Dataset Information

The socioeconomic distribution of alcohol-related violence in England and Wales.

ABSTRACT: Inequalities in alcohol-related health harms have been repeatedly identified. However, the socioeconomic distribution of alcohol-related violence (violence committed by a person under the influence of alcohol)-and of subtypes such as alcohol-related domestic violence-remains under-examined. To examine this, data are drawn from nationally representative victimisation survey, the Crime Survey for England and Wales, from years 2013/14 to 2017/18. Socioeconomic status specific incidence and prevalence rates for alcohol-related violence (including subtypes domestic, stranger, and acquaintance violence) were created. Binomial logistic regressions were performed to test whether the likelihood of experiencing these incidents was affected by socioeconomic status when controlling for a range of pre-established risk factors associated with violence victimisation. Findings generally show lower socioeconomic groups experience higher prevalence rates of alcohol-related violence overall, and higher incidence and prevalence rates for alcohol-related domestic and acquaintance violence. Binomial logistic regression results show that the likelihood of experiencing these types of violence is affected by a person's socioeconomic status-even when other risk factors known to be associated with violence are held constant. Along with action to address environmental and economic drivers of socioeconomic inequality, provision of publicly funded domestic violence services should be improved, and alcohol pricing and availability interventions should be investigated for their potential to disproportionately benefit lower socioeconomic groups.

SUBMITTER: Bryant L

PROVIDER: S-EPMC7891736 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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The socioeconomic distribution of alcohol-related violence in England and Wales.

Bryant Lucy L Lightowlers Carly C

PloS one 20210218 2

Inequalities in alcohol-related health harms have been repeatedly identified. However, the socioeconomic distribution of alcohol-related violence (violence committed by a person under the influence of alcohol)-and of subtypes such as alcohol-related domestic violence-remains under-examined. To examine this, data are drawn from nationally representative victimisation survey, the Crime Survey for England and Wales, from years 2013/14 to 2017/18. Socioeconomic status specific incidence and prevalen ...[more]

PMID: 33600492

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Project description:BACKGROUND:Interpersonal violence is a leading cause of death and disability globally, has immediate and long-term impacts on individuals' health and wellbeing, and impacts global health care expenditures and national economies. A public health approach to violence prevention is crucial, and addressing risk factors is a key priority. Global research has demonstrated that childhood adversity increases risk of a range of poor outcomes across the lifecourse. This study examined the association between being a victim of child abuse and the risk of physical assault (PA), intimate partner violence (IPV), and sexual violence (SV) victimisation in adulthood. METHODS:Data from a nationally representative survey of household residents (adults aged 16 to 59?years; n?=?21,845) was analysed. Types of child abuse examined included physical, sexual, and psychological abuse and witnessing domestic violence. Logistic regressions examined the independent relationships between child abuse types, experiencing multiple types, and adulthood violence outcomes. RESULTS:Most individual types of child abuse were significantly associated with each adulthood violence outcome, after controlling for sociodemographics and other abuse types. Compared to individuals who experienced no abuse in childhood, those who experienced one form of abuse were over twice as likely to experience PA in the past year and three times as likely to have experienced IPV and/or SV since age 16?years, whilst individuals who experienced multiple types were three, six, and seven times more likely to experience PA, IPV, and SV, respectively. After controlling for sociodemographics and multi-type childhood victimisation, the type or combination of types which remained significant differed by violence outcome; child psychological and physical abuse were significantly associated with IPV; psychological and sexual abuse with SV; and psychological abuse with PA. CONCLUSIONS:Prevention of child abuse is an important goal, and evidence from the current study suggests such efforts will have a downstream effect on preventing interpersonal violence across the lifecourse. With adulthood victimisation likely to compound the already detrimental effects of childhood abuse, and given that many associated outcomes also represent adversities for the next generation, breaking the cycle of violence should be a public health priority.

