Green Mark A, Strong Mark, Conway Lucy, Maheswaran Ravi
Department of Geography & Planning, University of Liverpool, Liverpool, UK.
Public Health GIS Unit, School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
BMC Public Health. 2017 May 8;17(1):412. doi: 10.1186/s12889-017-4265-0.
Prevalence of alcohol-related harms in England are among the highest in Europe and represents an important policy issue. Understanding how alcohol-related trends vary by demographic factors is important for informing policy debates. The aim of our study was to examine trends in alcohol-related admissions to hospital in England, with a focus on variations by sex, age and socioeconomic deprivation.
We used data on hospital admissions for England for the financial years 2002/03 to 2013/14. Our four main outcome variables were acute and chronic conditions wholly and partially attributable to alcohol consumption. We also looked at four specific conditions wholly attributable to alcohol. Socioeconomic deprivation was measured using the English Indices of Deprivation of a patient's residence (categorised by quintile). We calculated crude rates, age-specific rates (visualised by Lexis plots) and directly standardised rates by deprivation category, separately for males and females.
Total admissions for all alcohol-attributable admissions increased from 201,398 in 2002/03 to 303,716 in 2013/14. The relative increase of these admissions was larger than compared to non-alcohol attributable admissions. Acute admissions wholly attributable to alcohol had the largest relative increase of our outcome measures, and displayed a bimodal distribution with higher rates in adolescence/young adults and middle age. Chronic conditions wholly attributable to alcohol were concentrated in middle age (particularly males). While admission rates were generally higher for males, females had higher rates of hospitalisations due to 'Intentional self-poisoning due to alcohol'. We also found evidence of wide social inequalities by level of deprivation, which were wider for men than compared to women across all of our outcome measures other than 'Intentional self-poisoning due to alcohol'.
Our study expands the evidence base to help understand population level trends in alcohol-related admissions by age, sex and socioeconomic deprivation. There have been increasing hospital admissions attributable to alcohol between 2002/03 and 2013/14, particularly concentrated in middle aged males and deprived areas. However, the increase in young females being admitted for 'Intentional self-poisoning due to alcohol' raises additional concerns.
在欧洲，英格兰与酒精相关危害的患病率位居前列，这是一个重要的政策问题。了解与酒精相关的趋势如何因人口因素而异，对于为政策辩论提供信息至关重要。我们研究的目的是调查英格兰因酒精导致的住院趋势，重点关注性别、年龄和社会经济剥夺程度的差异。
我们使用了2002/03财年至2013/14财年英格兰的住院数据。我们的四个主要结果变量是完全和部分归因于饮酒的急性和慢性疾病。我们还研究了完全归因于酒精的四种特定疾病。社会经济剥夺程度使用患者居住地的英国贫困指数（按五分位数分类）来衡量。我们分别计算了男性和女性的粗发病率、年龄别发病率（通过莱克西斯图可视化）以及按剥夺类别直接标准化的发病率。
2002/03年所有归因于酒精的住院总数为201,398例，到2013/14年增加到303,716例。与非酒精归因的住院相比，这些住院的相对增幅更大。完全归因于酒精的急性住院在我们的结果指标中相对增幅最大，呈现双峰分布，在青少年/年轻人和中年人群中发病率较高。完全归因于酒精的慢性疾病集中在中年（尤其是男性）。虽然男性的住院率总体上较高，但女性因“酒精所致故意自伤中毒”的住院率更高。我们还发现了因剥夺程度而存在广泛社会不平等的证据，除“酒精所致故意自伤中毒”外，在我们所有的结果指标中，男性的不平等程度比女性更大。
我们的研究扩展了证据基础，有助于了解按年龄、性别和社会经济剥夺程度划分的与酒精相关住院的人群水平趋势。在2002/03年至2013/14年期间，因酒精导致住院的人数不断增加，尤其集中在中年男性和贫困地区。然而，年轻女性因“酒精所致故意自伤中毒”而住院人数的增加引发了更多担忧。
