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User Guide: Local Alcohol Profiles for England 2014

1. i ICD10 0 15 16 24 25 34 35 44 45 54 55 64 65 74 75 Condition code s M F M F M F M F M F M F M F M F Malignant neoplasm of c00 0 00 0 00 0 53 0 38 0 44 0 35 0 44 0 42 0 46 0 43 0 47 0 40 0 40 0 31 0 29 0 24 Lip oral cavity and pharynx C14 Oesophagus C15 0 00 0 00 058 049 061 048 061 053 063 0 53 063 051 060 045 052 0 38 C18 0 00 0 00 016 0 11 O18 O12 0 18 O13 0 19 O14 O19 O13 0 17 O11 0 13 0 11 Colorectal C20 C21 Liver and intrahepatic bile ducts C22 0 00 0 00 015 0 11 O17 0 11 0 17 0 12 O18 O13 0 18 O12 0 16 O10 0 12 0 11 Larynx C32 0 00 0 00 035 0 25 039 0 23 039 0 28 041 O29 0 41 O27 O36 O21 0 28 0 17 Breast C50 0 00 0 00 0 00 0 12 0 00 013 0 00 0 14 0 00 0 15 0 00 014 0 00 012 0 00 0 11 Diabetes mellitus Diabetes mellitus type II E11 0 00 0 00 0 04 0 20 0 04 0 21 0 04 0 22 0 04 0 22 0 03 0 22 0 04 0 20 0 03 0 15 Diseases of the nervous system F sabi G40 0 00 0 00 032 0 22 035 0 20 035 0 24 0 37 025 0 37 0 23 0 33 O18 0 24 0 15 Epilepsy and Status epilepticus G41 Cardiovascular disease Hypertensive diseases 10 115 0 00 0 00 0 22 0 26 0 25 0 17 0 25 0 30 0 27 0 31 0 27 0 25 0 23 0 09 0 15 0 06 Ischaemic heart disease 120 125 0 00 0 00 0 10 0 10 0 10 0 08 0 10 0 10 0 10 0 10 0 10 0 09 0 11 0 07 0 10 0 02 Cardiac arrhythmias 147 48 0 00 0 00 0 15 0 10 0 17 0 11 0 17 0 12 0 18 0 13 0 18 0 12 0 16 0 10 0 12 0 11 Haemorrhagic stroke Mortality 160 162 0 00 0 00 0 18 0 25 0 2
2. O is the observed number of events in the local or subject population in age group ni is the number of individuals in the local or subject denominator population in age group or the 27 User Guide Local Alcohol Profiles for England 2014 Caveats Method used to create this indicator Summary footnote population x period at risk e g person years w is the number or proportion of individuals in the reference or standard population in age group The Excel formulae available at www apho org uk resource item aspx RID 48617 were used to calculate confidence intervals The spreadsheet uses Excel s built in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Mortality data are considered to be complete and robust Records without a valid area code are excluded the number of these is negligible There is the potential for the underlying cause of death to be incorrectly attributed on the death certificate and the cause of death misclassified The directly age standardised rate is the rate of events that would occur in a population with a standard age structure if that population were to experience the age specific rates of the subj
3. Q Barnet gt Q dense 28 828 a Barromin Furness 13 8 sere Q Basildon 2 San Q nanngstoke snd 0 a Q Barsetiaw iraa 3238 Q Rath and North s ae Q vedtord s m A Bexley sss 210 03 a O e Bar Chart Trend data available Cromm Copyright sad database rights 2014 Ordeance Survey 300016969 gt lt gt 2006 2008 2007 2009 2008 2010 20 User Guide Local Alcohol Profiles for England 2014 6 0 Indicator overview and metadata This section provides an overview and metadata for the 26 indicators below No ONDOOAFRWDNDN Indicator Name click link below Months of life lost males Months of life lost females Alcohol specific mortality males Alcohol specific mortality females Mortality from chronic liver disease males Mortality from chronic liver disease females Alcohol related mortality males Alcohol related mortality females Alcohol specific hospital admission under 18s Alcohol specific hospital admission males Alcohol specific hospital admission females Alcohol related hospital admission broad males Alcohol related hospital admission broad females Alcohol related hospital admission narrow males Alcohol related hospital admission narrow females Admission episodes for alcohol related conditions broad Admission episodes for alcohol related conditions narrow Alcohol related recorded crimes Alcohol related violent crimes Alcohol relate
4. 1003 2487 73 1246 93 18 318 Ei 315 23 N4 25 m Rs ne Maps Atlas Data Resources Area profile summary i Download this profile as a PDF Footnotes tab un provides definitions for data indicators ann 159 21 129 7206 761 68 mn 2051 72 1050 39 User Guide Download E shot Sien Up es Maps Atlas Data Resources Click here to display all areas in England User Guide Local Alcohol Profiles for England 2014 5 4 Downloading data Data including trend data for some indicators can be downloaded using the Data tab Data are available for local authorities PHE centres and for England For the 2014 profiles the data download also provides data for former government office regions l APE 4 User Guide Download C shot Sian Up Contact Profiles Maps Atlas data Resources Local Alcohol Profiles for England Data Downloads Click on the links below to access alcohol indicators at Local Authority and Primary Care Trust level Local Alcohol Profile datasets North West Public Health Observatory data User Guide For guidance and methods advice downtoad our Local Authority alcohol indicators 2014 Update a User Guide Associated documents Requires Adobe Acrobat Reader A Tovograpty of Drinking Behaviours in England Alcohol E shot Sign Up Keep in touch with the latest alcohol research m Results from the 2
5. Denominator source Confidence interval methodology fractions were not available for children For a more information on the broad and narrow measures see section 2 2 The Health and Social Care Information Centre HSCIC Mid year population estimates 2012 by five year age bands all persons The Office for National Statistics Byar s methodology was used to generate 95 confidence intervals as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available from www apho org uk resource item aspx RID 48457 An accompanying Excel spreadsheet replicating all formulae is also available from this website The confidence limits for the directly age standardised rate lower are given by SR SR a x Ower o Var O DSR jyye DSR pe One O where Var O O is the total observed count of events in the local or subject population Ojower ANd Oupper are the lower and upper confidence limits for the observed count of events Var O is the variance of the total observed count O DSR is the directly age standardised rate Var DSR is the variance of the directly age standardised rate D Using Byar s method the 100 1 a confidence limits for the observed number of events are given by 3 1 z 0 20 lenn low 90 is 3 1 Z uper 0 1 X0 1 3 iz where z is the 100 1 a
6. User Guide Local Alcohol Profiles for England 2014 Caveats to 21 units 22 to 35 units 36 to 50 units and gt 50 units Bis is the mean coefficient value for covariate i state j listed in Tables 1 to 6 se is the standard error of B listed in Tables 1 to 6 1 000 estimates were generated for the prevalence of people who abstain from drinking and lower increasing and higher risk drinkers of the drinking population using equations expla E AEN DE eA fors 1 1 0 eee where s are the states 1 Abstainers Consume gt 0 to 9 units Consume 10 to 14 units Consume 15 to 21 units Consume 22 to 35 units Consume 36 to 50 units Consume gt 50 units is the vector of attributes of the ith local authority is the sampled vector of coefficients for state s 8 t are the sampled vector of coefficients for states 2 to 7 By replacing the mean B values Tables 3 to 8 with the sample from the B distribution a different sampled estimate for each of the 1 000 estimates is calculated This gives a sampled distribution for each state By sorting the 1 000 estimates in ascending order for each state in turn then removing the first and last 2 5 of observations gives a sampled 95 confidence interval General Lifestyle Survey data are based on self reported drinking behaviour and self reported consumption which may be prone to respondent bias The General Lifestyle Survey only includes people in priv