Project description:BackgroundThe recent World Report on Disability highlighted violence as a leading cause of morbidity among disabled people. However, we know little about the extent to which people with disability experience different violence types, and associated health/economic costs. The recent introduction of disability measures into the England&Wales victimization survey provided an opportunity to address this gap.Methods and findingsAnalysis of the 2009/10 British Crime Survey (BCS), a nationally representative cross-sectional survey of 44,398 adults living in residential households in England&Wales. Using multivariate logistic regression, we estimated the relative odds of being a victim of past-year violence (physical/sexual domestic or non-domestic violence) in people with disability compared to those without, after adjusting for socio-demographics, behavioural and area confounders. 1256/44398(2.4%) participants had one or more disabilities including mental illness ('mental illness') and 7781(13.9%) had one or more disabilities excluding mental illness ('non-mental disability'). Compared with the non-disabled, those with mental illness had adjusted relative odds (aOR) of 3.0(95% confidence interval (CI) 2.3-3.8) and those with non-mental disability had aOR of 1.8(95% CI: 1.5-2.2) of being a victim of past-year violence (with similar relative odds for domestic and non-domestic violence). Disabled victims were more likely to suffer mental ill health as a result of violence than non-disabled victims. The proportion of violence that could be attributed to the independent effect of disability in the general population was 7.5%(CI 5.7-9.3%), at an estimated cost of £1.51 billion. The main study limitation is the exclusion of institutionalised people with disability.ConclusionsPeople with disability are at increased risk of being victims of domestic and non-domestic violence, and of suffering mental ill health when victimized. The related public health and economic burden calls for an urgent assessment of the causes of this violence, and national policies on violence prevention in this vulnerable group.

Project description:ObjectivesTo examine if, and to what extent, a history of adverse childhood experiences (ACEs) combines with adult alcohol consumption to predict recent violence perpetration and victimisation.DesignRepresentative face-to-face survey (n=12?669) delivered using computer-assisted personal interviewing and self-interviewing.SettingDomiciles of individuals living in England and Wales.ParticipantsIndividuals aged 18-69 years resident within randomly selected locations. 12?669 surveys were completed with participants within our defined age range.Main outcome measuresAlcohol consumption was measured using the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) and childhood adversity using the short ACEs tool. Violence was measured using questions on perpetration and victimisation in the last 12 months.ResultsCompliance was 55.7%. There were strong positive relationships between numbers of ACEs and recent violence perpetration and victimisation in both sexes. Recent violence was also strongly related to positive AUDIT-C (?5) scores. In males, heavier drinking and ?4ACEs had a strong multiplicative relationship with adjusted prevalence of recent violent perpetration rising from 1.3% (95% CIs 0.9% to 1.9%; 0 ACEs, negative AUDIT-C) to 3.6% (95% CIs 2.7% to 4.9%; 0 ACEs, positive AUDIT-C) and 8.5% (95% CI 5.6% to 12.7%; ?4ACEs, negative AUDIT-C) to 28.3% (95% CI 22.5% to 34.8%; ?4ACEs, positive AUDIT-C). In both sexes, violence perpetration and victimisation reduced with age independently of ACE count and AUDIT-C status. The combination of young age (18-29 years), ?4ACEs and positive AUDIT-C resulted in the highest adjusted prevalence for both perpetration and victimisation in males (61.9%, 64.9%) and females (24.1%, 27.2%).ConclusionsThose suffering multiple adverse experiences in childhood are also more likely to be heavier alcohol users. Especially for males, this combination results in substantially increased risks of violence. Addressing ACEs and heavy drinking together is rarely a feature of public health policy, but a combined approach may help reduce the vast costs associated with both.

Project description:BackgroundCOVID-19 poses one of the most profound public health crises for a hundred years. As of mid-May 2020, across the world, almost 300,000 deaths and over 4 million confirmed cases were registered. Reaching over 30,000 deaths by early May, the UK had the highest number of recorded deaths in Europe, second in the world only to the USA. Hospitalization and death from COVID-19 have been linked to demographic and socioeconomic variation. Since this varies strongly by location, there is an urgent need to analyse the mismatch between health care demand and supply at the local level. As lockdown measures ease, reinfection may vary by area, necessitating a real-time tool for local and regional authorities to anticipate demand.MethodsCombining census estimates and hospital capacity data from ONS and NHS at the Administrative Region, Ceremonial County (CC), Clinical Commissioning Group (CCG) and Lower Layer Super Output Area (LSOA) level from England and Wales, we calculate the number of individuals at risk of COVID-19 hospitalization. Combining multiple sources, we produce geospatial risk maps on an online dashboard that dynamically illustrate how the pre-crisis health system capacity matches local variations in hospitalization risk related to age, social deprivation, population density and ethnicity, also adjusting for the overall infection rate and hospital capacity.ResultsBy providing fine-grained estimates of expected hospitalization, we identify areas that face higher disproportionate health care burdens due to COVID-19, with respect to pre-crisis levels of hospital bed capacity. Including additional risks beyond age-composition of the area such as social deprivation, race/ethnic composition and population density offers a further nuanced identification of areas with disproportionate health care demands.ConclusionsAreas face disproportionate risks for COVID-19 hospitalization pressures due to their socioeconomic differences and the demographic composition of their populations. Our flexible online dashboard allows policy-makers and health officials to monitor and evaluate potential health care demand at a granular level as the infection rate and hospital capacity changes throughout the course of this pandemic. This agile knowledge is invaluable to tackle the enormous logistical challenges to re-allocate resources and target susceptible areas for aggressive testing and tracing to mitigate transmission.

