Presentation on theme: "An Alcohol Harm Reduction Strategy for Christchurch Where Are We Now & Why Are We Here? November 2014."— Presentation transcript:
An Alcohol Harm Reduction Strategy for Christchurch Where Are We Now & Why Are We Here? November 2014
An Alcohol Harm Reduction Strategy Overview How did we get here? Impact of alcohol – why are we here? The AHRS process (?) 2
What have we got? The go ahead from CDHB and CCC to co-develop an Alcohol Harm Reduction Strategy for Christchurch
How did we get here? Timeline 2009: Groundwork undertaken through Healthy Christchurch – Key actions identified 2012: Co-ordinator post appointed in health sector – Enable CDHB to assume a leadership role in reducing alcohol-related harm
Healthy Christchurch Actions What came of them… Tri-agency enforcement partnership A joint alcohol working group established Improved surveillance Advocate for national/local policy Effective primary care response In Progress A local Alcohol Harm Reduction Strategy
Why the wait for the AHRS? CDHB committed to develop an alcohol harm reduction strategy in May 2013 Strategy development process ‘parked’ to focus on Local Alcohol Policies (LAPs) Initial alcohol key stakeholder strategy planning session took place in November 2013 – Good overview of stakeholders priorities – CDHB/CCC commitment affirmed
Average drinker? 9.85 litres of pure alcohol was purchased per NZ adult in 2012 (taxation data) AND 80% of adults report drinking in the past year That’s 18.68 standard drinks per adult drinker per week (before untaxed alcohol) - c.f. guidelines But only 19% of drinkers report drinking hazardously (NZHS2012) then… – These hazardous drinkers would be drinking 6 bottles of wine per week on average (44SD) 8
9 Weekly Consumption (Standard Drinks) Modelling self-reported drinking rates f * Average guideline (M/F) 44 12.5* 015 30..81% of drinkers...…………………..19% of drinkers……………………….......
10 Weekly Consumption (Standard Drinks) Modelling actual rates (based on sales) f … 60% of drinkers ….. ….. 40% of all drinkers ……………………………………………………………………………..…….. What if 40% are hazardous drinkers? Weekly Consumption (Standard Drinks) f 12.5* 015 30 Weekly Consumption (Standard Drinks) f 45 12.5* 015 30
How do we know? Look at what Population A drinksLook at what Population B drinks Rule out every other variable you can think of Compare their hospital admissions Get an exact measure of alcohol’s contribution to 60+ conditions by age category and sex (Alcohol Attributable Fractions) Apply that to your own hospital admissions to work out how alcohol consumption is impacting on health for any variable captured by that admission Examples Alcohol Cirrhosis 100% Oesophageal cancer 18 – 38% Hypertension 3 – 30% Road Traffic Accidents 2 – 46%
A useful way to look at alcohol-related harm ACUTE Immediate Accidents Assaults, Self harm, drowning, etc Enforcement Control Engage in ED WHOLLY Mid Term* Mental disorders (dependence), Other chronic diseases Alcohol poisoning (acute) Primarily AOD services CHRONIC Long Term Conditions 42 conditions (cancers, CV, bowel) Engage in health system Prevention
How alcohol harm in changing over time in Christchurch? 14 Approximately 7% of the total health burden and increasing by 7% per year Currently in the region of an $100M per year to the health system in Canterbury
Arrival Month Detected Alcohol Related Event Count Estimate of alcohol associated events in ED* Aug-12266459 Sep-12246424 Oct-12258445 Nov-12270466 Dec-12305526 Jan-13238410 Feb-13257443 Mar-13334576 Apr-13251433 May-13235405 Jun-13277478 Jul-13276476 Aug-13256441 Sep-13259447 Oct-13293505 Nov-13301519 Dec-13289498 Jan-14258445 Total48698395 Table/Graph of monthly recorded and estimated actual alcohol- related events in Christchurch ED (August 2012 – January 2014) Recorded admission (green line) indicates alcohol incidence that staff detected *Recent research estimates actual alcohol incidence (blue line) to be over 70% higher (where alcohol involved but not detected) at approx. 5600 incidents per year NB: Alcohol-related admissions often impact disproportionately on ED resources
AREAEPISODES Linwood126 Sydenham112 Phillipstown102 Cathedral Square99 Addington92 Hornby South89 Avon Loop89 Sockburn86 Aranui83 Ensors83 Ilam81 Riccarton79 Edgeware69 Spreydon67 Rawhiti66 Barrington North65 Hillmorton63 St Albans East62 Shirley East58 North Beach58 Top 20 Census Area (units) for alcohol-related ED admissions (August 2012 – January 2014) Admissions are recorded by residence for each TLA and Census Area (in Christchurch) 41% of all recorded alcohol-related ED admissions for Christchurch residents are accounted for by the top 20 Census Areas (16% of all areas) listed here Share of all alcohol-related ED admissions Christchurch (inc. Banks P)82% Waimakariri 6% Selwyn 5% Canterbury95%
Highlights peak in alcohol-related events between 10pm and 5am the next day Alcohol-related attendance can be observed above the daily averages from Friday 6pm to Sunday 4pm. This accounts for 54% of weekly incidence.
Graph of monthly recorded alcohol-related events in Christchurch ED by age band and gender (August 2012 – January 2014) 58% of all events occur in the under 30s 66% of all events are due to males
…even before the Alcohol Strategy is launched 21 Activity underway Activity in the work programme
The new Alcohol HR Strategy The process will be as important as the end product – Champions identified, awareness raised, views and ideas shared, new prevention initiatives and partnerships developed, resources identified, targets set, etc. Milestones – Perhaps a strategy launch by November 2016 ???