12.1 Introduction

The harm associated with alcohol use has become a growing public health issue and in 2004 the Government launched the Alcohol Harm Reduction Strategy for England (Cabinet Office Strategy Unit 2004) . The White Paper Choosing Health: Making Healthier Choices Easier (2004) and more recently Our Health, Our Care, Our Say (2006) also acknowledge the consequences of excessive alcohol consumption and binge drinking. This chapter examines trend data for alcohol related harm in the West Midlands.

All the charts show directly standardised rates (DSR) for selected alcohol-related causes. The selected ICD codes for alcohol-related mortality are consistent with those used by the ONS (Table 12.1). Deaths were extracted from the ONS annual death extracts from 1994 to 2004 using the year of occurrence and standardised to the European Standard Population. Local Authority codes were allocated using the ‘gridallNov05 NHS Organisation Code’ table supplied by the Organisation Codes Service division of the NHS Information Authority.  Local Authority populations were derived using the UKACR (United Kingdom Association of Cancer Registries) LA Populations for the appropriate year until 2002. For 2003 and 2004 populations, ONS mid-year estimates were used.

From January 2001 following recommendation from the World Health Organisation (WHO) mortality data cause of death has been coded in accordance with the Tenth Revision of the International Classification of Diseases (ICD-10).  This means that for trend analysis, the number of deaths coded to the equivalent ICD-9 code is multiplied by the comparability ratio supplied by ONS.  This produces an ‘expected’ number of deaths which would have been coded to that specific cause under ICD-10.  Further information on comparability ratios can be found at
http://www.statistics.gov.uk/about/classifications/icd10/comparability_ratios.asp

Hospital admission data were extracted from the national Hospital Episodes Statistics database. The selected causes shown are for those routinely produced in the ONS Statistical Bulletin (Table 12.0 1). Data are for finished admission episodes with a diagnosis occurring in either the primary diagnosis field or any of the secondary diagnoses fields unless specified.

In order to highlight the variation across the region, this chapter presents trend data for those Local Authorities with DSRs which fall into the top 3 and bottom 3 of all West Midlands Local Authorities in the baseline year. The CD-ROM enclosed with this publication contains alcohol-related mortality and admission data for all Local Authorities across the West Midlands Region.

12.2 Alcohol-related mortality

Figure 12.02.01: Local Authorities with DSRs that fall into the top 3 of all West Midlands Local Authorities (1990-1994 baseline)

Figure 12.02.01 Local Authorities with DSRs that fall into the top 3 of all WMLAs

Figure 12.02.02: Local Authorities with DSRs that fall into the bottom 3 of all West Midlands Local Authorities (1990-1994 baseline)

Figure 12.02.02 LAs with DSRs that fall into the bottom 3 of all WMLAs

12.3 Alcohol-related accident hospital admissions

Figure 12.03.01: Local Authorities with DSRs that fall into the top 3 of all West Midlands Local Authorities (1999-00 baseline)

Figure 12.03.01: LAs with DSRs that fall into the top 3 of all WMLAs

Figure 12.03.02: Local Authorities with DSRs that fall into the bottom 3 of all West Midlands Local Authorities (1999-00 baseline)

Figure 12.03.02: LAs with DSRs that fall into the bottom 3 of all WMLAs

12.4 Hospital admissions due to alcoholic liver disease, chronic hepatitis not elsewhere mentioned and fibrosis and cirrhosis of the liver

Figure 12.04.01: Local Authorities with DSRs that fall into the top 3 of all West Midlands Local Authorities (1999-00 baseline)

Figure 12.04.01:LAs with DSRs that fall into the top 3 of all WMLAs

Figure 12.04.02: Local Authorities with DSRs that fall into the bottom 3 of all West Midlands Local Authorities (1999-00 baseline)

Figure 12.04.02:LAs with DSRs that fall into the bottom 3 of all WMLAs

12.5 Hospital admissions due to mental and behavioural disorders related to alcohol use

Figure 12.05.01: Local Authorities with DSRs that fall into the top 3 of all West Midlands Local Authorities (1999-00 baseline)

Figure 12.05.01: LAs with DSRs that fall into the top 3 of all WMLAs

Figure 12.05.02: Local Authorities with DSRs that fall into the bottom 3 of all West Midlands Local Authorities (1999-00 baseline)

Figure 12.05.02: LAs with DSRs that fall into the bottom 3 of all WMLAs

References

1. Cabinet Office Strategy Unit (2004) Alcohol Harm Reduction Strategy for England. London, Strategy Unit.
   
   
2. Department of Health (2004) Choosing Health: Making Healthier Choices Easier. London, Stationery Office.
   
   
3. Secretary of State for England (2006) Our health, our care, our say: a new direction for community services. London, Crown Copyright.