Alcohol Harms in Canada. Dana Riley Katy Molodianovitsh Facilitated by: Jason LeMar Tuesday, November 28, 2017

Transcription

1 Alcohol Harms in Canada Dana Riley Katy Molodianovitsh Facilitated by: Jason LeMar Tuesday, November 28, 2017

2 Disclaimer This document may be freely used without permission for noncommercial purposes only and provided that appropriate credit is given to Public Health Ontario. No changes and/or modifications may be made to the content without explicit written permission from Public Health Ontario. PublicHealthOntario.ca 2

3 Webinar features Adobe connect technology Use landline for audio Chat function to ask questions or if you need help Lecture mode PublicHealthOntario.ca 3

4 Health Promotion Capacity Building We provide training and support services to Ontario s public health and health care intermediaries to assist them to plan, conduct and evaluate interventions which improve health and prevent chronic disease and injury at a community and population level. PublicHealthOntario.ca 4

5 Learning objectives By the end of this webinar session you will be able to: Understand pan-canadian variations in alcohol consumption, drinking patterns and hospitalizations entirely caused by alcohol. Examine the rates of hospitalizations entirely caused by alcohol in Ontario and the LHINs and compare them with the Canadian results using CIHI s Your Health System website and the Health Indicators e- Publications. PublicHealthOntario.ca 5

6 Learning objectives Discuss evidence-based and cost-effective strategies to reduce harm and explore how these strategies are implemented and the importance of monitoring. PublicHealthOntario.ca 6

7 Alcohol Harm in Canada Katy Molodianovitsh, Project Lead, Indicator Research and Development Dana Riley, Program Lead, Canadian Population Health Initiative Canadian Institute for Health Information November 28, 2017

8 CIHI s Strategic Plan,

9 Why focus on Alcohol? Alcohol is part of Canadian culture - 22M Canadians (80%) drank alcohol in M were at high risk for chronic health effects Alcohol harm is a major public health issue Leading risk factor for death, disease and disability Linked to 200+ types of diseases and injury 1 $14.6 billion estimated cost of alcohol abuse in Canada 2 $3.3 billion attributed to direct healthcare costs 2 References: (1) Rehm et. al, (2) Rehm et. al,

10 Alcohol Harm in Canada Examining Hospitalizations Entirely Caused by Alcohol and Strategies to Reduce Alcohol Harm (released June, 2017) 10

11 Media coverage 11

12 Hospitalizations Entirely Caused by Alcohol Indicator Definition Age-standardized rate of alcohol-attributable hospitalizations per 100,000 population aged 10 years and older Hospitalizations for conditions that are 100% attributable to alcohol Inpatient care at general and psychiatric hospitals Report publicly at national, P/T and regional levels Data Sources: Hospital Morbidity Database, Discharge Abstract Database, Ontario Mental Health Reporting System 12

13 Just the tip of the iceberg, but a starting point HOSPITALIZATIONS ENTIRELY CAUSED BY ALCOHOL In-scope HOSPITALIZATIONS FOR PARTIALLY ALCOHOL ATTRIBUTABLE CONDITIONS EMERGENCY DEPT. VISITS Out-of-scope PRIMARY CARE USE AND MORE REHAB SERVICES 13 Copyright Showeet.com

14 Nearly 3 out of 4 hospitalizations entirely caused by alcohol are coded as mental and behavioural disorders Mental health conditions (% of hospitalizations) Physical conditions (% of hospitalizations) Chronic alcohol use Alcohol-induced cirrhosis of disorder (24%) liver (13%) Alcohol withdrawal (23%) Alcohol-induced acute pancreatitis (6%) Harmful alcohol use (18%) Alcohol-induced hepatitis (4%) Alcohol intoxication (9%) Alcohol withdrawal delirium (5%) Alcohol-induced hepatic failure (4%) Toxic effects of alcohol (3%) Sources Hospital Morbidity Database, Discharge Abstract Database, National Ambulatory Care Reporting System and Ontario Mental Health Reporting System, , Canadian Institute for Health Information; population estimates, 2015, Statistics Canada. 14

15 Impact of Hospitalization Entirely Caused by Alcohol In , about 77,000 hospitalizations in Canada were due to conditions entirely caused by alcohol, compared with about 75,000 for heart attacks This is on average, 212 Canadians 10 years and older were hospitalized each day 15

16 Comparability and Actionability This new Hospitalizations Entirely Caused by Alcohol indicator provides a Canada-wide comparable baseline measure of alcohol harm that can help to: Identify the most vulnerable populations Inform decisions regarding the allocation of resources for prevention, management and treatment to improve health outcomes Provide insight into the effectiveness of broader alcohol policies and strategies for reducing alcohol harm Examine the impact of changes to alcohol policies that are underway in several jurisdictions 16

17 Alcohol Harm in Canada Report 17

18 Alcohol Harm in Canada Report Purpose: 1. Present pan-canadian results of the Hospitalizations Entirely Caused by Alcohol indicator 2. Highlight selected policies and interventions that influence harmful alcohol use by province and territory to identify potential opportunities for reducing harm Government Ownership Physical Availability Pricing Screening, Brief Intervention & Referral 18

19 Heavy drinking and alcohol sales across provinces and territories 40% 14 Percentage of population reporting heavy drinking 35% 30% 25% 20% 15% 10% Absolute volume for total per capita sales (litres) 5% 2 0% N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. N.W.T. Nun. Can. 0 Percentage of population reporting heavy drinking, age 12+ Absolute volume for total per capita sales (litres), age 15+ Sources Statistics Canada. Table : Sales and per capita sales of alcoholic beverages by liquor authorities and other retail outlets, by value, volume, and absolute volume, annual. CANSIM (database). Accessed April 7, Statistics Canada. Table : Health indicator profile, annual estimates, by age group and sex, Canada, provinces, territories, health regions (2013 boundaries) and peer groups, occasional. CANSIM (database). Accessed April 7, 2017.

