The North East has the highest rate of alcohol related deaths in England. In this blog, Sue Taylor, Head of Alcohol Policy at Balance the North East Alcohol Office, explores why alcohol harm is so high in the North East and considers what can be done to tackle the health inequalities.
What is health inequality?
Health inequality refers to the various differences in health which exist between socio-economic classes or geographical areas and which often play out in terms of life expectancy.
For example, a baby boy born into the poorest communities in the North East of England can expect to live on average 15 years less than a baby boy born into the most affluent English communities. This is an astonishing fact which seems incredibly unfair and which illustrates the social divides in the country.
There is no doubt that these staggering statistics are linked to the fact that the North East has the lowest average income of any region in England and 500,000 people in the North East live in poverty.
What does health inequality look like in the North East?
We know that cultural and behavioural factors such as alcohol consumption, smoking, exercise and diet fuel health inequalities and we know that more deprived regions – such as the North East – suffer more than other areas of England. Whilst public health is taken extremely seriously in this region, we still face bigger challenges and must work harder to give our residents the best possible outcomes.
The situation around alcohol in the North East is particularly challenging. For instance:
- Rates of alcohol-related hospital admissions are the highest in England
- Deaths because of alcohol are the highest in England and reached record levels during 2020
- Only one in five people who require alcohol treatment are currently accessing it
- People already drinking at higher levels are the most likely to have increased their drinking during the COVID-19 pandemic. We have an estimated 855,000 people in our region drinking above the Chief Medical Officers’ low-risk drinking guidelines, storing up health problems in the future
How does alcohol impact health inequalities?
There is a lot of research identifying the link between alcohol and health inequalities; however, alcohol-related health inequalities are more complicated than those linked to other substances, such as tobacco.
At the heart of this sits the ‘alcohol harm paradox’ – which shows that although people from poorer groups often report lower average levels of alcohol consumption than those from wealthier groups, people from deprived communities are significantly more likely to end up in hospital as a result of drinking alcohol and to die from causes linked to alcohol.
Alcohol is also involved in a wide range of health and social concerns including; dangerous driving, crime, cancer, heart and liver disease and accidents at work. Given this, and the fact that poorer communities tend to be more affected by these issues, tackling problems associated with alcohol should be at the heart of efforts to reduce health inequalities across society.
How should we tackle alcohol harm?
Put simply, we need more action from the government to tackle the harm.
We know so much about the problems associated with alcohol, and yet it is still possible to buy 2.5 litres of 7.5% cider – the equivalent of 19 units of alcohol – for just £3.59 in England. That’s significantly more alcohol in one bottle than the weekly low-risk drinking guidelines recommend – and it costs less than a high street cup of coffee.
A minimum unit price (MUP) for alcohol would be an extremely effective lever to reduce health inequalities and cut consumption among low-income heavy drinkers.
The Sheffield Alcohol Policy Model estimates that an MUP of 50p would cut consumption among low-income heavy drinkers by around 300 units a year per drinker, with little effect on moderate drinkers. It would also have the biggest impact on reducing alcohol related deaths among heavy drinkers on low incomes, reducing the gap in harms between the richest and poorest and be the most effective policy to reduce health inequalities.
Availability is also key. Research carried out in Glasgow examined the links between alcohol outlet density (on-trade and off-trade) and alcohol-related health outcomes in Scotland. It found that alcohol-related hospital admissions and deaths were much higher in poorer neighbourhoods with the most on and off-trade premises. This indicates that efforts to reduce alcohol-related harm and associated health inequalities, should consider the important role of the alcohol retail environment.
Population level measures must be coupled with a substantial increase in the availability of alcohol treatment services, which might particularly benefit those from economically disadvantaged groups.
The pandemic has not just seen an increase in health inequalities, it has also witnessed a surge in alcohol-related harms, with poorer regions – including the North East – suffering the most. And it comes on top of dire warnings from doctors that cases of liver disease have risen a staggering 400% in the last 40 years.
If the Government is serious in its aim of ‘levelling up’ it must prioritise the introduction of a comprehensive, evidence-based national alcohol strategy, which tackles alcohol harms and helps the communities which need it the most. The time for action is now, or we will see more suffering and more premature deaths.
Written by Sue Taylor
The Alcohol Health Alliance joins members of the Inequalities in Health Alliance in writing to the Prime Minister calling for an explicit health inequalities strategy, that considers the role of every department and every available policy lever in tackling health disparities. A cross-government strategy is the only way to address the underlying causes of health inequalities.
This blog was published with the permission of the author. The views expressed are solely the author’s own and do not necessarily represent the views of the Alcohol Health Alliance or its members.