7. data Alcohol specific mortality is based on three consecutive years of mortality data and is a directly age standardised rate Mortality from chronic liver disease is based on three years of mortality data and is a directly age standardised rate Finally alcohol related mortality is based on one year of mortality data and is a directly age standardised rate 22 User Guide Local Alcohol Profiles for England 2014 Indicator details months of life lost due to alcohol males and females IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition Numerator source Denominator definition 1 and 2 Months of life lost due to alcohol males and females An estimate of the increase in life expectancy at birth which would be expected if all alcohol related deaths among males females aged less than 75 years were prevented Males and females aged less than 75 years Calendar years 2010 2012 three year moving average Trends are available for years 2006 2008 2007 2009 2008 2010 and 2009 2011 Months of life lost due to alcohol males and females aged less than 75 years Produced annually by the Knowledge and Intelligence Team North West The Office for National Statistics provides Knowledge and Intelligence Teams with the annual extract and mid year population estimates around July September Th
8. of individuals in the reference or standard population in age group The Excel formulae available at www apho org uk resource item aspx RID 48617 were used to calculate confidence intervals The spreadsheet uses Excel s built in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Hospital admission data can be coded differently in different parts of the country In some cases details of the patient s residence are insufficient to allocate the patient to a particular area and in other cases the patient has no fixed abode These cases are included in the England total but not in the local authority or PHE centre figures Male female alcohol specific hospital admission are calculated as follows Select hospital episode statistics records where the admission is a finished episode epistat 3 the admission is an ordinary admission day case or maternity classpat 1 2 or 5 the sex of the patient is valid sex 1 or 2 there is a valid age at start of episode startage between 0 120 or between 7001 7007 the region of residence is one of the English regions no fixed abode or unknown resgor lt K or U or Y the episode end date epiend fall
9. 2 7 Changes to the employees in bars indicator The Business Register and Employment Survey BRES data which are used to construct the Employees in Bars indicator underwent changes in 2011 in relation to working owners The changes aimed to ensure that all limited companies excluding limited liability partnerships correctly filled out the survey For example research conducted by the Office for National Statistics revealed that directors of limited companies classified themselves in the survey as working proprietors despite the guidance from Her Majesty s Revenues and Customs stating they should be P Further information is available from www who int classifications icd en 8 User Guide Local Alcohol Profiles for England 2014 considered employees of the company As a result of the changes some directors previously classified as working owners will now be classified as employees this increased the BRES estimate of employees and caused a discontinuity in the 2011 and 2010 surveys In their Working owners discontinuity in the Business Register and Employment Survey BRES briefing available at www ons gov uk ons guide method method quality specific labour market business register and employment survey bres bres working owners discontinuity article pdf the Office for National Statistics note that counting directors of limited companies as employees rather than working owners should not
10. 3yr_Qtle 5 male female White Black Asian AG15 AG20 AG25 AG30 AG35 AG40 AG45 AG50 AG55 AG60 AG65 AG70 AG75 IMD_LSOA_Qtile 1 IMD_LSOA_Qtile 2 IMD_LSOA_Qtile 3 o j oj ojojojojojojojojojloj IMD_LSOA Qtile 4 IMD_LSOA_Qtile 5 Peopleandplaces A Peopleandplaces B Peopleandplaces C Peopleandplaces D Peopleandplaces E Peopleandplaces F Peopleandplaces G Peopleandplaces H Peopleandplaces l Peopleandplaces J Peopleandplaces k Peopleandplaces L Peopleandplaces M Peopleandplaces U The reference category is Abstain This parameter is set to zero because it is redundant TT User Guide Local Alcohol Profiles for England 2014 Table 6 Estimated model parameters for drinkers consuming 22 to 35 units with respect to the base category abstainers 95 Confidence Interval for Exp B y Lower Upper NewDrinkCat ig Bound Bound 22 to 35 Intercept AS_Adm_ 3yr_Qtle 1 AS_Adm_ 3yr_Qtle 2 AS_Adm_ 3yr_Qtle 3 AS_Adm_ 3yr_Qtle 4 AS_Adm_ 3yr_Qtle 5 male female White Black Asian AG15 AG20 AG25 AG30 AG35 AG40 AG45 AG50 AG55 AG60 AG65 AG70 AG75 IMD_LSOA_Qtile 1 IMD_LSOA_Qtile 2 IMD_LSOA_Qtile 3 o j ojojojojojojojojojoljoj IMD_LSOA_Qtile 4 IMD_LSOA_Qtile 5 Peopleandplaces A Peopleandplaces B Peopleandplaces C Peopleandplaces D Peopleandplaces E Peopleandplaces F Peopleandplaces G Peopleandplac
11. England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts and PHE centres The data download also provides data for former government office regions Deaths from alcohol related conditions Appendix 1 based on underlying cause of death registered in the calendar year 2012 for males and females of all ages Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable fractions were not available for children Annual death extracts from the Office for National Statistics Mid year population estimates 2012 by five year age bands males and females The Office for National Statistics Byar s methodology was used to generate 95 confidence intervals as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers 32 User Guide Local Alcohol Profiles for England 2014 below correspond to those in the briefing available from www apho org uk resource item aspx RID 48457 An accompanying Excel spreadsheet replicating all formulae is also available from this website The confidence limits for the directly age standardised rate are given by DSR DSR FODOR y o o Var O DSR DSR ye DSR pane x O O where Var O O is the total observed count of events in the loca
12. age standardised rates In 2009 a decision was made to revise the European standard population in recognition that the population of Europe is ageing This methodological change will cause age standardised mortality hospital admission rates to increase in most cases because the new European standardised population is weighted towards older ages and most deaths hospital admissions occur at older ages Consequently the age standardised rates calculated using the new European standard population would differ from the age standardised rates calculated using the old European standard population without there being any underlying change in the overall number of deaths hospital admissions For more information about these changes and their implications see guidance from the Office for National Statistics www ons gov uk ons guide method user guidance health and User Guide Local Alcohol Profiles for England 2014 life events revised european standard population 201 3 2013 esp index html Indicators that have been updated by the Knowledge and Intelligence Team North West for the Local Alcohol Profiles for England 2014 use the new European standard population Trend data have been updated using the new European standard population 2 5 Changes to the recording of mortality data There have been changes to the manner in which the text about causes of death on death certificates are translated by the Office for National Statistics into International C
