Behind the anti-booze hysteria is one very dodgy fact

One headline stood out in the hysteria over booze and hospital admissions yesterday…

‘Three in four people in A&E at weekend are there because of alcohol’

It refers to a study published in Emergency Medicine which is actually quite useful. It took two sets of data from two different years at the Newcastle Upon Tyne Hospitals NHS Foundation Trust and estimated the proportion of A&E attendances that were alcohol-related.

The Telegraph reports that…

‘The alcohol-related attendance rate varied substantially from four per cent to 60 per cent on weekdays, but rose to 70 per cent at the weekend.’

While focusing on the range, the newspaper fails to mention the average. The study actually concluded that ‘the prevalence rates of alcohol-related attendances were 12 per cent and 15 per cent for the retrospective and prospective cohorts, respectively’.

Is 12-15 per cent a lot? Well, it’s a damn sight lower than the 35 per cent estimate that underpins every single ‘cost of alcohol’ study the government has issued in the last 15 years. As I explained in a recent IEA report, the 35 per cent figure is based on a long-forgotten MORI survey from 2000. It was not based on any clinical evidence at all. Studies like the one published yesterday which bother to breath-test people who come in to A&E typically arrive at much lower estimates.

When I calculated the cost of alcohol to the public purse, I used an estimate that more closely reflects real evidence: 14 per cent. Given that a study in Newcastle — a notorious city for binge-drinking — has arrived at a similar estimate, I suspect that 14 per cent is still too high for the country as a whole. (Incidentally, none of the newspapers that covered this study bothered to mention that Newcastle was the city in question.)

Speaking of the cost of alcohol…

‘Based on the figures, researchers calculated that it costs each emergency unit around £1 million a year just to treat drink-related problems and injuries.’

That seems like a lot of money until you realise that Newcastle’s NHS Trust has an annual budget of £1,006,000,000. Alcohol-related A&E attendances therefore make up 0.1 per cent of its expenditure.

As for the idea that ‘three in four people in A&E at weekend are there because of alcohol’, this claim is made (more or less) in the text of the study — ‘On weekend days, over 70 per cent of attendances were alcohol related…’ — but it is not borne out by the data. Table 2 of the study shows that alcohol-related attendances made up 17.4 per cent of Saturday’s total in the retrospective study and 23.9 per cent of Saturday’s total in the prospective study. For Sundays, the figures were 16.9 per cent and 19.7 per cent.

In other words, alcohol-related attendances made up less than 20 per cent of the weekend total, not ‘three in four’. This is further confirmed by a graph showing the hourly rates at the weekend.

newcastle study graph

The only time when attendances reach 70 per cent is between 2am and 4am when the total number of attendances is very low because most people are in bed. During the daytime, the figure is well below 10 per cent.

With a little scrutiny of the data, it becomes clear that ‘On weekend days, over 70 per cent of attendances were alcohol-related’ should have read: ‘On weekend days, alcohol-related attendances reached a peak of 70 per cent at 3 am’. The sloppy wording of that sentence led the journal to issue a press release titled ‘Almost three quarters of weekend emergency care caseload linked to booze’ and the newspapers took it from there. It will not be long before this ridiculous factoid becomes the conventional wisdom.

  • John Dalton

    Alas this barely scratches the surface of dodgy medical data.

  • Summer Isles

    More top quality ‘medical journalism’, this time from a ‘ Director of Lifestyle Economics ‘.

    The Spectator approach seems to be to set up a Straw Man in the form of the nanny state preventing decent law abiding readers from enjoying life and to then knock it down by getting an economist or historian to ‘analyse’ a medical research paper.

    Anyone, and that means anyone, who has worked in or attended an A/E unit in the evening will be in no doubt as to the harm that alcohol causes. You don’t even need to go to hospital, ask taxi drivers or policeman or walk about any city centre after 8pm and you will be surrounded by people suffering the harmful effects of alcohol.

    The health message is perfectly straightforward, drink in moderation, preferably not on an empty stomach, and in a safe place.

    It’s not rocket science.

    • Aethelbald

      Your second paragraph is itself a strawman “The Spectator approach seems to be…”.

      In your third paragraph you make the point that alcohol is harmful. Few would disagree. The trouble is that it’s also fun, and the idea of drinking in moderation, not on an empty stomach and in a safe place is hopelessly bourgeois.

      The real problem here, I suggest, is that most MSM journalists are still general purpose and have no reputation to lose. It is occasionally the job of people like the author and Tim Hartford to try and prick their stupid bubbles. More power to them.

      • Callipygian

        ‘Few would disagree’. Perhaps in your teetotal circle, but not in mine! Alcohol is NOT (necessarily) harmful. It’s also important to distinguish between types: cider is not a sugary cocktail; wine is not whiskey; beer is not vodka. To the extent that one’s chosen alcohol makes life a little more lustrous, it certainly has benefits, and anyone that studies the body knows that a person’s emotional state is very important to its functioning.

    • JonathanBagley

      Surely, accurate reporting is at worst, harmless?

  • johnfrancish

    If they made a study of which patients had blood in their veins when visiting A&E, we could put down 100% of people being there because they had blood in their veins.

  • Mary Ann

    “which bother to breath-test people who come in to A&E typically arrive at much lower estimates.”

    A figure which would leave out all those who are their because of the behaviour of drunks, the innocent people caught up in RTAs caused by a drunken driver, the battered wives………

  • scaz

    With medical journalism basically lies believe nothing until the competence of the author is checked and they have been rigorously challenged on what they say and write, treat all of them whether government or not like the Daily mail or other tabloid rag they are not interest in your welfare