Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland: A comparative timeseries study between 2012-2019

Frank De Vocht; Cheryl Mcquire; Claire Ferraro; Philippa Williams; Madeleine Henney; Colin Angus; Matt Egan; Andrea Mohan; Richard I Purves; Nason Maani Hessari; Niamh Shortt; Laura Mahon; Gemma  Crompton; Rachel  O’Donnell; James Nicholls; Linda Bauld; Niamh Fitzgerald

doi:10.1016/j.lanepe.2022.100450

Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland: A comparative timeseries study between 2012-2019

Frank De Vocht, Cheryl Mcquire, Claire Ferraro, Philippa Williams, Madeleine Henney, Colin Angus, Matt Egan, Andrea Mohan, Richard I Purves, Nason Maani Hessari, Niamh Shortt, Laura Mahon, Gemma Crompton, Rachel O’Donnell , James Nicholls, Linda Bauld, Niamh Fitzgerald

Research output: Contribution to journal › Article › peer-review

Abstract / Description of output

Background Public health teams (PHTs) in England and Scotland engage to varying degrees in local alcohol licensing systems to try to reduce alcohol-related harms. No previous quantitative evidence is available on the effectiveness of this engagement. We aimed to quantify the effects of PHT engagement in alcohol licensing on selected health and crime outcomes.
Methods 39 PHTs in England (n=27) and Scotland (n=12) were recruited (of 40 contacted) for diversity in licensing engagement level and region, with higher activity areas matched to lower activity areas. Each PHT’s engagement in licensing for each 6 month period from April 2012 to March 2019 was quantified using a new measure (PHIAL) developed using structured interviews, documentary analyses, and expert consultation. Outcomes examined were ambulance callouts, alcohol-related hospital admissions, alcohol-related and alcohol-specific mortality and violent, sexual and public order offences. Timeseries were analysed using multivariable negative binomial mixed-effects models. Correlations were assessed between each outcome and 18-month average PHIAL score (primary metric), cumulative PHIAL scores and change in PHIAL scores. Additionally, 6-month lagged correlations were also assessed.
Findings There was no clear evidence of any associations between the primary exposure metric and the public health or crime outcomes examined, nor between cumulative PHIAL scores or change in PHIAL score and any outcomes. There were no significant associations in England or Scotland when analysed separately or between outcomes and lagged exposure metrics.
Interpretation There is no clear evidence that allocating PHT resources to engaging in alcohol licensing is associated with downstream reductions in alcohol-related health harms or crimes, in the short term or over a seven year follow-up period. Such engagement likely has benefits in shaping the licensing system to take account of health issues longer term, but as current systems cannot reduce alcohol availability or contain online sales, their potential benefits are somewhat constrained.

Original language	English
Article number	100450
Journal	The Lancet Regional Health Europe
Volume	20
Early online date	30 Jun 2022
DOIs	https://doi.org/10.1016/j.lanepe.2022.100450
Publication status	Published - 1 Sept 2022

Keywords / Materials (for Non-textual outputs)

Alcohol
Alcohol licensing
Ambulance
Crimes
Growth models
Hospital admissions
Policy
Public health
Timeseries

Access to Document

10.1016/j.lanepe.2022.100450Licence: Creative Commons: Attribution (CC-BY)

Cite this

De Vocht, F., Mcquire, C., Ferraro, C., Williams, P., Henney, M., Angus, C., Egan, M., Mohan, A., Purves, R. I., Maani Hessari, N., Shortt, N., Mahon, L., Crompton, G., O’Donnell , R., Nicholls, J., Bauld, L., & Fitzgerald, N. (2022). Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland: A comparative timeseries study between 2012-2019. The Lancet Regional Health Europe, 20, Article 100450. https://doi.org/10.1016/j.lanepe.2022.100450

@article{1e5f1b417ae4492088432d2adf404674,

title = "Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland: A comparative timeseries study between 2012-2019",

abstract = "Background Public health teams (PHTs) in England and Scotland engage to varying degrees in local alcohol licensing systems to try to reduce alcohol-related harms. No previous quantitative evidence is available on the effectiveness of this engagement. We aimed to quantify the effects of PHT engagement in alcohol licensing on selected health and crime outcomes.Methods 39 PHTs in England (n=27) and Scotland (n=12) were recruited (of 40 contacted) for diversity in licensing engagement level and region, with higher activity areas matched to lower activity areas. Each PHT{\textquoteright}s engagement in licensing for each 6 month period from April 2012 to March 2019 was quantified using a new measure (PHIAL) developed using structured interviews, documentary analyses, and expert consultation. Outcomes examined were ambulance callouts, alcohol-related hospital admissions, alcohol-related and alcohol-specific mortality and violent, sexual and public order offences. Timeseries were analysed using multivariable negative binomial mixed-effects models. Correlations were assessed between each outcome and 18-month average PHIAL score (primary metric), cumulative PHIAL scores and change in PHIAL scores. Additionally, 6-month lagged correlations were also assessed.Findings There was no clear evidence of any associations between the primary exposure metric and the public health or crime outcomes examined, nor between cumulative PHIAL scores or change in PHIAL score and any outcomes. There were no significant associations in England or Scotland when analysed separately or between outcomes and lagged exposure metrics. Interpretation There is no clear evidence that allocating PHT resources to engaging in alcohol licensing is associated with downstream reductions in alcohol-related health harms or crimes, in the short term or over a seven year follow-up period. Such engagement likely has benefits in shaping the licensing system to take account of health issues longer term, but as current systems cannot reduce alcohol availability or contain online sales, their potential benefits are somewhat constrained. ",