13. census 2001 England and former government office regions Health Survey for England commissioned by the Department of Health and carried out by the Joint Health Survey Unit of Social and Community Planning Research and of the Department of Epidemiology and Public Health 83 User Guide Local Alcohol Profiles for England 2014 Denominator definition Denominator source Confidence interval methodology Caveats at University College London Local authority East Midlands Public Health Observatory now the Knowledge and Intelligence Team East Midlands England and former government office regions Total number of respondents with valid measurements on drinking habits in the last week aged 16 and over in the Health Survey for England 2007 2008 Local authority Not applicable England and former government office regions Health Survey for England commissioned by the Department of Health Information Centre and carried out by the Joint Health Surveys Unit of National Centre for Social Research the Department of Epidemiology and Public Health at the Royal Free and University College Medical School London Local authority Not applicable The methodology for the Middle Super Output Area level estimate confidence intervals is available at www apho org uk resource item aspx RID 96790 The confidence intervals for the aggregated estimates have been calculated using an approximate method details available at www apho or
14. due to the use of small resident population figures as the denominator of the crime rate The transient population that migrates into these areas on a daily basis either for work or leisure will not be reflected in the resident population figures Because data are based on crimes rather than offender no data are available on the sex or age of the offender Changes in population estimates between years must be borne in mind when comparing changes in crime rates Rounded resident populations provided by the Office for National Statistics are used to generate rates see Table 8c available through this link for further details on the populations www ons gov uk ons guide method method quality specific crime statistics methodology user guide to crime statistics pdf Crime data are produced at Community Safety 64 User Guide Local Alcohol Profiles for England 2014 Method used to create this indicator Partnership level At the time of their introduction Community Safety Partnerships were formed to match each local authority area As a result of mergers of both local authorities and Community Safety Partnerships availability of data for local authorities in England changes from year to year Where an area has no numerator or denominator data displayed the rate is combined with another area s Please see Information on police recorded crime at Community Safety Partnership level for further details ons gov uk ons rel crime
15. external cause that is attributable to the exposure of a specific risk factor such as alcohol in a given population Local Alcohol Profiles for England use attributable fractions to estimate the number of deaths and hospital admissions that are related to alcohol consumption Attributable fractions may be estimated directly for example by assigning specific attributable fractions to external causes of morbidity and mortality Alternatively indirectly estimated attributable fractions can be derived from the relative risk associated with the exposure of interest in combination with information about the prevalence of the exposure in the target population The population attributable fraction calculation assumes a causal association between risk factor and outcome meaning that the attributable fraction can also be viewed as the expected proportional reduction in cases of an outcome arising in the population as a result of removing the exposure in this case alcohol Appendix 1 shows the attributable fractions used to estimate the number of alcohol related deaths and hospital admissions reported in Local Alcohol Profiles for England 2014 These alcohol attributable fractions were updated in 2014 and are taken from Jones et al 2014 Sex and age specific alcohol attributable fractions reflect the difference in exposure prevalence and physiological differences between males and females and between age groups The table includes outcomes with a negati
16. locality 24 User Guide Local Alcohol Profiles for England 2014 Summary footnote 7 Calculate local regional and England three year attributable years of life lost rates per 10 000 population by age group and sex 8 Standardise to the European standard population in age groups 9 This gives the average years of life lost for each year lived in an area 10 Multiply by 12 to convert to months and by life expectancy at birth to project lifetime effect This methodology was developed by Tom Hennell Knowledge and Intelligence Team North West Comparability ratios were used in the calculation of trend data see section 2 5 for more details An estimate of the increase in life expectancy at birth that would be expected if all alcohol related deaths among males females aged less than 75 years were prevented Knowledge and Intelligence Team North West from 2010 2012 England and Wales life expectancy tables for males and females from Office for National Statistics alcohol related deaths from the Public Health Mortality File 2010 2012 for males females aged less than 75 years and the Office for National Statistics mid year population estimates for 2010 2012 25 User Guide Local Alcohol Profiles for England 2014 Indicator details alcohol specific mortality males and females IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness G
17. making assumptions about relationships in the data The suitability of the chosen models for the given data and the validity of the model in describing real world dynamics have a bearing on the nature and magnitude of the errors introduced A key source of modelling error arises from omitting variables that would otherwise help improve the model predictions either by error or because there are no available or reliable data source for them The model based estimate generated for a particular area is the expected measure for that area based on its population characteristics and is not an estimate of the actual prevalence In statistical terms the model based estimate is actually a biased estimate of the true value for the area and as such should be treated with caution As mentioned above the model based estimates are unable to take account of any additional local factors that may impact on the true prevalence rate To interpret the estimates National Centre for Social Research recommend that users adopt statements such as given the characteristics of the local population we would expect approximately x of adults within Local Authority Y to indulge in binge drinking 85 User Guide Local Alcohol Profiles for England 2014 Method used to create this indicator Summary footnote The Health Survey for England questions concerning alcohol consumption ask respondents to give the number of days they drank alcohol in the previou
18. of weapons and public order offences Similarly homicide is now a separate category in its own right rather than being included in the violence with injury category Exploitation of prostitution and soliciting for the purposes of prostitution offences previously included under sexual offences are also now moved into a separate offence category of miscellaneous crimes against society All recorded crime data currently available from Office for National Statistics and for previous years has now been amended to reflect these changes The Office for National Statistics publishes data split into 21 offence sub groups with raw data available for individual offences within these broader categories Therefore for the purposes of consistency with previous versions of the Local Alcohol Profiles for England the Knowledge and Intelligence Team North West has produced the current alcohol related recorded crime indicator using updated crime data but based on the same crime groupings as last year where possible For more information about where these changes apply see the crime indicators detailed in section 6 3 10 User Guide Local Alcohol Profiles for England 2014 3 0 Alcohol attributable fractions 3 1 Alcohol attributable fractions used to calculate alcohol related mortality and hospital admissions Attributable fraction values or population attributable fractions are the proportion of a health condition or
