Alcohol

Excessive alcohol consumption is England’s second biggest cause of premature mortality behind tobacco use. Regular heavy drinking and binge-drinking behaviours are associated with a whole range of issues including anti-social behaviour, and an increased risk of physical and mental health problems. Long-term alcohol misuse is linked to a range of cancers, cardiovascular diseases, chronic liver disease and diabetes as well as having an impact on the social wellbeing of a person, their family, and friends. Long-term alcohol misuse can lead to social problems such as unemployment, domestic abuse and homelessness.

The term 'alcohol-specific conditions' refers to conditions caused wholly by the use of alcohol including alcohol-induced behavioural disorders and alcohol-related liver cirrhosis.

• The rate of hospital admissions for alcohol-specific conditions for all persons in 2023/24 was significantly higher in Lancashire-12 (692 per 100,000) than observed for England (612) but significantly lower than the North West average (796) – the county had a total of 8,766 admissions in the period. Trend data shows that the rate of admissions is declining in Lancashire-12.

• Preston (1,071), Chorley (940), South Ribble (815), Fylde (754), Lancaster (712), Burnley (699), and Wyre (684) all had significantly worse(/higher) rates of admissions for alcohol specific conditions (all persons, 2023/24) than England, the remaining districts had a lower rate. Burnley, Pendle, Hyndburn, West Lancashire, and Ribble Valley were all seeing a decline in these admissions.

• Inequalities data show that males had an admission rate (962) that was twice as high as females (438) for the period 2023/24 - rates for both males and females were significantly higher in Lancashire-12 than the respective rates at a national level (868 and 373). Across all districts admissions rates for males were higher than for females.

• Chorley, Fylde, Preston, and South Ribble all had admissions rates that were higher than England for both sexes. In Burnley and Lancaster male admissions rates were higher than England with female rates being similar to England, whilst in Wyre the reverse is true. Pendle, and Ribble Valley both had male and female admissions rates that were lower than England.

• Rates of male admission were declining in Burnley, Hyndburn, Pendle, and West Lancashire with no significant change elsewhere. Whilst female admissions were declining in Hyndburn, Ribble Valley. Rossendale, and West Lancashire, but increasing in South Ribble.

Under 18 admissions (rates per 100,000)

• Between 2021/22-2023/24, Lancashire-12 had a similar rate of hospital admission episodes for alcohol-specific conditions involving persons aged under 18 years when compared with England. The area had 179 admissions, resulting in a DSR of 23.5 per 100,000 people, England's rate was 22.6. Two thirds of those admissions were female (with a resulting rate of 33.7, the male rate was 15.4, both similar to England) which is roughly in line with what is observed nationally wherein under 18 female admissions rates are approximately twice as high as males (30.0 vs 15.4 respectively).

• Generally, the districts had statistically similar rate of admissions for alcohol-specific conditions for under 18s however in Lancaster the rate was significantly higher for all persons (40.8) and females (59.7), in Fylde they were higher for females (57.4) whilst in Preston they were significantly lower for males (3.8).

Mortality

• The 2023 alcohol-specific mortality rates show that there were 215 deaths across Lancashire-12-12, giving the area a DSR of 17.0 per 100,000 people (all ages), statistically similar to the England rate of 15.0. Trend data show Lancashire-12's rate of alcohol-specific mortality shows no significant change though the number of deaths was fewer in 2023 than in 2022 (250).

Admissions for alcohol-related conditions (narrow) refers to where the primary diagnosis is an alcohol-related condition, or a secondary diagnosis is an alcohol-related external cause. Alcohol-related mortality refers to deaths with an alcohol attributable fraction based on the underlying cause of death (including ethanol or methanol poisoning and the toxic effects of alcohol). 

Admissions:

• In 2023/24, across Lancashire-12-12, 6,182 hospital admissions were due alcohol-related conditions, the county's rate of admission was 483 per 100,000 which is significantly lower than England (504). Trend data shows no significant change in this rate locally.

• Fylde (612), Wyre (598), Lancaster (553), and Preston (551) all had statistically significantly higher rates of admissions for alcohol-related conditions when compared to England whilst Pendle (443), South Ribble (441), Rossendale (377), Hyndburn (351), West Lancashire (350) and Ribble Valley (331) were significantly lower. Recent trend data show that Hyndburn and West Lancashire were seeing a decline in these admissions.

• The rate of hospital admissions for alcohol-related conditions for Lancashire-12 males (664) was significantly lower in Lancashire-12 than nationally (686), female admissions (316) were also significantly lower than nationally (340).

• In the districts Wyre had significantly higher rates of admissions for alcohol-related conditions for both males (772) and females (439) when compared with England. Preston also had worse rates for males (782) whilst Fylde (513) and Lancaster (433) had worse rates for females. Trend data shows admissions were declining for both sexes in West Lancashire and for females in Hyndburn with no significant change elsewhere.

Admissions by condition (2023/24, rate per 100,000):

• Admissions for alcohol-related unintentional injuries in Lancashire-12 (60.9 per 100,000) were similar to England (61.6) for all persons, for males (106.5 in Lancashire-12 vs 109.4 for England), and for females (17.3 vs 16.7 for England). With no significant change in terms of trend.

• Admissions for alcohol-related unintentional injuries for all persons are significantly worse/higher in Preston (79.3), all other districts had admission rates similar to England.

