Is alcohol abuse killing thousands, hospitalising tens of thousands and costing billions?

19 July 2012

"Alcohol has been 'blamed for 6,600 deaths and 198,000 hospital admissions a year, and which costs the NHS £3.5bn annually."  

Independent, 19 July 2012

Yesterday the Guardian and Independent both reported calls from the House of Commons Health Select Committee for a reassessment of the Government's alcohol strategy.

MPs are concerned that the government concentrates too much on the social impact of binge drinking at the expense of highlighting the serious health effects of of chronic alcohol misuse.

Both papers cited similar figures on alcohol misuse. The Independent stated that alcohol is responsible for 6,600 deaths and 198,000 admissions to hospital each year, and costs the NHS £3.5 billion, while the Guardian reported 6,500 deaths and a cost of "more than £3 billion a year."

Analysis

Although it is an official estimate, we remain dubious about the claimed £3.5 billion cost, which the Department of Health told the Select Committee is the latest update of a 2003 estimate.

We were dubious before when the Prime Minister cited its £2.7 billion predecessor back in February. We are waiting to hear back from the Department of Health with more information to allow us to reach firmer conclusions.

For the rest, the Guardian and the Independent both reference the Health Select Committee report on the Government's Alcohol Strategy as the source of their figures and its notable that they use the smaller of the range of figures in the report.

Paragraph 9 of the report cites "the latest Government figures" into the costs of alcohol which observe that in 2010:

"there were 6,669 directly related to alcohol" and that "[i]n 2010/2011, there were 198,000 hospital admissions where the primary diagnosis was attributable to alcohol."

Putting aside differences in rounding, the select committee and papers appear to concur. However we decided to look at the origins of these figures to ensure that they were telling the whole story.  

Annual deaths

The "latest Government figures" on alcohol-related mortality are taken from Statistics on Alcohol: England, 2012 published as National Statistics by the NHS Information Centre in May.

The report uses the Office for National Statistics's definition for an alcohol related death which

"only includes those causes regarded as being most directly due to alcohol consumption… It does not include other diseases where alcohol has been shown to have some causal relationship, such as cancers of the mouth, oesophagus and liver."

With this in mind, the figure of 6,669 could be described as a conservative estimate of the deaths associated with alcohol misuse. It does not, for example, include the annual deaths caused by drink drivers.

A more expansive figure, cited in the same publication, has been calculated by independent researchers at the North West Public Health Observatory. They estimate 15,401 deaths in 2009 could be attributed to alcohol in some way.

Hospital admissions

Statistics on hospital admissions can be found in the same NHS Information Centre publication as the figures on mortality.

They adopt both a broad and a narrow definition regarding hospital admissions. The main difference between the two is whether or not the definition includes both primary and secondary diagnoses or solely primary.

The figure of 198,000 (cited in the Independent) refers to the narrow definition and relates to the figures in section 4.4.4:

"In 2010/11, there were 198,900 admissions where the primary diagnosis was attributable to the consumption of alcohol" either wholly or partially.

As eagle-eyed readers will note, the Independent's figure is rather oddly rounded down by 900 to 198,000. That can be traced back to the Select Committee's report itself.

When secondary diagnoses are included (the broad measure), the figure for 2010/11 rises to 1,168,300 as stated in section 4.4.2.

Rather like the alcohol related mortality rate, it would appear that the papers have been conservative in their choice of statistic.

The select committee's report cites the same statistic but there is a slight discrepancy in the actual figure with the committee citing 1,163,300.

This morning the Select Committee confirmed that their number was wrong. They will arrange for it to be corrected next week, as well as correcting the 198,000 admissions to 198,900. We are very grateful to them for the quick response.

Conclusions

The figures cited by the Commons Select Committee and published in the Guardian and Independent are backed up by National Statistics, save for the Committee's slips, which do not affect the thrust of either the report of the newspaper stories.

The figures on alcohol-related mortality and hospital admissions printed in the two papers only refer to cases in which alcohol was the primary causal factor. The Committee itself, in what is obviously a much longer report, gives a wider range of figures.

Full Fact will return to the financial costs of alcohol misuse when we have enough information to make a better informed judgement.

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