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Areas with more alcohol vendors have higher hospital admission rates

August 20, 2018

The study is the largest of its kind worldwide and examined data on more than one million hospital admissions wholly attributable to alcohol over 12 years.

Areas with a high density of alcohol outlets have higher drink-related hospital admission rates, a new study from the University of Sheffield has found.

The study, conducted by researchers from the University's School of Health and Related Research (ScHARR), revealed that the places in England with the most pubs, bars and nightclubs had a 13 per cent higher admission rate for acute conditions caused by alcohol such as drunkenness and vomiting.

These areas also had a 22 per cent higher hospital admission rate for chronic conditions caused by alcohol - such as liver disease, compared with places with the lowest density of alcohol vendors.

The research, funded by Alcohol Research UK, analysed both on-trade outlets - where alcohol can be bought and consumed on the premises such as pubs, clubs and restaurants - as well as off-trade outlets - where alcohol is purchased to drink elsewhere, like supermarkets and convenience stores.

The study, which is the largest of its kind worldwide, examined data on more than one million admissions wholly attributable to alcohol over 12 years. It included all 32,482 census areas in England.

The results also showed:
  • Places with the highest density of restaurants licenced to sell alcohol had nine per cent higher admission rates for acute conditions and nine per cent higher admission rates for chronic conditions caused by alcohol.

  • Areas with the highest density of other on-trade outlets (such as hotels, casinos and sports clubs) had 12 per cent higher admission rates for acute conditions and 19 per cent higher admission rates for chronic conditions caused by alcohol, compared with areas with the lowest density of other on-trade outlets.

  • Places with the highest density of convenience stores had 10 per cent higher admission rates for acute conditions and seven per cent higher admission rates for chronic conditions compared with areas with the lowest density of convenience stores.
Ravi Maheswaran, Professor of Epidemiology and Public Health at the University of Sheffield, said: "The strongest link was between pubs, bars and nightclubs and admissions for alcoholic liver disease.

"We also observed an association between restaurants licenced to sell alcohol and hospital admissions, which we had not expected. This needs further investigation to establish if there is a causal link.

"While convenience stores were clearly associated with hospital admissions, the association for supermarkets was modest, as we had expected. Supermarkets account for a significant proportion of alcohol sales, however they tend to serve large catchment areas whilst our study was set up to examine the effects of outlet density in small local areas."

Outlet density was measured as the number of alcohol retail outlets within a 1km radius of the centre of every residential postcode in England. This was classified into four categories, ranging from lowest to highest and the analysis adjusted for other factors which could have influenced associations, including differences in age, socio-economic deprivation and hospital admission policies in different areas.

Professor Maheswaran added: "Although we have observed clear associations between alcohol outlet densities and hospital admissions, our study cannot confirm if these associations are causally linked.

"However, there is emerging evidence from other studies suggesting that local licencing enforcement could reduce alcohol related harms."

The research was funded by Alcohol Research UK, an independent charity working to reduce alcohol-related harm through ensuring policy and practice can be developed on the basis of reliable, research-based evidence.

Dr James Nicholls, Director of Research and Policy Development at Alcohol Research UK said: "Understanding the relationship between outlet density and alcohol hospital admissions is essential to reducing harm. Local licensing authorities, in particular, need to factor this information into their decisions.

"We often hear that no individual outlet can be held responsible for increased hospital admissions, and because of this licensing teams can't plan on that basis. However, this study adds weight to the argument that licensing needs to also think about the overall level of availability in a given area.

"As the evidence on the relationship between availability and harm becomes stronger, those tasked with regulating the market need to respond."

Previous work by the University of Sheffield researchers showed a vast increase in the number of off-trade outlets, such as convenience stores and supermarkets that sell alcohol. The amount of convenience stores selling alcohol more than doubled from 2003 to 2013, with an increase of 104 per cent. The number of supermarkets selling alcohol also increased by 33 per cent.
-end-
To view the full study (after the embargo lifts) please visit: https://onlinelibrary.wiley.com/doi/full/10.1111/add.14285

To find out more about the University of Sheffield's School of Health and Related Research (ScHARR), please visit: https://www.sheffield.ac.uk/scharr

For further information, please contact: Harry Clulow, Media and PR Apprentice, University of Sheffield, 0114 222 1047

Notes to editors

The University of Sheffield

With almost 29,000 of the brightest students from over 140 countries, learning alongside over 1,200 of the best academics from across the globe, the University of Sheffield is one of the world's leading universities.

A member of the UK's prestigious Russell Group of leading research-led institutions, Sheffield offers world-class teaching and research excellence across a wide range of disciplines.

Unified by the power of discovery and understanding, staff and students at the university are committed to finding new ways to transform the world we live in.

Sheffield is the only university to feature in The Sunday Times 100 Best Not-For-Profit Organisations to Work For 2018 and for the last eight years has been ranked in the top five UK universities for Student Satisfaction by Times Higher Education.

Sheffield has six Nobel Prize winners among former staff and students and its alumni go on to hold positions of great responsibility and influence all over the world, making significant contributions in their chosen fields.

Global research partners and clients include Boeing, Rolls-Royce, Unilever, AstraZeneca, Glaxo SmithKline, Siemens and Airbus, as well as many UK and overseas government agencies and charitable foundations.

Alcohol Research UK

Alcohol Concern and Alcohol Research UK merged in April 2017 to form a major independent national charity, working to reduce the harms caused by alcohol. For more information visit: http://www.alcoholconcern.org.uk and http://www.alcoholresearchuk.org.

University of Sheffield

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