North West tops alcohol-related liver deaths table

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Rates of premature death from liver disease are higher in the North West than anywhere else in England and are also increasing at a faster rate, according to a report from the North West Public Health Observatory. Rates of premature mortality from liver disease in the region in 2010 were nearly double those in 1995, says Burden of liver disease and inequalities in the North West of England.

The peak ages of liver disease death in the North West are 55-64 years for both men and women, with alcohol-related liver disease accounting for the greatest proportion. Death rates from alcohol-related liver disease were also highest in the region’s most deprived local authority areas. 

Prevalence of hepatitis C among injecting drug users also remains higher in the North West, with hospital admissions for hepatitis C increasing from less than 3,000 in 2005 to almost 5,000 in 2010. Admission rates among males were double those among females, with 75 per cent of all cases the result of sharing contaminated injecting equipment. 

The report is also unlikely to do justice to the ‘full burden’ of liver disease in the region, it adds, as hospital admission data ‘represent the most severe cases of liver disease and do not include people treated in primary care or outpatient departments where the majority of people with liver disease are treated’.  

‘The premature and avoidable mortality’ caused by liver disease as well as the gap between the North West and the rest of England ‘indicate the scale and urgency of the problem,’ the report concludes, calling for liver disease action to be made a priority for the region’s commissioners. It also wants to see better strategies for early diagnosis, improved surveillance to address information gaps and better use of local intelligence to target the populations most at risk. Prevention efforts should also target groups ‘whose current behaviours put them at risk of progression to chronic liver disease’, such as young women, it states. 

Meanwhile, a new report from the Children’s Commissioner states that more than 2.5m children in the UK are living with a hazardous drinker and more than 700,000 with a dependent drinker. Just over 950,000 children live with at least two binge drinkers, says Silent voices: supporting children and young people affected by parental alcohol misuse, while just under 460,000 live with a lone parent who is a binge drinker.

Children living with parental alcohol misuse come to the attention of services later than children living with parental drug misuse, says the report, and the true size of the problem ‘remains unknown’. The document calls for more policy focus on ‘the wide group of children in need of support as a result of parental alcohol misuse’ rather than just those in need of protection, as well as policies and strategies that ‘take into account the impact on children who may be affected by a range of levels of parental alcohol consumption and not just dependent drinkers’. 

The links between parental alcohol misuse and domestic violence also need to be taken into account in policy development at local and national level, it says, while the new health and wellbeing boards must make sure that parental alcohol misuse is well understood in their area.

The report signalled ‘a growing awareness amongst policy advisors that you don’t have to be addicted to a substance to suffer from alcohol or drug misuse’, said Action on Addiction chief executive Nick Barton, while Turning Point said it highlighted the need for better information. ‘We are aware that the provision of services for families for alcohol misuse is patchy and we know that this needs to change,’ said director of substance misuse services Jackie Kennedy. ‘For us the key lies in replicating services that have already proved effective; focusing on family focused substance misuse services, partnership working and home-based services for families. We need more services to meet the needs of parents to prevent a new generation of children at risk of poor mental health, drug and alcohol addictions, truancy and worse.’

Burden of liver disease at www.nwph.net/nwpho

Silent voices at www.childrenscommissioner.gov.uk