The politics of drinking
            February 23, 2011

The rich get drunker and the poor get sicker

Somewhere in the middle of the Lancet’s sensationalist warning that 250,000 more of us are going to die alcohol-related deaths if we don’t put prices up, and the equally spurious advice that drinking can protect against heart disease* a much more important report was getting lost.

Perhaps the NHS’s Alcohol Statistics Scotland 2011 needs a jazzier title. It’s almost like they don’t want anyone to read it. And you can see why.

The stats inside point quite unequivocally towards a fact that would make the government and those leading the alcohol policy debate uncomfortable: alcohol-related illness and death has less – much less – to do with how much you’ve had to drink than how much money you’ve got in your pocket.

I’ve covered this before, more than once, but it needs repeating. And the gap between rich and poor on this matter is widening.

In 2009-10, the period covered by the NHS report, someone living in the most deprived areas of Scotland is 7.5 times as likely to go to hospital with an alcohol-related complaint than someone living in the least deprived areas. In 2005-6 the multiple was ‘only’ 7.0. And for psychiatric hospitals it goes up to 9.0.

The overall figure for alcohol-related discharges, incidentally, has been declining over the last couple of years. And they measure discharges rather than admissions because some of them don’t get out alive.

Those in the poorest fifth of the population are six times more likely to die than those in the wealthiest fifth. In 2009, 64% of alcohol-related deaths occurred among the most deprived 20%.

Yet, if anything, the better-off drink more than the worse-off. The report gives some clues about the underlying patterns of consumption.

People living in the most deprived areas are polarised between those who don’t drink at all, probably because they can’t afford it, and those drinking at ‘harmful’ levels, presumably the ones bumping up the sick and dead numbers for their cohort.

It suggests that the problem cannot by addressed by reducing overall consumption. That we need to pay close attention to the small minority who are drinking dangerously.

This, however, requires human resources on the ground, in the hospitals and in the alcohol services. No amount of ‘nudging’, no Big Society, is going to help the people who need help the most.

Yet government policy is, of course, determined to head in the opposite direction, towards more cuts.

And there is an even larger, louder message in these figures. That if we are to deal with alcohol problems at their root we have to address the issues of deprivation, poverty and inequality.

So how about it Mr Lansley? Yeah, maybe not.

*This story has appeared about once every three months for at least 20    years now and is always inconclusive and useless in terms of giving anyone advice. See my general comments on such things here.

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