keywords = "Alcohol, Alcohol licensing, Ambulance, Crimes, Growth models, Hospital admissions, Policy, Public health, Timeseries",

author = "{De Vocht}, Frank and Cheryl Mcquire and Claire Ferraro and Philippa Williams and Madeleine Henney and Colin Angus and Matt Egan and Andrea Mohan and Purves, {Richard I} and {Maani Hessari}, Nason and Niamh Shortt and Laura Mahon and Gemma Crompton and Rachel O{\textquoteright}Donnell and James Nicholls and Linda Bauld and Niamh Fitzgerald",

note = "Funding Information: The ExILEnS project is funded by the UK National Institute for Health Research Public Health Research Programme (15/129/11). The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health. The study received HRA and Health and Care Research Wales (HCRW) Approval (IRAS reference 224965). FdV is partly funded by National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust. The authors would like to thank all participating public health teams and their current or former staff who provided documentation, took part in interviews or responded to queries. We are grateful to Public Health England (now UKHSA), Office for National Statistics, East of England Ambulance Service, London Ambulance Service, North East Ambulance Service, North West Ambulance Service, {"}South Central Ambulance Service, South East Coast Ambulance Service, South Western Ambulance Service, Yorkshire Ambulance Service, East Midlands Ambulance Service, Information Services Scotland, National Records Scotland, the Scottish Government, and Scottish Ambulance Service for providing outcome data. We would like to thank Dr. Isabelle Uny for support with exposure data coding and Eilidh Sutherland for administrative support. We wish to acknowledge the input and advice of international colleagues at workshops during the Kettil Bruun Society annual symposium, and the support of all members of our Study Steering Committee. Funding Information: Colin Angus has received funding related to commissioned research from Systembolaget and Alko, the Swedish and Finnish government-owned alcohol retail monopolies. Other authors declare no competing interests. Funding Information: The ExILEnS project is funded by the UK National Institute for Health Research Public Health Research Programme (15/129/11). The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health. The study received HRA and Health and Care Research Wales (HCRW) Approval (IRAS reference 224965). Publisher Copyright: {\textcopyright} 2022 The Authors",

year = "2022",

month = sep,

day = "1",

doi = "10.1016/j.lanepe.2022.100450",

language = "English",

volume = "20",

journal = "The Lancet Regional Health Europe",

issn = "2666-7762",

publisher = "Elsevier",

}

De Vocht, F, Mcquire, C, Ferraro, C, Williams, P, Henney, M, Angus, C, Egan, M, Mohan, A, Purves, RI, Maani Hessari, N, Shortt, N, Mahon, L, Crompton, G, O’Donnell , R, Nicholls, J, Bauld, L & Fitzgerald, N 2022, 'Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland: A comparative timeseries study between 2012-2019', The Lancet Regional Health Europe, vol. 20, 100450. https://doi.org/10.1016/j.lanepe.2022.100450

TY - JOUR

T1 - Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland

T2 - A comparative timeseries study between 2012-2019

AU - De Vocht, Frank

AU - Mcquire, Cheryl

AU - Ferraro, Claire

AU - Williams, Philippa

AU - Henney, Madeleine

AU - Angus, Colin

AU - Egan, Matt

AU - Mohan, Andrea

AU - Purves, Richard I

AU - Maani Hessari, Nason

AU - Shortt, Niamh

AU - Mahon, Laura

AU - Crompton, Gemma

AU - O’Donnell , Rachel

AU - Nicholls, James

AU - Bauld, Linda

AU - Fitzgerald, Niamh

N1 - Funding Information: The ExILEnS project is funded by the UK National Institute for Health Research Public Health Research Programme (15/129/11). The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health. The study received HRA and Health and Care Research Wales (HCRW) Approval (IRAS reference 224965). FdV is partly funded by National Institute for Health Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol NHS Foundation Trust. The authors would like to thank all participating public health teams and their current or former staff who provided documentation, took part in interviews or responded to queries. We are grateful to Public Health England (now UKHSA), Office for National Statistics, East of England Ambulance Service, London Ambulance Service, North East Ambulance Service, North West Ambulance Service, "South Central Ambulance Service, South East Coast Ambulance Service, South Western Ambulance Service, Yorkshire Ambulance Service, East Midlands Ambulance Service, Information Services Scotland, National Records Scotland, the Scottish Government, and Scottish Ambulance Service for providing outcome data. We would like to thank Dr. Isabelle Uny for support with exposure data coding and Eilidh Sutherland for administrative support. We wish to acknowledge the input and advice of international colleagues at workshops during the Kettil Bruun Society annual symposium, and the support of all members of our Study Steering Committee. Funding Information: Colin Angus has received funding related to commissioned research from Systembolaget and Alko, the Swedish and Finnish government-owned alcohol retail monopolies. Other authors declare no competing interests. Funding Information: The ExILEnS project is funded by the UK National Institute for Health Research Public Health Research Programme (15/129/11). The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health Research, or the Department of Health. The study received HRA and Health and Care Research Wales (HCRW) Approval (IRAS reference 224965). Publisher Copyright: © 2022 The Authors

