Abstract

Background: Alcohol misuse is associated with a variety of acute and chronic conditions and diseases. The total annual cost to the society of alcohol-related harm is estimated to be £21bn, and the National Health Service (NHS) incurs a cost of about £3.5bn per year. We used admission data based on Alcohol attributable fractions (AAFs), available from the Health and Social Care Information Centre (HSCIC) and chloropleth maps to study the distribution of alcohol-related hospital admissions in England by age, gender, local authority and socioeconomic status. Methods: Alcohol attributable fractions (AAFs) for 47 conditions in the year 2012–13 by age, gender and local authority (LA) in England (n = 353) were paired with population estimates of mid-2012 for age groups; <16, 16–24, 25–34, 35–44, 45–54, 55–64, 65–74 and 75+ years. Alcohol attributable admission rate (AAAR) is presented in chloropleth maps to identify geographical patterns in alcohol-related hospital admissions. A gender specific admission rate ratio by age group is also presented. The average socioeconomic status (NS-SeC) of local authorities was explored to determine effects on respective admission rates by gender and age group. Results: Relatively high <16 admission rates were associated with small birth weight, which may be due to maternal drinking during pregnancy. In adults of working age (16–65), LAs within the North West and North East generally had the highest rates. As the population ages, LAs within Greater London begin to show a high burden of admission: this is of note in age groups 55–64 and particularly the elderly (65–74 and 75+), where Islington accounted for the highest rate in the country. Admission rates were highest in men in the majority of LAs for most age groups, except for people aged <16. Conclusion: In males, AAAR increases exponentially with age. For females, the highest AAARs were seen at ages 55–64. LAs in Greater London have some of the highest AAAR for males aged 55+. However, in those aged 16–54, the highest AAARs were seen in the North West and North East of the country. Low NS-SeC was strongly associated with high AAAR at ages 35–44 for women and 45–54 for men. The online interactive chloropleth maps produced are original within this study, and can be used for health needs assessment and monitoring the impact of public health interventions. Key messages: Calculating age and sex specific alcohol-related admission rates by local authority has identified populations in England for targeted screening and interventions. At a local and national level, chloropleth mapping could be a valuable means of visualizing trends and the effectiveness of public health strategies and interventions to reduce alcohol-related harm.

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