more alcohol control pillar: a review of the effects of the alcohol tax cuts in Finland in 2004. Addiction. 2009;104:554–63.CrossRefPubMedPubMedCentral Mäkelä P, Österberg E. Weakening of one more alcohol control pillar: a review of the effects of the alcohol tax cuts in Finland in 2004. Addiction. 2009;104:554–63.CrossRefPubMedPubMedCentral
38.
go back to reference Wilkinson S, Taylor G, Templeton L, Mistral W, Bennett P. Admissions to hospital for deliberate self-harm in England 1995 – 2000 : an analysis of hospital episode statistics. J Public Health. 2002;24:179–83.CrossRef Wilkinson S, Taylor G, Templeton L, Mistral W, Bennett P. Admissions to hospital for deliberate self-harm in England 1995 – 2000 : an analysis of hospital episode statistics. J Public Health. 2002;24:179–83.CrossRef
41.
go back to reference Hawton K, Saunders KEA, O’Connor RC. Self-harm and suicide in adolescents. Lancet. 2012;379:2373–82.CrossRefPubMed Hawton K, Saunders KEA, O’Connor RC. Self-harm and suicide in adolescents. Lancet. 2012;379:2373–82.CrossRefPubMed
43.
go back to reference Clements C, Turnbull P, Hawton K, Geulayov G, Waters K, Ness J, et al. Rates of self-harm presenting to general hospitals : a comparison of data from the multicentre study of self-harm in England and hospital episode statistics. BMJ Open. 2016;6:e009749.CrossRefPubMedPubMedCentral Clements C, Turnbull P, Hawton K, Geulayov G, Waters K, Ness J, et al. Rates of self-harm presenting to general hospitals : a comparison of data from the multicentre study of self-harm in England and hospital episode statistics. BMJ Open. 2016;6:e009749.CrossRefPubMedPubMedCentral
44.
go back to reference Cooper J, Steeg S, Bennewith O, Lowe M, Gunnell D, House A, et al. Are hospital services for self-harm getting better ? An observational study examining management, service provision and temporal trends in England. BMJ Open. 2013;3:e003444.CrossRefPubMedPubMedCentral Cooper J, Steeg S, Bennewith O, Lowe M, Gunnell D, House A, et al. Are hospital services for self-harm getting better ? An observational study examining management, service provision and temporal trends in England. BMJ Open. 2013;3:e003444.CrossRefPubMedPubMedCentral
45.
go back to reference Hazeldine S, Hydes T, Sheron N. Alcoholic liver disease - the extent of the problem and what you can do about it. Clin Med. 2015;15:179–85.CrossRef Hazeldine S, Hydes T, Sheron N. Alcoholic liver disease - the extent of the problem and what you can do about it. Clin Med. 2015;15:179–85.CrossRef
Metadata
Title
Trends in alcohol-related admissions to hospital by age, sex and socioeconomic deprivation in England, 2002/03 to 2013/14
Authors
Mark A Green
Mark Strong
Lucy Conway
Ravi Maheswaran
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4265-0

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