19. the rate r are given by lower Tower 7 Oe where Ojower ANd Oupper are the lower and upper confidence limits for the observed count of events Using Byar s method the 100 1 c confidence limits for the observed number of events are given by 63 User Guide Local Alcohol Profiles for England 2014 Caveats 3 1 z O e O x wA lowe 90 is Oper O 1 d k opat 90 1 3 0 1 where z is the 100 1 ca 2 th percentile value from the standard normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the standard normal distribution The Excel formulae available at www apho org uk resource item aspx RID 48457 were used to calculate confidence intervals The spreadsheet uses Excel s built in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Crimes that have not been reported to the police or incidents that the police decide not to record are not included Caution needs to be taken when considering crime rates in London and other city centre areas due to the very small populations in these areas The high reported crime rates in city centres are partly
20. 0 0 22 0 20 0 27 0 21 028 022 026 0 19 0 19 0 15 0 13 s Semorhadic Stoke Morbidity a 000 000 020 011 022 014 023 011 024 010 024 012 021 016 O17 015 Ischaemic stroke Mortality 163 166 0 00 0 00 0 01 0 09 0 02 0 14 0 02 0 09 0 03 0 08 0 04 0 10 0 01 0 16 0 00 0 14 Ischaemic stroke Morbidity ee 0 00 0 00 0 00 0 06 0 01 0 07 0 01 0 06 0 02 0 06 0 03 0 07 0 00 0 07 0 01 0 06 Oesophageal varices Mortality 0 00 0 00 0 70 064 073 062 074 068 076 069 0 76 066 0 70 058 0 55 0 57 Oesophageal varices Morbidity 189 0 00 0 00 044 0 31 047 041 048 0 38 0 50 040 0 50 041 044 042 0 33 0 51 Respiratory infections J10 0 0 00 0 00 012 0 07 0 14 0 06 0 14 0 08 O15 0 08 0 15 0 08 O13 0 05 0 10 0 03 J11 0 Pneumonia J12 J15 J18 Digestive disease Unspecified liver disease Mortality K73 0 00 0 00 0 70 0 64 0 73 062 0 74 O68 0 76 O69 0 76 O66 0 70 0 58 0 55 0 57 93 Local Alcohol Profiles for England 2014 User Guide a ICD10 0 15 16 24 25 34 35 44 45 54 55 64 65 74 75 Condition code s M F M F M F M F M F M F M F M F Unspecified liver disease Morbidity K74 0 00 0 00 0 44 0 31 0 47 0 41 0 48 0 38 0 50 0 40 0 50 0 41 0 44 0 42 0 33 0 51 Cholelithiasis gall stones K80 0 00 0 00 0 25 0 17 0 28 0 17 0 28 0 19 0 30 0 19 0 30 0 18 0 27 0 16 0 21 0 14 K85 0 00 0 00 0 35 0 17 0 39 0 14 0 40 0 20 0 43 O21 0 43 0 18 0 35 0 1
21. 0 08 0 17 0 06 0 12 0 04 0 05 0 02 Other unintentional injuries Mortality Restof 0 00 0 00 0 32 0 18 0 37 0 17 0 37 0 20 040 0 19 0 38 0 14 0 26 0 08 0 12 0 04 r A RN X 0 00 0 00 0 14 0 008 0 17 O08 0 16 0 09 0 18 0 08 O17 0 06 0 12 004 0 05 0 02 Other unintentional injuries Morbidity es Intentional injuries Intentional self harm Mortality X60 0 00 0 00 032 0 18 0 37 O17 O37 0 20 040 019 0 38 0 14 0 26 0 08 0 12 0 04 pan 0 00 0 00 0 14 0 08 0 17 0 08 0 16 0 09 0 18 0 08 0 17 0 06 0 12 0 04 0 05 0 02 Intentional self harm Morbidity excl X65 94 Local Alcohol Profiles for England 2014 User Guide za ICD10 0 15 16 24 25 34 35 44 45 54 55 64 65 74 75 Condition code s M F M F M F M F M F M F M F M F Event of undetermined intent Mortality Y10 0 00 0 00 032 0 18 0 37 O17 O37 0 20 040 019 0 38 0 14 0 26 0 08 0 12 0 04 Ven 0 00 0 00 0 14 0 08 0 17 0 08 0 16 0 09 0 18 0 08 0 17 0 06 0 12 0 04 0 05 0 02 Event of undetermined intent Morbidity excl Y15 Assault Mortality X85 0 00 0 00 0 32 0 18 0 37 0 17 0 37 0 20 0 40 0 19 0 38 0 14 0 26 0 08 0 12 0 04 Assault Morbidity er 0 00 0 00 014 0 08 0 17 0 08 016 0 09 0 18 0 08 0 17 006 0 12 004 0 05 0 02 V021 V029 V031 V039 V041 V049 V092 V093 V123 V129 V133 V139 V143 V149 V194 V196 V203 V209 V213 V219 V223 V229 V233 V239 V243 V249 V253 V259 V263 V269 V273 V279 V283 V289 V294 V299 V304 V309 V314 V319 V324 V329 V334 V339 V344 V349
22. 0 possible diagnostic codes from diag_nn the code s with the largest alcohol attributable fraction is selected In the event of there being two or more codes with the same alcohol attributable fraction within the same episode select the one from the lowest diagnostic position diag_nn Diagnostic position takes an integer value between 1 and 20 corresponding to the 20 diagnosis fields diag_01 to diag_20 3 Calculate directly standardised rates by aggregating alcohol related admissions above by 5 year age groups 0 4 5 9 to 85 89 and 90 years and over for each area of residence using mid year population estimates to derive age group and sex specific rates for each area calculating directly age standardised rate per 100 000 population standardised to the European standard population The directly age standardised rate is the rate of events that would occur in a standard population if that population were to experience the age sex specific rates of the subject population Explicitly b3 Wil DSR x 100 000 Ev i expressed per 100 000 population where w is the number or proportion of individuals in the standard population in age sex group i ris the crude age sex specific rate in the subject poptlation in age sex group given by n where O is the observed number of events in the subject population in age sex group i 58 User Guide Local Alcohol Profiles for England 2014 Summa
23. 00 1 00 1 00 1 00 1 00 1 00 1 00 Excess alcohol blood levels R78 0 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Ethanol poisoning T51 0 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Methanol poisoning T51 1 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Toxic effect of alcohol unspecified T51 9 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Accidental poisoning by and exposure X45 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 to alcohol Intentional self poisoning by and X65 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 exposure to alcohol Poisoning by and exposure to alcohol Y15 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 undetermined intent Evidence of alcohol involvement 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Y90 determined by blood alcohol level Evidence of alcohol involvement Y91 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 determined by level of intoxication Partially attributable conditions Chronic conditions Infectious and parasitic diseases Tubaroulasic fe 4 0 00 0 00 030 019 033 017 O34 O21 O35 022 035 020 031 O14 0 22 0 11 92 Local Alcohol Profiles for England 2014 User Guide
24. 012 Lape stakeholder user survey evidenon policy and madia artides Sign up far our E shot Admission episodes for alcohol related conditions Department of Health data Quarterly Data 2008 09 Quarter 1 to 2012 13 Quarter 4 Updated 10 09 2013 Annual Trends 2002 03 to 2011 12 Updated 10701 2013 K Subanalysis by 10 conditions 2007 08 Subanalysis by 10 conditions 2008 09 Updated 16 10 10 Associated documents Am Alcohol related admissions summary of responses to the consultation and future plans ia Consultation document Methods used to estimate alcohol related hospital admissions for England 19 User Guide Local Alcohol Profiles for England 2014 5 5 Associated reports and maps The Maps tab allows access to mapped data for the alcohol indicators by local authority LAPE Local Alcohol Profiles for England Maps Se Te Profiles Atlas Data Resources Click on the inks below to access mapped data for the alcohol indicators at Local Authority level Alcohol attributable mortality Male Aicohobattributeble mortality Female Aleohol specific mortality Male Alcohol specific mortality Female Months of life lost Male Months of lite lost Female Mortality from chronic liver disease Mele Mortality from chronic liver disease Female Mortality from land wansport accidents Admissions Alcohol attributable hospital admissions Male Alcohoh ettributable hospital edmission
25. 2 0 20 0 10 Pre K86 1 Acute and chronic pancreatitis excl K85 2 Pregnancy and childbirth Spontaneous abortion 003 0 00 0 00 0 00 0 08 0 00 0 08 0 00 0 1141 0 00 0 11 0 00 0 00 0 00 0 00 0 00 0 00 P05 0 05 0 05 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 0 00 Low birth weight PO7 Partially attributable conditions Acute conditions Unintentional injuries Road pedestrian traffic accidents 0 00 0 00 042 0 25 0 46 0 22 0 39 0 22 041 0 23 0 28 0 14 0 16 0 07 0 06 0 03 Mortality Road pedestrian traffic accidents 0 00 0 00 0 28 0 17 O31 O15 0 26 0 15 0 27 O15 0 19 0 09 O11 0 05 0 04 0 02 Morbidity Poisoning Mortality X40 0 00 0 00 0 32 0 18 0 37 0 17 0 37 0 20 0 40 0 19 0 38 0 14 0 26 0 08 0 12 0 04 X43 0 00 0 00 0 14 0 08 0 17 0 08 0 16 0 09 0 18 0 08 0 17 0 06 0 12 0 04 0 05 0 02 Poisoning Morbidity excl X45 Fall injuries Mortality Wo0 0 00 0 00 0 32 0 18 0 37 0 17 0 37 0 20 0 40 0 19 0 38 0 14 0 26 0 08 0 12 0 04 Fall injuries Morbidity W19 0 00 0 00 0 14 0 08 O17 O08 0 16 0 09 0 18 0 08 O17 0 06 0 12 004 0 05 0 02 Fire injuries Mortality x00 0 00 0 00 0 32 0 18 0 37 0 17 0 37 0 20 0 40 0 19 0 38 0 14 0 26 0 08 0 12 0 04 Fire injuries Morbidity X09 0 00 0 00 0 14 0 08 0 17 0 08 0 16 0 09 0 18 0 08 0 17 0 06 0 12 0 04 0 05 0 02 Drowning Mortality W65 0 00 0 00 0 32 0 18 0 37 0 17 0 37 0 20 0 40 0 19 0 38 0 14 0 26 0 08 0 12 0 04 Drowning Morbidity W74 0 00 0 00 0 14 0 08 0 17 0 08 0 16 0 09 0 18
26. 2 th percentile value from the 54 User Guide Local Alcohol Profiles for England 2014 Caveats Standard Normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the Standard Normal distribution The variances of the observed count O and the DSR are estimated by Var O 50 1 20 Var DSR nro where t w O is the observed number of events in the local or subject population in age group i ni is the number of individuals in the local or subject denominator population in age group or the population x period at risk e g person years w is the number or proportion of individuals in the reference or standard population in age group The Excel formulae available at www apho org uk resource item aspx RID 48617 were used to calculate confidence intervals The spreadsheet uses Excel s built in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Hospital admission data can be coded differently in different parts of the country In some cases details of the patient s residence are insufficient to allocate the patient to a particular area and in other cas
27. 5 Confidence Interval for Exp B y Lower Upper NewDrinkCat ig Bound Bound Intercept AS_Adm_3yr_Qtle 1 AS_Adm_3yr_Qtle 2 AS_Adm_ 3yr_Qtle 3 AS_Adm_3yr_Qtle 4 AS_Adm_ 3yr_Qtle 5 male female White Black Asian AG15 AG20 AG25 AG30 AG35 AG40 AG45 AG50 AG55 AG60 AG65 AG70 AG75 IMD_LSOA_Qtile 1 IMD_LSOA_Qtile 2 IMD_LSOA_Qtile 3 o j ojojojojojojojojojojoj IMD_LSOA_Qtile 4 IMD_LSOA_Qtile 5 Peopleandplaces A Peopleandplaces B Peopleandplaces C Peopleandplaces D Peopleandplaces E Peopleandplaces F Peopleandplaces G Peopleandplaces H Peopleandplaces l Peopleandplaces J Peopleandplaces k Peopleandplaces L Peopleandplaces M Peopleandplaces U The reference category is Abstain This parameter is set to zero because it is redundant Summary Abstainers footnote Mid 2009 synthetic estimate of the percentage of 80 User Guide Local Alcohol Profiles for England 2014 abstainers in the population aged 16 years and over who report abstaining from drinking Estimates were derived from a statistical model developed to estimate the percentage of abstainers lower risk as a percentage of drinkers increasing risk as a percentage of drinkers and higher risk drinkers as a percentage of drinkers in local authority populations The Local Alcohol Profiles for England 2012 refresh of this indicator and included in subsequent refreshes of data w
28. People and Places classification was included to capture sub region level unobserved heterogeneity Predicted probabilities and 2001 Lower Super Output Areas prevalence estimates For each 2001 Lower Super Output Areas a series of population subgroups were defined according to a Sex male female b Ethnicity white Asian and black other c Age band 16 19 20 24 70 74 and 75 years Along with 2001 Lower Super Output Areas level covariate values for Index of Multiple Deprivation 2010 and alcohol specific hospital admission 2007 08 to 2009 10 hospital episode statistics and P People and Places classification The updated covariate values were then substituted in the final multinomial logistic regression model and predicted probabilities obtained using reih P x PETE A FA fors 1 1 RO EA where s are the states 1 Abstainers Consume gt 0 to 9 units Consume 10 to 14 units Consume 15 to 21 units Consume 22 to 35 units Consume 36 to 50 units Consume gt 50 units x is the vector of attributes of the th local authority amp is the vector of coefficients Tables 3 to 8 for state S Bare the vector of coefficients for states 2 to 7 Mid 2010 population estimates for Lower Super Output Areas by age bands 16 19 20 25 70 74 NOOO BW PD 73 User Guide Local Alcohol Profiles for England 2014 75 sex and ethnicity were obtained from Office for National Statistics These estimated
29. Profiles for England 2014 The abstainers lower risk increasing risk and higher risk drinking estimates were developed by the former North West Public Health Observatory now the Knowledge and Intelligence Team North West and the binge drinking estimates by the National Centre for Social Research and East Midlands Public Health Observatory now the Knowledge and Intelligence Team East Midlands These local area synthetic estimates are generated from statistical models combining national survey and local area level data 67 User Guide Local Alcohol Profiles for England 2014 Indicator details alcohol consumption by adults synthetic estimates IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition 21 22 23 and 24 Abstainers from drinking lower risk drinking as a percentage of drinkers increasing risk drinking as a percentage of drinkers and higher risk drinking as a percentage of drinkers synthetic estimates Percentage of adults aged 16 and over who abstain from drinking and who are lower increasing higher risk drinkers as a percentage of drinkers Persons aged 16 years and over Multinomial logistic regression model calculated using the General Lifestyle Survey 2008 and 2009 Predicted probabilities from the model are applied to mid 2010 population data Estimate of the percenta
30. Public Health Observatories datasets for further information www apho org uk resource view aspx RID 91 736 86 User Guide Local Alcohol Profiles for England 2014 6 5 The alcohol economy 26 Employees in bars percentage of all employees The proportion of employees working in bars has been calculated for each area using data from the Business Register and Employment Survey carried out on behalf of the Office for National Statistics See section 2 7 for further details on this indicator 87 User Guide Local Alcohol Profiles for England 2014 Indicator details employees in bars ID Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition Numerator source Denominator definition 26 Employees in bars percentage of all employees The number of employees employed in bars as a percentage of all employees Persons employed in bars Single year September 2012 The number of employees employed in bars as a percentage of all employees Produced annually by the Knowledge and Intelligence Team North West The Office for National Statistics ONS publishes the Business Register and Employment Survey BRES data of the following year 2012 data published in 2013 England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts
