Inequalities in the distribution of the costs of alcohol misuse in Scotland: a cost of illness study.
OBJECTIVE
To examine the distribution of the costs of alcohol misuse across Scotland in 2009/2010, in relation to deprivation.


METHODS
A cost of illness approach was used. Alcohol-related harmful effects were assessed for inclusion using a literature review. This was based upon the following categories: direct healthcare costs, intangible health costs, social care costs, crime costs and labour and productivity costs. An analysis of secondary data supplemented by a literature review was carried out to quantify each harmful effect, determine its value and provide an estimate of the distribution by deprivation. The deprivation distributions used were area measures (primarily the Scottish Index of Multiple Deprivation).


RESULTS
The overall cost was £7457 million. Two alcohol harmful effects were not included in the overall cost by deprivation due to a lack of data. These were 'children's social work and hearing system' and the criminal justice system costs from 'alcohol-specific offences'. The included alcohol harmful effects demonstrated that 40.41% of the total cost arose from the 20% most deprived areas. The intangible cost category was the largest category (78.65%).


CONCLUSIONS
The study found that the burden of alcohol harmful effects is greater in deprived groups and these burdens do not simply arise from deprived groups but are also experienced more by these groups. The study was limited by a lack of data availability in certain areas, leading to less-precise cost estimates.
Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen AB25 2ZD, UK. marjorie.johnston@nhs.net
Marjorie C
MC
Johnston
Anne
A
Ludbrook
Mariesha A
MA
Jaffray
D000437:Alcoholism / Q000191:economics* / Q000453:epidemiology* / Q000628:therapy; D017281:Cost of Illness; D017048:Health Care Costs / Q000639:trends; D006801:Humans; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors