VicHealth Innovation Challenge - Alcohol: Dr Michael Livingston, University of New South Wales

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Doing Something Good collaborated with Vic Health to facilitate a 1 Day Forum that explored ways to shape a better alcohol culture in Victoria. We bought together researchers, healthcare providers, changemakers, venue owners, youth workers, service design professionals, social entrepreneurs, policy makers, behaviour change specialists, and representatives from organisations working on youth and mental health issues. The Forum gave participants the opportunity to connect, learn, exchange useful information and provide a space for conversations that matter. The format incorporated innovative methodologies including World Café and Open Space with an opening keynote presentation and 10 Lightning Talks throughout the day. Find more on the Discovery & Insights Forum at http://doingsomethinggood.com.au/vichealth-innovation-challenge-alcohol-discovery-insights-forum/ Learn more about the VicHealth Innovation Challenge Alcohol at http://challenge.vichealth.vic.gov.au/challenges/alcohol/

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Alcohol in Australia: Key trends and recent developments

Michael Livingston

Background – why alcohol?

Contributes to an array of health and social problems –  Liver disease, heart disease, cancers, etc etc –  Injuries from accidents (e.g. falls, traffic), violence –  Mental health (e.g. Suicide, depression)

But: widely enjoyed, moderate consumption associated with improved health outcomes and psychological wellbeing

Societal ambivalence

Historical  consump/on  data  

0  

2  

4  

6  

8  

10  

12  

14  Alcohol   Spirits  

Wine   Beer  

Interna/onal  consump/on  data  

0

4

8

12

16

20

Interna/onal  consump/on  data  

0

4

8

12

16

20

Recent trends in consumption

Perception that alcohol is an increasing problem in Australia society –  “Epidemic of binge drinking” (Rudd) –  “Drink until you drop culture” (Scippione) –  “Binge drinking out of control” (AMA)

Per-capita consumption is at its lowest level since the mid 1990s

Distinct shifts in drinking behaviour among young people

Consumption

Underage drinking

0%

10%

20%

30%

40%

50%

60%

70%

80%

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

NDSHS (14-17) ASSAD (12-15) ASSAD (16-17)

Consumption

Age at first drink (of current drinkers aged 18-24)

12.0

12.5

13.0

13.5

14.0

14.5

15.0

15.5

16.0

2001 2004 2007 2010

Consumption

Risky drinking by young adults

0

10

20

30

40

50

60

2001 2004 2007 2010 2013

18-24 year olds 25-29 year olds

Consumption

But...

0

10

20

30

40

50

60

2001 2004 2007 2010 2013

18-24 year olds 25-29 year olds 40-49 year olds 50-59 year olds 60-69 year olds

Consumption trends Drinking among young people steadily declining

–  Particularly those under the age of 18 –  Trends appear to be consistent across an array of population

sub-groups (e.g. rich and poor, urban and rural) and not due to increasing cultural diversity

–  Not offset by illicit drug use

Drinking among older cohorts is steady or potentially increasing –  Some evidence that very heavy or ‘binge’ drinking is

extending into later adulthood –  E.g. 5% of 30-39 year olds drink 20+ drinks at least monthly,

up from ~2% 10 years ago

Source: National Drug Strategy Household Survey, 2001-2010, pop aged 14+

Attitude shifts

Clear evidence that public attitudes towards alcohol are shifting –  Greater media concern –  More worry about alcohol as a problem –  Increased support for restrictions –  Attitude changes not limited to particular subgroups of the

population

Drug of ‘most concern’ for the general community

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

2001 2004 2007 2010

Alcohol Tobacco Meth/Amphetamines Heroin

Drug causes the most deaths

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

50%

2001 2004 2007 2010

Alcohol Tobacco

Meth/Amphetamines Heroin

Support for restrictive policies

0

0.5

1

1.5

2

2.5

3

3.5

4

1995 1998 2001 2004 2007 2010

Price Outlets Trading hours

Media focus of alcohol stories

Azar, White, Bland, Livingston, Room, Chikritzhs, Durkin, Wakefield (submitted) Something’s brewing: changing trends in alcohol coverage in Australian newspapers 2000-2011

Harm trends

Generally increasing harm rates over the past decade (although road injuries and deaths are steady)

0

10

20

30

40

50

60

70

2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10 2010/11 2011/12 2012/13

Hospital admissions Ambulance attendances Treatment episodes

Assault Family incidents Emergency Department

Harm trends In spite of promising data on consumption, rates of

problems are high and increasing –  Recent research estimates that >5,000 die each year due to

alcohol, and more than 150,000 are hospitalised –  Harms are spread fairly evenly across the age spectrum

–  Higher rates of injuries among young people

–  Higher rates of chronic disease in older groups

–  Men generally experience higher rates of harm

Conclusions

Victorian and Australian alcohol trend data provides a confusing picture –  Reasonable evidence of harm increases

–  Generally stable levels of consumption, which obscure: •  Major reductions in teenage drinking •  Declines in risky drinking, particularly among young adults •  Some slight increases in drinking among older people

–  Big shifts in attitudes towards alcohol

Conclusions

Little evidence to explain these changes –  Increased public health presence in media coverage of

alcohol may be driving or reflecting changes in public attitudes

–  Declines in youth consumption may represent a reaction against heavier drinking cohorts

•  Reasonably good evidence that teenage consumption predicts future drinking behaviours, so current reductions are promising for ongoing gains

•  Alcopops tax and secondary supply may have contributed, but can’t explain the degree of change observed

•  The success of FebFast and Hello Sunday Morning may be a cause of or a reflection of changes in attitudes to drinking among young people

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