The impacts of minimum alcohol pricing on alcohol attributable morbidity in regions of British Colombia, Canada with low, medium and high mean family income.

BACKGROUND AND AIMS

Previous research indicates that minimum alcohol pricing (MAP) is associated negatively with alcohol-attributable (AA) hospitalizations. Modeling studies predict that this association will be stronger for people on lower incomes. The objective of this study was to test whether the association between MAP and AA hospitalizations is greater in low-income regions.

DESIGN

Cross-sectional versus time-series analysis using multivariate multi-level effect models.

SETTING

All 89 Local Health Areas in British Columbia (BC), Canada, 2002-13 (48 quarters).

PARTICIPANTS

BC population.

MEASUREMENTS

Quarterly rates of AA hospital admissions, mean consumer price index-adjusted minimum dollars per standard alcoholic drink and socio-demographic covariates.

FINDINGS

Family income was related inversely to the effect of minimum prices on rates of some types of AA morbidity. A 1% price increase was associated with reductions of 3.547% [95% confidence interval (CI) = -5.719, -1.377; P < 0.01] in low family-income regions and 1.64% (95% CI = -2.765, -0.519; P < 0.01) across all income regions for 100% acute AA hospital admissions. Delayed (lagged) effects on chronic AA morbidity were found 2-3 years after minimum price increases for low income regions and all regions combined; a 1% increase in minimum price was associated with reductions of 2.242% (95% CI = -4.097, -0.388; P < 0.05) for 100% chronic AA and 2.474% (95% CI = -3.937, -1.011; P < 0.01) for partially chronic AA admissions for low-income regions.

CONCLUSION

In Canada, minimum price increases for alcohol are associated with reductions in alcohol attributable hospitalizations, especially for populations with lower income, both for immediate effects on acute hospitalizations and delayed effects on chronic hospitalizations.