Project description:BackgroundPrevalence 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.MethodsWe 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.ResultsTotal 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'.ConclusionsOur 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.

Project description:BACKGROUND: 'Traffic light' (red-yellow-green) maps are potentially powerful tools for 'at a glance' problem detection, for optimising resource allocation/reallocation, setting priorities, and targeting interventions to areas most in need. The maps can be also used for administrative area comparisons and performance monitoring over time. Interactive Web versions of the maps can be generated with many handy features to further empower organisations and decision makers. Methodological issues to consider when creating 'traffic light' maps include hue thresholding, data timeliness and stability of administrative boundaries. RESULTS: We used 'traffic light' maps to study the distribution of dentists per 1,000 population in all 304 English Primary Care Trusts (PCTs) and 22 Welsh Local Health Boards (LHBs) using datasets of dentist numbers per PCT (as at 31 December 2002) and LHB (as at 26 February 2004) from the Dental Practice Board, and 2001 Census population figures for PCTs and LHBs from the Office for National Statistics. The overall NHS dentists per 1,000 population figures for England (0.374) and Wales (0.359) are low compared to many other countries, with less than 0.3 dentist per 1,000 people available to 24.1% of the total population of England (81 PCTs or 26.6% of all PCTs) and 26.1% of the total population of Wales (6 LHBs or 27.3% of all LHBs). A general shortage of NHS dentists can be observed at a glance across England and Wales on all the 'traffic light' maps in our study, even on those using a more "tolerant" classification and an additional orange-yellow class. The distribution of NHS dentists in England and Wales was also found to be not uniform, with some PCTs/LHBs, especially those located in some of the deprived or less populated urban and rural communities, suffering significantly more shortage of dentists than others (see http://healthcybermap.org/PCT/dentists/). These results confirm recent media reports of a shortage of NHS dentists in various parts of England and Wales. CONCLUSION: Suitable programmes are urgently needed to increase the numbers of NHS dentists across England and Wales. We have included a set of recommendations to dental health policymakers and planners, in addition to ideas for further work.

Project description:OBJECTIVES:Although adolescence is a sensitive developmental period in oral health, the social equalization hypothesis that suggests health inequalities attenuate in adolescence has not been examined. This study analyses whether the socioeconomic gap and ethnic disadvantage in oral health among children aged 5 reduces among adolescents aged 15. METHODS:Data from the cross-sectional Children's Dental Health Survey 2013 were analysed, comprising of 8541 children aged 5, 8, 12 and 15 attending schools in England, Wales and Northern Ireland. Oral health indicators included decayed and filled teeth, plaque, gingivitis and periodontal health. Ethnicity was measured using the 2011 UK census ethnic categories. Socioeconomic position was measured by family, school and residential deprivation. Negative binomial and probit regression models estimated the levels of oral health by ethnicity and socioeconomic position, adjusted for demographic and tooth characteristics. RESULTS:The predicted rate of decayed teeth for White British/Irish children aged 5 was 1.54 (95%CI 1.30-1.77). In contrast, the predicted rate for Indian and Pakistani children was about 2-2.5 times higher. At age 15, ethnic differences had reduced considerably. Family deprivation was associated with higher levels of tooth decay among younger children but not among adolescents aged 15. The influence of residential deprivation on the rate of tooth decay and filled teeth was similar among younger and older children. Moreover, inequalities in poor periodontal health by residential deprivation was significantly greater among 15-year-old children compared to younger children. CONCLUSIONS:This study found some evidence of smaller ethnic and family socioeconomic differences in oral health among British adolescents compared to younger children. However, substantial differences in oral health by residential deprivation remain among adolescents. Community levels of deprivation may be particularly important for the health of adolescents.

Dataset Information

The socioeconomic distribution of alcohol-related violence in England and Wales.

Publications

The socioeconomic distribution of alcohol-related violence in England and Wales.

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