PY - 2022/9/1

Y1 - 2022/9/1

N2 - Background Public health teams (PHTs) in England and Scotland engage to varying degrees in local alcohol licensing systems to try to reduce alcohol-related harms. No previous quantitative evidence is available on the effectiveness of this engagement. We aimed to quantify the effects of PHT engagement in alcohol licensing on selected health and crime outcomes.Methods 39 PHTs in England (n=27) and Scotland (n=12) were recruited (of 40 contacted) for diversity in licensing engagement level and region, with higher activity areas matched to lower activity areas. Each PHT’s engagement in licensing for each 6 month period from April 2012 to March 2019 was quantified using a new measure (PHIAL) developed using structured interviews, documentary analyses, and expert consultation. Outcomes examined were ambulance callouts, alcohol-related hospital admissions, alcohol-related and alcohol-specific mortality and violent, sexual and public order offences. Timeseries were analysed using multivariable negative binomial mixed-effects models. Correlations were assessed between each outcome and 18-month average PHIAL score (primary metric), cumulative PHIAL scores and change in PHIAL scores. Additionally, 6-month lagged correlations were also assessed.Findings There was no clear evidence of any associations between the primary exposure metric and the public health or crime outcomes examined, nor between cumulative PHIAL scores or change in PHIAL score and any outcomes. There were no significant associations in England or Scotland when analysed separately or between outcomes and lagged exposure metrics. Interpretation There is no clear evidence that allocating PHT resources to engaging in alcohol licensing is associated with downstream reductions in alcohol-related health harms or crimes, in the short term or over a seven year follow-up period. Such engagement likely has benefits in shaping the licensing system to take account of health issues longer term, but as current systems cannot reduce alcohol availability or contain online sales, their potential benefits are somewhat constrained.

AB - Background Public health teams (PHTs) in England and Scotland engage to varying degrees in local alcohol licensing systems to try to reduce alcohol-related harms. No previous quantitative evidence is available on the effectiveness of this engagement. We aimed to quantify the effects of PHT engagement in alcohol licensing on selected health and crime outcomes.Methods 39 PHTs in England (n=27) and Scotland (n=12) were recruited (of 40 contacted) for diversity in licensing engagement level and region, with higher activity areas matched to lower activity areas. Each PHT’s engagement in licensing for each 6 month period from April 2012 to March 2019 was quantified using a new measure (PHIAL) developed using structured interviews, documentary analyses, and expert consultation. Outcomes examined were ambulance callouts, alcohol-related hospital admissions, alcohol-related and alcohol-specific mortality and violent, sexual and public order offences. Timeseries were analysed using multivariable negative binomial mixed-effects models. Correlations were assessed between each outcome and 18-month average PHIAL score (primary metric), cumulative PHIAL scores and change in PHIAL scores. Additionally, 6-month lagged correlations were also assessed.Findings There was no clear evidence of any associations between the primary exposure metric and the public health or crime outcomes examined, nor between cumulative PHIAL scores or change in PHIAL score and any outcomes. There were no significant associations in England or Scotland when analysed separately or between outcomes and lagged exposure metrics. Interpretation There is no clear evidence that allocating PHT resources to engaging in alcohol licensing is associated with downstream reductions in alcohol-related health harms or crimes, in the short term or over a seven year follow-up period. Such engagement likely has benefits in shaping the licensing system to take account of health issues longer term, but as current systems cannot reduce alcohol availability or contain online sales, their potential benefits are somewhat constrained.

KW - Alcohol

KW - Alcohol licensing

KW - Ambulance

KW - Crimes

KW - Growth models

KW - Hospital admissions

KW - Policy

KW - Public health

KW - Timeseries

U2 - 10.1016/j.lanepe.2022.100450

DO - 10.1016/j.lanepe.2022.100450

M3 - Article

C2 - 35799613

SN - 2666-7762

VL - 20

JO - The Lancet Regional Health Europe

JF - The Lancet Regional Health Europe

M1 - 100450

ER -

Impact of public health team engagement in alcohol licensing on health and crime outcomes in England and Scotland: A comparative timeseries study between 2012-2019

Abstract / Description of output

Keywords / Materials (for Non-textual outputs)

Access to Document

Fingerprint

Cite this