If only people stayed still

My PC died… so it’s been a while.

The moral panic about bing drinking rumbles on. Yes, people are harming themselves through overdrinking, but this is the same story we had in Hogarth‘s day, and in the late Victorian era, and so on and so on. Anyway, this post is about NHS statistics and regional variation in alcohol-related admissions. According to the Observer, ‘Nine of the 10 areas with the highest rates of emergency admissions are in the north, with Liverpool, Manchester and Middlesbrough in the top five for both men and women’.

At face value, it looks like the people of these cities are more drunk than those of Wokingham. However, there are a number of reasons, some of which can be controlled for, which make this analysis fairly meaningless.

First, and most obviously, there are differences in population. My bet is that it’s your 18-24 or maybe 34 that are more likely to end up in A&E after a night out. So the population of Nottingham are more likely to be part of these statistics than people from Bournemouth. There might be a similar thing with class, although I don’t know which way it would work: one imagines that posh people are less likely to sort things out with fists, but they might also be more likely to fall over, who knows.

Context will also make a difference. Drinking in a place where everyone knows your name (the village pub, the working men’s club) might mean you don’t want to look silly being carried out horizontally. But in my experience there are often fights because people know each other. And then there’s the ‘vertical drinking establishments’ in city centres that are designed to get people to drink loads, with the potential for fights on the lines of ‘did you spill my pint/look at my girlfriend’ etc.

Lastly, though, there’s the issue of people not necessarily drinking / being admitted to A&E where they live. This makes the denominator (bottom part of the fraction) for the statistics more than a tad unreliable. An extreme example is the City of London, that is the financial centre. Few people live there, but loads go there to work. So when you look at crime stats it always comes up really high if you look at crimes per 100,000 residents. The crimes that happen aren’t all happening to the residents, but are reported as such.

For drink-related admissions this could be really quite significant. Places like Liverpool, Manchester and Liverpool are venues for drink-related nights out for young people from further afield. Indeed, Wokingham might have the lowest figures because all its young people go out in London and get admitted to London hospitals, not Wokingham’s. Hen and stag dos will change the way the statistics appear, as people fly in to places like Newcastle, drink and go home.

The biggest influence on this might well be the student population. Depending on how it’s counted a city’s population could be officially much lower than it actually is in term time. Cambridge has a population of 111,000 but has 144,000 registered with the city’s GPs. Many of these are Cambridge Uni and APU students who are there in term-time only… when are they most likely to end up in A&E? At home in the summer, or in term time out of parents’ sight? With population movements like this, especially of the group most likely to end up in hospital, any geographic analysis of alcohol and A&E has a tendency to be meaningless.

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