. Alcohol Focus Scotland. Response to Tackling poverty, Inequality and deprivation in Scotland
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- Kerry Stanley
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1 . Alcohol Focus Scotland. Response to Tackling poverty, Inequality and deprivation in Scotland Introduction Problem drinking and social groupings. Alcohol prob.lems affect people from all social groups. Alcohol Focus Scotland does not believe that poverty itself is necessarily the cause of a person's alcohol problem - people from across the social spectrum are affected by personal alcohol problems. However, the evidence is clear that people from areas of deprivation will suffer greater from health and social inequalities as a result of problematic drinking.. Alcohol misuse is associated with a w!de rarige of problems; physical health problems such as cancer and heart disease; offending behaviouts, not least domestic violence; suicide and deliberate self-harm; child abuse and child neglect; mental health problems; and social problems such as homelessness,1 and.unemployment. 2. However, the impact on individuals and families can vary. One of the mo~t notable differences is the marked socioeconomic gradient in alcohol related deaths and hospital admissions. People from the most deprived areas In Scotland are six times more Ifkely to be admitted to hospital with an alcohol-related diagnosis than people from the most affluent areas, while in 2005, 64% of alcohoj.;related deaths were amongst the most deprived members of society. For some families, the economic conseqijences of expenditures on alcohol can perpetuate the effects of poverty. 2 Single parent households, low income and parental unemployment are all significant risk factors for heavy alcohol use by children and young people. 2 Alcohol and health harm Evidence for the Impact of alcohol on health inequalities The excessive consumption of alcohol can result in many health problems -longer term excessive consumption can cause serious damage to parts of the body such as the liver and is also a contributory factor in many other illnesses such as cancer, stomach disorders; stroke and heart disease. I Models of care for alcohol users - June 2006, National Treatment Agency. 2 Alcohol misuse: taelding the UK epidemic - February 2008, BMA. I
2 As well as physical problems excessive consumption can also lead to mental health problems such as dependency and depression. There is evidence that suggests that alcohol consumption Is higher in the most deprived groups. Scottish Health Survey 2003, among men the percentage drinking more than 50 units per week was highest in the fifth quintue. Alcohol related hospital episodes and alcohol related deaths also show a strong relationship with deprivation. In 2005/06 people from the most deprived social groups were six times more likely to be admitted to general acute hospitals and eight times more likely to be admitted to psychiatric hospitals than people from the more affluent social groups.. In 2005 nearly two thirds of alcohol related deaths were amongst people who lived in the deprived social groups (SIMD dep quintiles 4 &5). The relationship between deprivation and alcohol related deaths has not changed during the last 5 years. Of the 20 council areas (throughout the UK) with the highest male mortality rates from alcohol, 15 are in Scotland. 3 Consumption is related to cost - It is known that the price of alcohol has a direct impact on alcohol consumption - when the price of alcohol falls, the more consumption' increases. The cheaper alcohol is, generally there are more problems. Alcohol was 62% more affordable in 2005 than in 1980 (ISD -Index of afford ability). Although there is no single approach that will be an instant fix to the rising problems related to alcohol consumption in Scotland, increasing price would make a huge contribution in reducing consumption and ultimately reducing harm to the people of Scotland. There is a substantial body of international evidence which shows that raising the price of alcohol Is one of the more effective policy tools for tackling alcohol misuse. Alcohol and Social Harm Alcohol misuse is viewed by a majority of the population aged 16 and over as a serious social issue in Scotland. 66% of respondents to the Scottish Crime and Victimisation Survey 2004 rated alcohol as a big problem in Scotland (only 5% said it is not a problem). Perception of alcohol as a neighbourhood problem - in addition to the perception that problem drinking is a general social problem, the~ is also evidence that individuals believe that other people's drinking affects their quality of life and level of contentment with their local neighbourhoods. People living in the most deprived areas are more likely to be affected by alcohol use. 55% of people living in the most deprived areas report public drunkenness or rowdy people having an effect on their quality of life. 3 Office ofnationai Statistics, 2007
3 Alcohol use amongst prison population - 66%. of young offenders were drunk at the time of the offence, with 52% reporting that their drinking is a problem outside of prison compared with 30% of adult prisoners. Young offenders also report that alcohol has affected their relationships and ability to hold down a Job. 4 Employment Part of the Scottish Executive's 'Closing the Opportunity Gap' approach to tackling poverty, is based on the principle that for the vast majority of people in Scotland, work is the surest way of achieving a better quality of life and avoiding disadvantage. Employment for people with alcohol problems It is recognised that people with substance misuse problems can represent some of the hardest to reach for any employability programme. Pilot services have been established to help people with alcohol problems into work such as Progress2WorK and Pathways to Work. What needs to be done? Raise alcohol awareness amongst local population - Given the greater risk of ill health for those living in deprived areas, much more needs to be done to raise awareness of the effect that excessive drinking can have on health, wellbeing and on the quality of life in communities. Alcohol awareness events being held in settings such as health practices and complemented by alcohol screening. Develop creative ways of working in the community to offer brief interventions - exploring new venues. Provision of alcohol services - improved access to specialist alcohol services and local GP practice backed up by surgery based counselling. Employability programmes - Helping to lift people out of poverty by having clear routes to programmes linked to alcohol services. This needs to be available across the country. Ensure employers have suitable workplace policies established to keep people out of poverty (through job losses) Improving facilities in communities to offer people alternatives to socialising - not simply drinking alcohol. 4 All stats listed under health and social hann from Alcohol Statistics 2007, ISD Scotland publication (unless referenced otherwise)
4 -----~ ~ ~--- "There is a clear social inclusion aspect to problematic alcohol consumption, with excessive drinking contributing to the persistent health inequalities within Scottish society. For the individuals concerned. alcohol misuse can lead to relationship breakdown, loss of employment and a fall into poverty, mental ill-health, social isolation and a range of other related negative impacts. Plan for action on alcohol problems: update. Feb 2007 Scot Exec.
5 About Alcohol Focus Scotland Alcohol Focus Scotland is the national charity for alcohol issues. The organisation was established in the early 1970's as the Scottish Council on Alcohol (SCA) and we became Alcohol Focus Scotland in We are the only Scottish charity dedicated to raising awareness of, and reducing the significant health and social harm caused by,.alcohol. Our long term aim is to achieve a culture change in Scotland where far fewer lives are affected by alcohol misuse, and moderate, responsibl~ drinking is the norm. We'll achieve this by providing accurate information to the public and professionals, training people to recognise arid help people overcome alcohol problems, influencing government and policy, and working in partnership with other organisations on specific projects. Mission Statement Alcohol Focus Scotland is committed to improving the quality of people's lives by changing Scotland's drinking culture - promoting responsible drinking behaviour and discouraging drinking to excess. Alcohol Focus Scotland is aiming to create a Scotland.: where moderate, responsible drinking is the norm, and drunkenness has become socially unacceptable where town and city centres are free from alcohol-fuelled disorder and violence where fewer families break up and have children taken into care because of parental drinking, where people who do develop alcohol problems can access appropriate treatment and support quickly and effectively where all alcohol producers and retailers take their legal and social responsibilities seriously where significantly fewer Scots have their lives cut short by alcohol misuse Alcohol problems cost Scotland an estimated 2.25 billion per year in NHS, social work, police, emergency services, and the wider economic and human costs. Alcohol misuse not only affects the health and wellbeing of the individual drinker, but also has a major impact on family relationships, communities and society as a whole. Alcohol Focus Scotland 166 Buchanan Street Glasgow G1 2LW Tel: enquirieslmalcohol-focus-scotland. oro. uk Registered Scottish Charity SC009538
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