title: Assessing and communicating the health and judicial impact of alcohol use.
abstract: BACKGROUND
  Alcohol consumption places an increasing burden on health services, criminal justice agencies and private industry throughout the UK. Despite a national strategy to tackle alcohol-related harm, there remains a lack of epidemiology on alcohol use and related harms at local levels. Utilising national data sources and existing research studies, Regional Public Health Observatories are appropriately placed to calculate such measures and examine their relationship with deprivation.
  
  
  METHODS
  For the North West of England, borough and health locality data were extracted from national sources. Alcohol consumption utilised lifestyle survey data and estimates of related harm were calculated by applying existing alcohol attributable fractions to deaths, hospital episodes and crime data. Contribution of alcohol to reduction in life expectancy was also calculated and all measures were correlated with deprivation.
  
  
  RESULTS
  For the North West, the annual burden of alcohol was estimated at over 3700 deaths, 56,700 hospital episodes and 71,000 crimes. Annual alcohol-related death rates for men varied from 0.43 to 1.17 per 1000 between Local Authorities and there was a six-fold variation in alcohol-related crime rate between areas. For males, alcohol reduced life expectancy by more than five months in the area worst affected. For both sexes, more deprived areas had significantly higher levels of alcohol-related hospital episodes, crime, and contribution to reduced life expectancy.
  
  
  CONCLUSIONS
  Alcohol-related harm requires urgent, multi-agency attention at local levels throughout the UK. Applying appropriate research methods to national data sources provides limited but valuable local measures of alcohol use and its impact on health and crime. Regional Public Health Observatories can facilitate partnership working through such provision of national intelligence tailored to support local and regional action. Application of these techniques also helps identify additional requirements for better local intelligence on health-related behaviours and the necessity for consistency across local health and behaviour surveys.
authors.affiliation: North West Public Health Observatory, Centre for Public Health, Faculty of Health and Applied Social Sciences, Liverpool John Moores University, Liverpool, L3 2AY, UK. m.a.bellis@livjm.ac.uk
authors.forename: Mark A
authors.initials: MA
authors.lastname: Bellis
authors.forename: Karen
authors.initials: K
authors.lastname: Hughes
authors.forename: Karen
authors.initials: K
authors.lastname: Tocque
authors.forename: Tom
authors.initials: T
authors.lastname: Hennell
authors.forename: Gayl
authors.initials: G
authors.lastname: Humphrey
authors.forename: Sacha
authors.initials: S
authors.lastname: Wyke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000401:mortality; D019973:Alcohol-Related Disorders / Q000401:mortality; D003415:Crime / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D011203:Poverty; D006113:United Kingdom / Q000453:epidemiology