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Worrying surge in alcohol-related deaths

ONS data for 2020 shows a 19.6% increase in alcohol-specific deaths compared to 2019.

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Highest annual figure

Yesterday (6 May 2021) the Office for National Statistics published its quarterly data on alcohol specific deaths in England and Wales up to the end of 2020. Provisional data show there were 7,423 deaths (13.0 per 100,000 people) from alcohol-specific causes registered in 2020, a staggering 19.6% increase compared with 2019 (6,209 deaths; 11.0 per 100,000 people) and the highest since this data was first recorded in 2011. Alcohol specific deaths are defined as deaths resulting from health conditions that are a direct consequence of alcohol misuse, such as alcoholic liver disease. The ONS identifies a list of 15 specific medical conditions which fit this definition. Deprivation, a topic much discussed with relation to COVID mortality rates, is a central feature of the analysis. Provisional analysis for England shows that the male alcohol-specific death rate in 2020 was 4.2 times higher in the most deprived local areas than the least deprived local areas (34.1 compared with 8.1 deaths per 100,000, respectively). This margin of difference continues to worsen, the comparable figure from 2019 was that death rates in the most deprived areas was 3.8 times higher than in the least deprived ones.

Key findings

Consistent with previous years, the alcohol-specific death rate for males in 2020 (17.6 deaths per 100,000 males; 4,891 deaths) was around twice the rate for females (8.7 deaths per 100,000 females; 2,532 deaths). When comparing quarterly rates for the English regions in 2020 with the corresponding quarter in 2019 there were significant increases in the North East and London in Quarter 2 2020, in the South West in Quarter 3 2020, and in the North West, West Midlands and South East in Quarter 4 2020. Rates for persons are presented in the reproduced graphic below, though caution is recommended when directly comparing regional rates; because of the relatively smaller number of deaths, rates for English regions by quarter of death registration have a wide degree of statistical uncertainty.

Reasons behind the increase

When trying to understand the elevated rates of alcohol-specific deaths seen since April 2020, the statisticians say that there will be many complex factors, and it may be some time before we fully understand all of these.

However, it seems that increased alcohol consumption by some people during the pandemic is likely to be the most important factor.

Data from Public Health England collected during the coronavirus (COVID-19) pandemic show there have been higher levels of abstinence from alcohol since the first national lockdown in England, compared with drinking habits beforehand. Despite this, data for the same time period show an increase in those reporting higher levels of drinking (greater than 35 units per week).

Other small studies have also found that lockdown may have resulted in increased alcohol consumption in people with alcohol use disorders and relapse for those who were previously abstinent.

Data on the purchasing of alcohol from food retailers have also seen an increase during the pandemic. However, it is possible that these figures reflect the reduction in alcohol purchased and consumed outside of the home. Further, more detailed work is required to understand whether this increase represents a full shift from sales in pubs, bars and restaurants, to sales purchased from supermarkets and shops to be consumed at home as opposed to more drink being purchased overall.

While it is clear that alcohol consumption in higher-risk drinkers has increased during the pandemic, statisticians caution that it will take time before the impact of this on mortality is fully understood.

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