31. V354 V359 V364 V369 V374 V379 V384 V389 V394 V399 V404 V409 V414 V419 V424 V429 V434 V439 V444 V449 V454 V459 V464 V469 V474 V479 V484 V489 V494 V499 V504 V509 V514 V519 V524 V529 V534 V539 V544 V549 V554 V559 V564 V569 V574 V579 V584 V589 V594 V599 V604 V609 V614 V619 V624 V629 V634 V639 V644 V649 V654 V659 V664 V669 V674 V679 V684 V689 V694 V699 V704 V709 V714 V719 V724 V729 V734 V739 V744 V749 V754 V759 V764 V769 V774 V779 V784 V789 V794 V799 V803 V805 V811 V821 V830 V833 V840 V843 V850 V853 V860 V863 V870 V878 V892 V01 V090 V091 V099 V100 V109 V110 V119 V120 122 V130 132 V140 V142 V150 V159 V160 V169 V170 V179 V180 V189 V191 V193 V20 V28 0 1 0 2 V290 V293 V30 V38 0 1 0 2 V390 V393 V40 V48 0 1 0 2 V490 V493 V50 V58 0 1 0 2 V590 V593 V60 V68 0 1 0 2 V690 V693 V70 V78 0 1 0 2 V790 V793 V800 V801 V806 V809 V810 V812 V819 V820 V822 V829 V834 V839 V844 V849 V854 V859 V864 V869 V879 V88 V890 V891 V893 V899 V90 V94 V95 V97 V98 V99 W20 W52 W75 W84 W85 W99 X10 X19 X20 X29 X30 X33 X50 X57 X58 X59 Y40 Y84 Y85 Y86 Y88 Y89 95
32. West Local Alcohol Profiles for England tool as one measure of the number of individuals being adversely affected by alcohol However an additional indicator admission episodes for alcohol related conditions was subsequently developed as a measure of pressures from alcohol on health systems For this indicator the alcohol attributable fractions are applied in order to estimate the number of admissions rather than the number of people Indicators 9 to 15 relate to the number of people admitted to hospital each year per 100 000 population for alcohol specific and alcohol related conditions In contrast indicators 16 and 17 relate to the number of admission episodes to hospital for alcohol related conditions for every 100 000 population Individuals may be admitted more than once in any year A person is counted only once in indicators 9 to 15 but may contribute more than one admission episode to indicators 16 and 17 The total alcohol related admission episodes for an area are the sum of episode specific data An illustration of this summation is given below Previously National Indicator 39 NI39 37 User Guide Local Alcohol Profiles for England 2014 The alcohol attributable fraction for accidental poisoning by and exposure to alcohol is 1 0 Appendix 1 Summing two people admitted for ethanol poisoning will give a total of 2 0 alcohol related admission episodes The alcohol attributable fraction for colorectal can
33. aes Public Health England User Guide Local Alcohol Profiles for England 2014 User Guide Local Alcohol Profiles for England 2014 About Public Health England Public Health England s mission is to protect and improve the nation s health and to address inequalities through working with national and local government the NHS industry and the voluntary and community sector PHE is an operationally autonomous executive agency of the Department of Health Public Health England 133 155 Waterloo Road Wellington House London SE1 8UG Tel 020 7654 8000 www gov uk phe Twitter PHE_uk Facebook www facebook com PublicHealthEngland Prepared by Knowledge and Intelligence Team North West For queries relating to this document please contact KITNorthWest phe gov uk Crown copyright 2014 You may re use this information excluding logos free of charge in any format or medium under the terms of the Open Government Licence v2 0 To view this licence visit OGL or email psi nationalarchives gsi gov uk Where we have identified any third party copyright information you will need to obtain permission from the copyright holders concerned Any enquiries regarding this publication should be sent to KITNorthWest phe gov uk Published April 2014 Corporate member of Plain English Campaign Committed to clearer communication User Guide Local Alcohol Profiles for England 2014 Contents About Public Health England 2 C
34. affect employment estimates because employment is the sum of employees plus working owners However further research by the Office for National Statistics into this issue also discovered cases of double counting as some directors of limited companies included themselves in both categories when completing the questionnaire The Office for National Statistics has since estimated the degree of double counting and discontinuity between 2010 and 2011 results and released revised 2010 data on Nomis www nomisweb co uk For consistency the Knowledge and Intelligence Team North West has produced the current indicator using the same approach as last year The changes described here increase the likelihood that the BRES data are measuring what they say they are There should also be fewer instances of double counting within the latest figures However this also means that the indicator presented in this data refresh which uses 2012 data is not directly comparable to data presented in previous Local Alcohol Profiles for England However the Office for National Statistics found that the broad industry groups most affected were the professional scientific and technical construction and property groups the Office for National Statistics UK Standard Industrial Classification of Economic Activities 2007 SIC 2007 www hse gov uk statistics industry sic2007 htm and it is of note that as the numerator data used in the Local Alcohol Profiles for Engla
35. aggregating alcohol related admissions above by age group 5 year age bands to age 89 and 90 years and over sex and area of residence using mid year population estimates to derive age group and sex specific rates for each area calculating directly age standardised rate per 100 000 population standardised to the European standard population Persons admitted to hospital due to alcohol related conditions broad measure primary diagnosis or any secondary diagnosis and narrow measure primary diagnosis or any secondary diagnosis with an external cause all ages males females directly age standardised rate per 100 000 population standardised to the European standard population Knowledge and Intelligence Team North West from hospital episode statistics 2012 13 Office for National Statistics mid year population estimates 2012 Does not include attendance at Accident and Emergency departments 52 User Guide Local Alcohol Profiles for England 2014 Indicator details admission episodes for alcohol related conditions broad and narrow measures IDs 16 and 17 nclcalor Admission episodes for alcohol related conditions name What is being Admission episodes for alcohol related conditions measured meee All admissions all ages measure When does it Financial year 2012 13 Trends are available for years measure 2008 09 2009 10 2010 11 and 2011 12 ee Hospital admissions for alcohol related conditions ceed directly age standar
