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Alcohol-fuelled violence on the rise despite falling consumption

Generally speaking, if a population drinks more, then there are more heavy drinkers and more harm from alcohol (similarly if a population drinks less, there will be less harm). But this link now appears…

Alcohol-related violence is rising while per capita consumption is falling. Kirti Poddar

Generally speaking, if a population drinks more, then there are more heavy drinkers and more harm from alcohol (similarly if a population drinks less, there will be less harm). But this link now appears to be unravelling.

One of the core assumptions of public health-focused alcohol research has been the overarching link between levels of alcohol consumption in a population and rates of harm. This has been demonstrated repeatedly, across a range of settings – when per-capita alcohol consumption goes up, rates of alcohol problems (mortality, morbidity and violence, for instance) go up with them.

Recently, these trends have begun to uncouple in a number of places. In Sweden, per-capita consumption of alcohol has fallen in the last five years; while harm rates have remained fairly stable. In England, harm rates have increased sharply since 2004 despite a steady decline in per-capita consumption levels. And a similar pattern is emerging in Australia.

Over the last decade or so, data from the Australian Bureau of Statistics have shown almost no change in the amount of alcohol consumed per person in Australia. In 2000/01, it was 10.15 litres of pure alcohol, while in 2010/11 (the most recent year for which data are available), it was 9.99 litres. In contrast, rates of alcohol-related harm are increasing.

Recent studies in Victoria of both adults and young people have found sharp increases in a range of problems from alcohol. This includes rates of alcohol-related hospitalisations, presentations at emergency departments due to intoxication, late-night assaults, domestic violence involving alcohol and alcohol treatment.

And a national study of alcohol-related harm between 1995 and 2006 found increases in alcohol-related hospitalisations in all states.

But what can explain these diverging trends? First, there’s the possibility that our data systems or coding practices have changed. While most measures of harm have increased in recent years, rates of alcohol-related mortality (the most reliably recorded) have not. So we could be seeing a coordinated shift in how hospital workers, paramedics and police treat alcohol data. This requires a shift in practice across multiple systems (and multiple states).

While possible, this seems unlikely to explain the full extent of the observed trends. And if we assume the available data reflect real underlying changes, then something more interesting is going on.

Australian alcohol consumption patterns may actually be fragmenting. Consider this simple example: a large number of light or moderate drinkers may have slightly reduced their alcohol consumption, while a smaller group of heavy drinkers increased theirs. This would lead to relatively steady per-capita consumption, but the potential for increases in alcohol-related harms (mostly experienced by the heavier drinkers). A recent study of Swedish youth finds some evidence of this kind of polarisation.

Where does this then leave alcohol policy? Public-health oriented alcohol policy has focused on shifting population consumption, through measures such as taxation or physical availability. But maybe the important question is not what effect taxation or earlier closing hours have on consumption levels, but rather what effect they have directly on rates of harm.

In Victoria, several recent analyses suggest that the vast increase in the number of places to buy alcohol has had little impact on overall consumption. But it has directly influenced rates of alcohol-related problems.

Perhaps changes to population level alcohol availability particularly impact risky or marginalised drinkers, those likely to experience harm from their drinking. Studies also show heavy drinkers respond to price changes and that increasing alcohol taxes reduces death and injury.

So it may be that population-level policy solutions still make the most sense, even as population-level consumption and harm rates drift apart. There are still a lot of questions we need research to address: whose drinking is shifting and why? Are particular policy changes likely to improve or exacerbate the recent harm increases? Are there particular demographic or sub-cultural groups of the population that research and policy should be targeting?

Whatever the case, recent increases in alcohol-related harm are of grave concern and it’s critical that we reverse this trend.

This is the fourth part of our series looking at alcohol and the drinking culture in Australia. Click on the links below to read the other articles:

Part One: A brief history of alcohol consumption in Australia

Part Two: Social acceptance of alcohol allows us to ignore its harms

Part Three: My drinking, your problem: alcohol hurts non-drinkers too

Part Five: ‘As a matter of fact, I’ve got it now’: alcohol advertising and sport

Part Six: Advertising’s role in how young people interact with alcohol

Part Seven: Big Alcohol and Big Tobacco – boozem buddies?

Part Eight: Explainer: foetal alcohol spectrum disorders

Part Nine: ‘Valuable label real estate’ and alcohol warning labels

Part Ten: Forbidden fruit: are children tricked into wanting alcohol?

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8 Comments sorted by

  1. Robin Bell

    Research Academic Public Health, at University of Newcastle

    Alcohol related violence visits tragedy and ruin where ever it occurs. But comparing population based measures of consumptions with individual acts of violence is a poor comparison. The problem requires deeper analyses at local community and individual patient data levels.
    More to the point, both alcohol abuse and violence are symptoms of deeper sociological issues. Peoples marginalised by poverty, discrimination, disempowerment and loss of identity become empowered in subcutures that offer the structure and status abscent in main stream society. More often than not these subcultures include drug or alcohol abuse.
    Until the deeper sociological issues are properly identified and addressed, there will never be enough caring or punishment to stop the violence

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  2. Anthony Nolan

    logged in via email @hotmail.com

    Michael Livinstone, the proposition you put is that alcohol causes violence, that alcohol use is on the increase and that this accounts for the rise in violence. Violence may, however, be increasing for reasons specific to violence alone: constant war as infotainment, the u-tubing of down home reality war, video games set in war zones, violent television, cage fighting, internal conflict as an urban environment are all mean by which war now constitutes a normalised reality of the 21C.

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  3. Gary Myers

    logged in via LinkedIn

    "Studies also show heavy drinkers respond to price changes"
    Perhaps they are now responding by drinking in less frequent binges, or dropping the nightly beer but keeping the weekend levels constant.

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  4. Julian Funkyj Cram

    logged in via Facebook

    What has also happened in the last 15 years?

    Sure, we've had shitty governments, shitty companies, and shitty music. All good reasons to have increases of violence, but if those were the real reasons society would have ended in the early 80s </sarcasm>

    No, something probably more pertinent is smoking bans in pubs and clubs.

    I've raised this before on various forums, and I'm so amazed not one single social analyst has thought of this as a topic of research, but it appears to me in every single…

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  5. David

    logged in via Twitter

    Any suggestion it may have something to do with increased monitoring and recording of alcohol related injuries? Seems the most obvious reason.

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  6. Nicky Robinson

    Communicator

    There is a growing divide between those who drink and those who choose not to. At all. I travelled around Europe a year ago and everywhere I went, people were astounded when I said I was Australian - and a teetotaller. I am not religious, nor some elite athlete. Just an average person who started to see the ugly side of alcohol as a young adult, and stopped drinking. Plenty of people DON'T drink alcohol at all. Millions don't - because of religious convictions, meditative practices, personal disciplines…

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  7. account deleted

    logged in via email @gmail.com

    Wowsers have always afflicted Australian society.

    There's nothing new under the sun. They seem to be getting younger, though.

    A good night out might cure that.

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