Alcohol-related harm and drinking behaviour

This indicator explores whether alcohol-related harm and drinking behaviour has changed over time.

Qualitywatch

Indicator

Last updated: 20/10/2023

Background

Excessive alcohol consumption can have harmful health consequences in the short term but also in the long term, through conditions such as liver disease, stroke and some cancers. Alcohol-related hospital activity and alcohol-related deaths are potentially avoidable burdens to the health service. Alcohol-related harm includes conditions that are a direct consequence of alcohol consumption, such as alcohol poisoning, as well as conditions that are partly related to alcohol, such as liver cancer. Alcohol-specific harm only includes health conditions which are a direct consequence of alcohol misuse, such as alcoholic liver disease and accidental poisoning by exposure to alcohol.


Population-specific differences in alcohol-specific deaths

Between 2006 and 2019, the alcohol-specific mortality rate in England remained roughly constant, fluctuating between a high of 11.3 deaths per 100,000 population in 2008 and a low of 10.0 deaths per 100,000 population in 2012. However, in 2020, alcohol-specific mortality rates increased 19% from the previous year to 13 deaths per 100,000 population. In 2021, it increased even further to 13.9 deaths per 100,000 population. This increase in alcohol-specific deaths was seen across genders and in the most and least deprived deciles of the population, albeit to varying degrees.

The alcohol-specific mortality rate in males was more than twice the rate in females. In 2020, there were 17.5 deaths per 100,000 males compared with 8.7 deaths per 100,000 females – a 17% increase in males and a 24% increase in females from 2019. Between 2008 and 2019, the rate of alcohol-specific mortality fluctuated around an average of 14.6 per 100,000 males and 6.9 per 100,000 females.

There is a bigger difference in the rates of alcohol-specific mortality between the most and least deprived deciles of the population. In 2021, alcohol-specific mortality was 19.8 per 100,000 population in the most deprived decile, compared with 9.5 per 100,000 population in the least deprived decile – a 31% increase in the most deprived decile and a 27% increase in the least deprived decile from 2019.


Alcohol misuse is estimated to cost the NHS £3.5 billion per year and society as a whole £21 billion annually. Monitoring alcohol-related hospital admissions supports the national ambition to reduce harm set out in the Government's Alcohol Strategy.

Between 2016/17 and 2019/20, the rate of hospital admissions related to alcohol consumption increased for both men and women. In 2020/21, the rate of hospital admissions decreased for the first time since this data was made available, potentially due to restrictions imposed by the Covid-19 pandemic. In 2021/22, the rate of hospital admissions increased again to 1,735 per 100,000 population (overall), similar to levels before the pandemic. In the same year, the rate of admissions for males was 2,683 per 100,000 population, almost three times the rate for females (906 per 100,000 population). These figures are rounded to the nearest 10.


The Health Survey for England conducts annual face-to-face interviews where people are asked about the maximum amount of alcohol they

The Health Survey for England conducts annual face-to-face interviews where people are asked about the maximum amount of alcohol they drank on any day in the last week. Data prior to 2006 is not shown due to changes in the methodology used to convert drinks to units of alcohol.

Between 2006 and 2021, the proportion of adults who drank more than 8 units (men) or 6 units (women) on any day in the past week fell for all age groups between 16 and 54 years old. The largest decrease occurred in people aged 16–24, from 29% drinking heavily in 2006 to 12% in 2021.

Over the same time period, the proportion of adults aged 55–64 who drank heavily in the week prior to interview fluctuated around 16%. For those aged 65–74, heavy drinking increased from 6% in 2006 to 7.3% in 2021, and for those aged 75 and over it wavered around 2%.

Overall, the 55–64 age group reported drinking the most heavily in 2021, with 15% exceeding 8/6 units on any day in the last week. By comparison, only 1.8% of people aged 75 and over reported heavy drinking. A relatively large decline was observed in alcohol drinking for the 25–34-year-old group from 21.6% in 2019 to 14.1% in 2021. Data from 2020 is unavailable because the survey could not be conducted due to disruptions caused by the Covid-19 pandemic.


Young people who start drinking alcohol at an early age tend to drink more often than those who start drinking later, and are more likely to develop alcohol problems in adolescence and adulthood. The Government’s Alcohol Strategysets out a national ambition to deliver a sustained reduction in the number of 11–15-year-olds drinking alcohol and the amounts consumed.

The Health Survey for England provides children aged 8–15 with a self-completion booklet which asks if they have ever had a whole alcoholic drink. Between 2006 and 2019, there has been a large decrease for all age groups in the percentage of respondents who say that they have had an alcoholic drink. The proportion of 13–15-year-olds who say that they have drunk alcohol decreased from 67% in 2006 to 35% in 2019. Over the same time period, the proportion of 11–12-year-olds who have drunk alcohol decreased from 26.3% to 8.6%, and for those aged 8–10 it decreased from 9.4% to 0.5%.


About this data

Alcohol-specific deaths

The number of alcohol-specific deaths are classified as deaths from alcohol-specific conditions. It is based on National Statistics definition of alcohol-specific deaths, which includes only wholly attributable conditions. For more information, see the Local Alcohol Profiles for England user guide.

Alcohol-related admissions (broad)

There is an updated methodology for calculating alcohol-related admissions. It is defined as a measure of hospital admissions where either the primary diagnosis (main reason for admission) or one of the secondary (contributory) diagnoses is an alcohol-related condition.  This represents a broad measure of alcohol-related admissions but is sensitive to changes in coding practice over time. For more information see the Local Alcohol Profiles for England Indicator Definitions and Supporting Information.

Alcohol drinking habits

The Health Survey for England (HSE) consists of an interview that asks adults aged 18 and over who drank in the last week about the maximum amount they drank on any day in the last week. Computer-assisted self-completion interviewing is used to ask young adults aged 16–17 about alcohol consumption to ensure confidentiality. HSE data is weighted for non-response. Data prior to 2006 is not shown due to changes to the methods used by the HSE to convert drinks to units of alcohol.

It also asks children aged 8–15 about their experience of alcohol. The questions are presented in a self-completion booklet, to allow the child to answer without revealing the answers to their parents. Children are asked “Have you ever had a proper alcoholic drink – a whole drink, not just a sip?” and “Have you ever drunk alcopops?”. They are counted as having drunk alcohol if they answer yes to either question.

For more information, please see the methods report and data quality statement.

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