Evidence into Action (and Action into Evidence)

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Evidence into Action (and Action into Evidence)

• Dr Lesley Graham
• ISD

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UK consumption 1900-2006
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Alcohol Problems in Scotland

• Enough alcohol is sold in Scotland for every
  adult over 18 to exceed male weekly limits
  Health Scotland 2010
• Excess consumption is across all age and
  socio-economic groups Scottish Health survey
  2009
• 1 in 20 deaths attributable to alcohol Grant,
  Springbett and Graham 2009
• Those from the most deprived areas in Scotland
  are 5 times more likely to die an alcohol related
  death Alcohol Statistics Scotland 2009

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Chronic Liver Disease mortality rates per 100,000
population 1950-2006updated from Leon and
McCambridge, Lancet 367 (2006)
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Alcohol and Crime

• Half (50) of prisoners in Scotland reported
  being drunk at the time of their offence, rising
  to three quarters (77) of young offenders
  Scottish Prison Survey 2009
• Rise in proportion of young offenders who
  consider alcohol has contributed to their
  offending (48 in 1979 58 in 1996 to 80 in
  2007) McKinlay et al 2009
• 1 in 6 deaths on British roads are caused by
  drink driving Road Casualties in Great Britain
  2007
• Alcohol related crime is estimated to cost
  Scotland over 700 million per year Societal
  Cost for Alcohol Misuse in Scotland in 2007
  University of York 2010

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Alcohol and Violent Crime

• Where known, alcohol is a factor in more than two
  thirds (69) of those accused of homicide
  Homicide in Scotland 2008/9
• 70 of assaults in AE may be alcohol related
  QIS 2006
• In 62 of violent crime, victims said the
  offenders were under the influence of alcohol
  Scottish Crime and Justice Survey 2010

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Effectiveness of Interventions
Measure Effective?
Pricing
Availability Age Limit Reducing Outlet Density
Safer Drinking environments Server Liability Enforcement
Advertising /
Treatment Brief Interventions (primary care) Brief Interventions (AE)
Information and education School education Product Labelling Public service messaging ? / No (on own) No (on own)
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Intermediate outcomes
Long term outcomes
A culture in which low alcohol consumption is
valued and accepted as the norm
Children in need receive timely and appropriate
support
Model 2
Less absenteeism presenteeism in educational
establishments
Increased educational attainment
Safer drinking wider environments
Model 3
Fewer children affected by parental drinking
Reduced acceptability of hazardous drinking and
drunkenness
Increased workplace productivity
Less absenteeism presenteeism the workplace.
Less alcohol related incapacity
National outcomes Reduce significant
inequalities
Model 4
Safer happier families and communities
Increased knowledge and changed attitudes to
alcohol drinking
Reduction in Individual and population
consumption Changed patterns of consumption
Less alcohol related violence/abuse, offences and
ASB
Reduced availability of alcohol
Reduced health, social care, justice costs
Model 5
Reduced alcohol related injuries, physical and
psychological morbidity mortality
Healthier individuals and populations
Reduced affordability of alcohol
Model 6
Fewer brain-damaged children
Individuals in need receive timely, sensitive
appropriate support
Model 7
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Key Events in alcohol in Scotland

• 2003 ISD alcohol team set up
• 2005 Alcohol Statistics Scotland published
• 2007 Scottish Health Action for Alcohol Problems
  established and publish Price, Policy and Public
  Health
• 2007 Health Scotland develop alcohol logic
  models
• 2007 SNP government
• 2009 Alcohol Framework
• 2010 Alcohol Bill
• 2011 alcohol and offender conference and
  publication of reports
• 2011 MESAS baseline report

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What are the key elements for success?
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Contact

• Dr Lesley Graham
• Public Health Lead for Substance Misuse
• ISD, NHS National Services Scotland
• Gyle Square
• 1 South Gyle Crescent
• Edinburgh EH12 9EB
• lesley.graham_at_nhs.net