36. and PHE centres The data download also provides data for former government office regions Employment employees and working proprietors in the beverage serving activities industry sector Standard Industrial Classification 2007 563 beverage serving activities See denominator definition for definitions of employee and working proprietors i e owners used here Office for National Statistics ONS Business Register and Employment Survey BRES data via Nomis www nomisweb co uk Please note that special authorisation under licence is required to access the raw data for low level geographies An employee is anyone aged 16 years or over that an organisation directly pays from its payroll s in return for carrying out a full time or part time job or being on a training scheme It excludes voluntary workers self employed working owners who are not paid via the pay as you earn tax Employment includes both employees and the working proprietors i e owners 88 User Guide Local Alcohol Profiles for England 2014 Denominator source Confidence interval methodology Caveats Working proprietors are sole traders sole proprietors partners and directors This does not apply to registered charities Office for National Statistics ONS Business Register and Employment Survey BRES data via Nomis www nomisweb co uk Please note that special authorisation under licence is required to access the raw data for low level geog
37. as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available from 26 User Guide Local Alcohol Profiles for England 2014 www apho org uk resource item aspx RID 48457 An accompanying Excel spreadsheet replicating all formulae is also available from this website The confidence limits for the directly age standardised rate are given by DSR over DSR ae x Ones T o Var O DSR pper DSR t Ua aai x Oppe E o here Var 0 O is the total observed count of events in the local or subject population Ojower and Oupper are the lower and upper confidence limits for the observed count of events Var O is the variance of the total observed count O DSR is the directly age standardised rate Var DSR is the variance of the directly age standardised rate Using Byar s method the 100 1 c confidence limits for the observed number of events are given by 1 3 O ower O x fi RA a 90 NO 3 1 Z O O 1 x 1 upper 9 0 1 3 in where z is the 100 1 c 2 th percentile value from the standard normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the standard normal distribution The variances of the observed count O and the DSR are estimated by Var O 910 2 Var DSR x 9 ge 7 where i
38. as generated using an enhanced methodology see metadata for details and care should be taken when comparing these with previous estimates Lower risk drinking as a percentage of drinkers Mid 2009 synthetic estimate of the percentage of drinkers in the population aged 16 years and over who report engaging in lower risk drinking consumption of fewer than 22 units of alcohol per week for males and fewer than 15 units of alcohol per week for females Estimates were derived from a statistical model developed to estimate the percentage of abstainers lower risk as a percentage of drinkers increasing risk as a percentage of drinkers and higher risk as a percentage of drinkers drinkers in local authority populations The Local Alcohol Profiles for England 2012 refresh for this indicator and included in subsequent refreshes of data was generated using an enhanced methodology see metadata for details and care should be taken when comparing these with previous estimates Increasing risk drinking as a percentage of drinkers Mid 2009 synthetic estimate of the percentage of drinkers in the population aged 16 years and over who report engaging in increasing risk drinking consumption of between 22 and 50 units of alcohol per week for males and between 15 and 35 units of alcohol per week for females Estimates were derived from a statistical model developed to estimate the percentage of abstainers lower risk as a percentage of drink
39. ate households and does not therefore include NOOO FR WD 70 User Guide Local Alcohol Profiles for England 2014 Method used to create this indicator people in institutions such as prisons or care homes or those who are homeless The people excluded from participation may have a different pattern of alcohol consumption Not all participants selected for inclusion participated in the survey possibly introducing selection bias where those that agreed to take part in the survey differed systematically from those who did not These are modelled estimates based on national survey data The process assumes that the relationships identified in the national General Lifestyle Survey between alcohol consumption and age sex and ethnicity are the same at the local authority level the model based estimates are unable to take account of any additional local factors that may impact on the true prevalence The General Lifestyle Survey collects information on a range of topics from people living in private households in Great Britain and samples approximately 9 000 responding households per annum More details can be found at data gov uk dataset general_lifestyle_survey Proportions of mid 2009 population estimates by ethnic group are applied to mid 2010 populations Mid 2009 population estimates by ethnic group released in May 2011 by the Office for National Statistics are experimental statistics This means that when these estimates we
40. ber of events in the local or subject population in age group ni is the number of individuals in the local or subject denominator population in age group or the population x period at risk e g person years w is the number or proportion of individuals in the reference or standard population in age group The Excel formulae available at www apho org uk resource item aspx RID 48457 were used to calculate confidence intervals The spreadsheet uses Excel s built in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Hospital admission data can be coded differently in different parts of the country In some cases details of the patient s residence are insufficient to allocate the patient to a particular area and in other cases the patient has no fixed abode These cases are included in the England total but not in the local authority or PHE centre figures Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions 49 User Guide Local Alcohol Profiles for England 2014 Method used to create this indicator alcohol attributable fractions were not a
41. bres quality and methods index html Percentages were calculated using the following formula a b x 100 where a employment in bars b all in employment The number of those in employment in the beverage serving activities industry sector Standard Industrial Classification 2007 563 as a percentage of all in employment Business Register and Employment Survey September 2012 Office for National Statistics from Nomis www nomisweb co uk 90 User Guide Local Alcohol Profiles for England 2014 7 0 References 1 Jones L and Bellis MA 2014 Updating England specific alcohol attributable fractions Liverpool Centre for Public Health Liverpool John Moores University 2 Jones L Bellis MA Dedman D Sumnall H and Tocque K 2008 Alcohol attributable fractions for England Alcohol attributable mortality and hospital admissions Liverpool Centre for Public Health Liverpool John Moores University 3 Public Health England Transition Team 2012 Structure of Public Health England Factsheet Online Available from http webarchive nationalarchives gov uk 201308051 12926 http healthandcare dh gov uk phe structure Accessed 11 November 2013 4 Eurostat 2013 Revision of the European standard population Report of Eurostat s task force Luxembourg Publications Office for the European Union 5 Eayres D 2008 APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals Y
