This week, Public Health England have released their updated Local Alcohol Profiles for England. Based on hospital admissions and mortality data, they provide the best available indicator of how alcohol-related health harms are distributed across English regions.
At a national level, the new figures show a 3% fall in alcohol-specific deaths in the period 2012-4 compared to the previous three years. They also show a 7% fall in chronic liver disease since 2006, although there has been little change in the last three years.
However, the data also shows a 1% rise in alcohol-related deaths over the same period.
Alcohol-specific deaths are those recorded as due to a condition, such as alcoholic liver disease, which is always caused by drinking. Alcohol-related deaths are attributable to conditions, such as certain cancers, for which alcohol may play a contributory role. The full methodology is available in the LAPE User Guide.
The calculation for alcohol-related deaths used by PHE differs from that used by the Office for National Statistics, and produces a much higher figure. There is a detailed discussion of this in the most recent ONS report on alcohol mortality. Both figures, however, show a fall in alcohol-specific mortality in recent years.
The fall in alcohol-specific deaths suggests a decline in the number of people dying as a direct result of very heavy alcohol consumption. The slight increase in estimated alcohol-related deaths, however, suggests there are still many people suffering from alcohol-related illness while drinking at levels below the severity that might lead to liver disease or similar acute conditions.
Beyond national figures, the most useful feature of the LAPE is what it shows us about the regional distribution of harms in England. The data suggests stark differences in trends across the country. For example, while 161 local authorities have seen a fall in alcohol-related deaths, 165 have seen an increase.
Furthermore, regional comparisons show a concentration of deaths in many deprived areas of the North West and North East, as well as in cities such as Bristol, Brighton and Portsmouth. This partly reflects consumption rates and patterns, but also the fact that drinkers in deprived areas suffer significantly higher levels of alcohol-related illness and mortality even when consumption rates are comparable to more affluent regions.
The LAPE provides tools that allow both mortality and specific alcohol-related conditions to be compared by income deciles. In most cases, this shows rates that are much higher in poorer areas than more affluent ones.
The latest LAPE data, therefore, highlights the extent to which deprivation, health inequalities, and regional variations overlay patterns of alcohol-related harm. While the figures show some promising trends at a national level, they also emphasise the need to look at alcohol harms at regional and local levels and to design policy and practice in ways that take full account of these factors.