• Admissions for mental and behavioural disorders due to use of alcohol in Lancashire-12 (all persons – 51.6, males - 74, and females - 30.1) were lower than England (all persons - 62.8, males – 90.9, females - 36). Admissions for all persons and females were declining whilst males saw no significant change.

• Admissions for mental and behavioural disorders due to alcohol are significantly worse than England in Preston (78.9) for all persons and males (119.3) but more than half of Lancashire-12's districts experienced significantly lower rates. Declining rates occurred in both West Lancashire and Burnley (for all persons and males).

• Admissions for self-poisoning were either significantly lower (all persons 16.6, and females 16.7) than England (all persons – 22.7, females – 25.3) or similar (males 16.6) to England (males – 20.0) and showing a declining trend for all measures.

Admissions by age (2023/24, rate per 100,000)

• Lancashire-12's rate of admissions to hospital for alcohol-related conditions for under 40 year olds was statistically significantly lower than England for all persons (Lancs – 122.6, Eng – 142.6), and for females (Lancs – 81.6, Eng – 106.7). The rate of admissions for males (Lancs – 165.3, Eng – 180.3) was similar to England. Local trend data shows that these rates are declining which is in line with the national trend.

• Most districts have a rate of admission that is similar to England however West Lancashire (96.0), Pendle (92.1), and Ribble Valley (84.6) all have lower rates for all persons. All districts are similar to England for males whilst Burnley (61.9), West Lancashire (56.3), and Pendle (53.3) are significantly lower for females. West Lancashire and Burnley are seeing a decline in overall admissions but only the former is seeing a decline for both sexes, all other districts had no significant change.

• For all persons aged 40-64 years old alcohol-related admissions in Lancashire-12 (769 per 100,000) were lower than England (802).The male rate of admissions in Lancashire-12 (978) was similar to England (993) and was nearly double the female admission rate (567) which was significantly lower than England (617), both rates show no significant change.

• Wyre (978), Preston (953), and Fylde (944) had significantly higher admission rates for 40-64 year old for all persons whilst South Ribble (664), West Lancashire (570), Rossendale (545), Hyndburn (544) and Ribble Valley (516) were all lower. Preston (1,261) and Burnley (1,260) both had significantly higher rate of admissions for males compared to England whilst Fylde (963) and Lancaster (794) had higher rates for females.

• Finally, for persons aged over 65 Lancashire-12's rate of hospital admissions for alcohol-related conditions was statistically similar to England for all persons (Lancashire-12 - 858, England - 864), males (Lancashire-12 - 1,326, England -1,379), and females (Lancashire-12 - 449, England -424) however the female rate is increasing.

• Fylde (1,243), Lancaster (1,034), and Wyre (1,016) all had higher rates of admissions for all persons aged 65+. Lancaster (636) and Wyre (773) had higher rates for females whilst Fylde had higher rates for both sexes (male – 1,798, female - 751).

• Hyndburn (593), Pendle (724), Ribble Valley (608), Rossendale (661), and West Lancashire (587) all had significantly lower admissions for all persons. In Hyndburn and Rossendale there were lower rates for males whilst Ribble Valley and West Lancashire had lower rates for both sexes.

• Fylde is the only district to see an increase for this age group, trend data show that the rate is increasing for all persons and females in this district.

Mortality

• There were 608 alcohol-related deaths recorded across Lancashire-12-12 in 2023, giving the area a DSR of 46.7, significantly higher than England's rate (40.7). Lancashire-12 rate has seen no significant change whereas nationally the rate is increasing. Alcohol related mortality was higher for males (69.8) than females (26.4) and significantly worse for both in Lancashire-12 when benchmarked against the national figures (62.1 and 22.1 respectively.)

• Hyndburn (60.7), Burnley (59.5), and Wyre (53.7) all had alcohol related mortality rates that were higher than England whilst the other district rates were similar. The mortality rates for males were higher than England in Wyre (90.4). For females, rates were higher in Burnley (42.3) and Hyndburn (39.5).

• The Potential years lost of life (PYLL) due to alcohol-related conditions (2023) was higher than England in Lancashire-12 for males (1,479 per 100,000 vs Eng – 1,246) and females (649 vs 533 for England). Lancashire-12's trend data showed no significant change in PYLL whereas for England this was increasing for both male and females. The PYLL rate for males was highest in Wyre (2,049) –significantly worse than England - whilst Hyndburn (1,079) and Burnley (983) were significantly higher for females.

• The rate of potential working years of life lost (PWYLL, DSR per 100,000) due to alcohol related conditions (2023) was also significantly higher in Lancashire-12 than England for both males (644 vs 492 for England) and females (241 vs 199 for England). The male rate is increasing.

• 8 Lancashire-12 districts had higher male PWYLL rate than England with this being highest in Wyre (961 per 100,000) and increasing in two of these districts (Chorley – 658 and Lancaster 798). Meanwhile, West Lancashire (201) had a lower male PWYLL than England. 6 districts had a higher female PWYLL than England and the highest rate was in Hyndburn (451). whilst 2 districts had lower female rates (Preston – 152, Fylde – 86).

• In 2022/23 in Lancashire-12 1,673 people were in treatment at specialist alcohol misuse services with 0.8% waiting more than 3 weeks for treatment which is better than the England rate of 2.4%

• In 2023 the successful completion rate of alcohol treatment services in Lancashire-12 was 41.1% which is significantly higher (better) than observed for England (34.2%) however the overall trend is one of decline.

• The mortality ratio for deaths in alcohol treatment in the period 2019/20-21/22 is significantly worse than England at 1.37 (vs 1).