20 Provinces and territories with higher sales also had higher prevalence of heavy drinking 40% 14 Percentage of population reporting heavy drinking 35% 30% 25% 20% 15% 10% Absolute volume for total per capita sales (litres) 5% 2 0% N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. N.W.T. Nun. Can. 0 Percentage of population reporting heavy drinking, age 12+ Absolute volume for total per capita sales (litres), age 15+ Sources Statistics Canada. Table : Sales and per capita sales of alcoholic beverages by liquor authorities and other retail outlets, by value, volume, and absolute volume, annual. CANSIM (database). Accessed April 7, Statistics Canada. Table : Health indicator profile, annual estimates, by age group and sex, Canada, provinces, territories, health regions (2013 boundaries) and peer groups, occasional. CANSIM (database). Accessed April 7, 2017.

21 Higher income groups report more heavy drinking Canadians with the lowest incomes report less heavy drinking Source Statistics Canada. Canadian Community Health Survey Public Use Microdata File (82M0013X ). All computations, use and interpretation of this data are entirely those of the Canadian Institute for Health Information. 21

22 Hospitalizations due to alcohol across Canada Hospitalizations due to alcohol per 100,000 people Age-adjusted rate Canada rate Sources Hospital Morbidity Database, Discharge Abstract Database, National Ambulatory Care Reporting System and Ontario Mental Health Reporting System, , Canadian Institute for Health Information; population estimates, 2015, Statistics Canada. 22

23 23 Canadians with the lowest incomes report less heavy drinking but are more than 2 times as likely to be hospitalized for conditions entirely caused by alcohol.

24 Variations in hospitalizations by age and sex Sources Hospital Morbidity Database, Discharge Abstract Database, National Ambulatory Care Reporting System and Ontario Mental Health Reporting System, , Canadian Institute for Health Information; population estimates, 2015, Statistics Canada.

25 Proportion of government ownership of alcohol retail stores, by province/territory Note Off-sales are not included in the calculation of government ownership. Sources Publicly available policy documents and data provided by provinces and territories during validation. 25

26 Alcohol retail density per 100,000 population, by province/territory 250 Alcohol retail stores per 100,000 population N.L. P.E.I. N.S. N.B. Que. Ont. Man. Sask. Alta. B.C. Y.T. N.W.T. Nun. 26

27 Pricing policies make alcohol less affordable Minimum pricing policy for all beverage types (beer, wine, spirits) N.L. Minimum N.L P.E N.S N. Qu On Ma Sas Alt B. Y.T. N.W Nu pricing P.E.I. N.S...I. N.B.. Que. B. e. Ont. n. k. Sask. a. C. Alta..T. B.C. n. Y.T.. policy for Off premise Y all beverage types (beer, wine, Y spirits) Y Y N* Y Y Y N Y N N N Off premise Y Y Y Y N* Y Y Y N Y N N N On premise Y On Y Y Y Y N Y Y Y Y N N N premise Y Y Y N Y Y Y Y Y N N N Indexed to N N Y Y N* Y Y N N N N N N inflation Indexed to Adjusted Y N Y Y N N Y N N inflation N N Y Y N* Y Y N N N N for percentag e of Adjusted for alcohol percentage of content N N alcohol Note * Quebec content has minimum prices for beer that are indexed to inflation but not for wine and spirits. Sources Publicly available policy documents and validation with provinces and territories. 27 Man N.W. T. Y N Y Y N Y N Y N N N N N Nun.

28 Less than 25% of Canadians reported having spoken to their health provider about alcohol in the past 2 years Note The total sample size in Canada was 4,567. The 3 territories are not reported separately due to small sample sizes (6 respondents in total), but they are included in the Canadian average. Source Canadian Institute for Health Information. How Canada Compares: Results From the Commonwealth Fund s 2016 International Health Policy Survey of Adults in 11 Countries

29 Your Health System (YHS) web tool 29

30 CIHI website and YHS 30

31 Your Health System tool 31

32 Your Health System In Brief tool Your Health System: In Brief Easy-to-understand health system performance web tool geared to Canadian public 32

33 Your Health System In Brief tool 33

34 Your Health System In Depth tool Your Health System: In Depth Expanded set of indicators targeted to regional health authorities and acute care facilities; includes data relating to acute care, long-term care and population health 34

35 Your Health System In Depth tool Hospitalizations Entirely Caused by Alcohol (per 100,000),

36 Your Health System In Depth tool 36

37 Health Indicators e-publication tool 37

38 Health Indicators e-publication A joint product with Statistics Canada tool Hospitalizations Entirely Caused by Alcohol (per 100,000),

39 Health Indicators e-publication Interactive tool Hospitalizations Entirely Caused by Alcohol, (per 100,000), by sex

40 Next Steps & Potential Future Avenues of Work Support CCSA work to examine partially attributable alcohol hospitalizations Explore opportunities to examine the contribution of alcohol to other harms Explore potential for examining ED visits due to alcohol where data allows Examine models of care in hospitals for managing alcohol harms 40

41 Key Resources CIHI website: Alcohol Harm in Canada: Your Health System: Visit Your Health System Health Indicators e-publication: Submit Data and View Standards Methodologies and Decision-support Tools Health Indicators e- Publication Visit Health Indicators e-publication Indicator Library: Submit Data and View Standards Methodologies and Decision-support Tools Indicator Library Visit Indicator Library 41

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43 cihi.ca @cihi_icis