42. broad indicator and the new narrow indicator Further information about this change and the difference between the broad and narrow indicators is detailed in an online blog available at publichealthmatters blog gov uk 2014 01 15 understanding alcohol related hospital admissions User Guide Local Alcohol Profiles for England 2014 In line with this change the Local Alcohol Profiles for England 2014 also includes both broad and narrow measures for alcohol related hospital admission For further details on alcohol attributable fractions see section 3 For further details on the methodology used to calculate alcohol related admission and admission episodes for alcohol related episodes see section 6 2 2 3 Geographical changes On the 27 March 2012 the Health and Social Care Act was passed this Act created a new geographical structure through which PHE will operate The new structure consists of four regions and 15 centres Figure 1 For more information about the new structure see the PHE Transition Team factsheet 2012 The Local Alcohol Profiles for England 2014 present data by local authority For indicators which have been updated this year because new data are available the local authority values in the profiles are compared to the relevant PHE centre For indicators which have not been updated this year the local authority values in the profiles are compared to the relevant former government office region On the excel spreadsheets
43. cation of Diseases version 10 codes Appendix 1 is used to extract all episodes containing alcohol related diagnoses from the hospital episode statistics datasets Sex and age specific alcohol attributable fractions are then applied to each episode Within the Local Alcohol Profiles for England the Knowledge and Intelligence Team North West calculates the number of men and women admitted to hospital each year for alcohol specific and alcohol related conditions The analysis carried out by Knowledge and Intelligence Team North West is person based yielding a period prevalence estimate of the number of persons admitted to hospital at least once during the course of a financial year Rules to allocate individuals to a single International Classification of Diseases version 10 code for person based analysis broad indicator For each individual 1 Identify all alcohol attributable diagnosis codes from their hospital episode statistics records 2 Select the code s with the largest attributable fraction 3 In the event of there being two or more episodes with the same high attributable fraction select the one from the earliest episode using start date 4 In the event of there being two or more diagnoses with the same high attributable fraction within the same episode select the one from the lowest diagnostic position To calculate the narrow indicator of alcohol related hospital admissions the following are extracted episode
44. cer for 16 to 24 year olds is 0 16 for males and 0 11 for females oe ae ee 01G Appendix 1 Summing five males and five females aged 16 to 24 years admitted for colorectal cancer will give a total of 1 35 alcohol related admission episodes 0 16 0 11 0 16 38 User Guide Local Alcohol Profiles for England 2014 Indicator details alcohol specific hospital admission under 18 year olds ID Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition Numerator source Denominator definition Denominator source Confidence interval methodology 9 Alcohol specific hospital admission under 18 year olds Individual persons aged less than 18 years admitted to hospital due to alcohol specific conditions Persons aged less than 18 years Three financial years 2010 11 to 2012 13 pooled Trends are available for years 2006 07 to 2008 09 2007 08 to 2009 10 2008 09 to 2010 11 and 2009 10 to 2011 12 Persons admitted to hospital due to alcohol specific conditions under 18 year olds crude rate per 100 000 population Produced annually by the Knowledge and Intelligence Team North West Hospital episode statistics publish annual extracts around August of each year The Office for National Statistics publishes mid year population estimates around July September England 2009 local a
45. ch local authority LAPE eer Read Local Alcohol Profiles for England a nn ou ncements preties about data Please click on a Public Health England centre area to access profiles releases here toca Authority Proites Authority Profiles nnouncements Ape 2014 Guide for further details Select region by clicking area on map Ape 2014 issue the Alcon 15 User Guide Local Alcohol Profiles for England 2014 5 3 Viewing local area profile charts and data The Chart tab shows the local results for each indicator as a circle against the national average Data for the relevant PHE centre are also described on the local authority profiles or former government office region for indicators which have not been updated this year Select Local LAPE amp Authority area camara Wi lt M ee anes from d rop Public Health England centre area Cheshire and Merseyside down menu Return to the map to choose another profile Area profile summary Data Footnotes lee Trend Charts STENo wa 2 Download the profile as a eee ene PDF includes displays from chart trend charts Months of life lost mates n Click here to tee djin i iais u data and footnotes tabs Aicohol spr 01 e o display interquartile PO a ranges on the chart mere remess ms lt i Mortality fom chronic liver disease femates ee Alcohotretated mortality mates o Akohokrelated mortait
46. consumption by adults 67 6 5 The alcohol economy 87 7 0 References 91 Appendix 1 Updated alcohol attributable fractions 92 User Guide Local Alcohol Profiles for England 2014 1 0 Background This document outlines the methods used by the Knowledge and Intelligence Team North West to produce a national alcohol dataset the Local Alcohol Profiles for England LAPE together with a brief guide on how to use the online tool The metadata and methods for individual indicators are outlined in section 6 Alcohol use has health and social consequences borne by individuals their families and the wider community In 2006 the former North West Public Health Observatory gathered routine data and intelligence from a range of sources including the Department of Health and the Home Office to provide a national indicator set intended to inform and support local sub national and national alcohol policies These indicators provided measures to help prioritise and target local areas of concern Local Alcohol Profiles for England have been published on an annual basis since 2006 The latest update Local Alcohol Profiles for England 2014 was released on 29 April 2014 The profiles contain 26 alcohol related indicators for every local authority and the majority are also available for all Public Health England PHE centres in England the data download also provides data for former government office regions see section 2 3 for more details about geo
47. d on the diagnostic codes age group and sex of the patient Appendix 1 Where there is more than one alcohol attributable International Classification of Diseases version 10 code among the 20 possible diagnostic codes from diag_nn the code s with the largest alcohol attributable fraction is selected In the event of there being two or more codes with the same alcohol attributable fraction within the same episode select the one from the lowest diagnostic position diag_nn Diagnostic position takes an integer value between 1 and 20 corresponding to the 20 diagnosis fields diag_01 to diag_20 3 Calculate directly standardised rates by aggregating alcohol related admissions above by 5 year age groups 0 4 5 9 to 85 89 and 90 years and over for each area of residence using mid year population estimates to derive age group and sex specific rates for each area calculating directly age standardised rate per 100 000 population standardised to the European standard population The directly age standardised rate is the rate of 56 User Guide Local Alcohol Profiles for England 2014 events that would occur in a standard population if that population were to experience the age sex specific rates of the subject population Explicitly Wil DSR x 100 000 Ev i expressed per 100 000 population where w is the number or proportion of individuals in the standard population in age sex group i ris
48. d sexual offences Abstainers synthetic estimate Lower Risk drinking of drinkers only synthetic estimate Increasing Risk drinking of drinkers only synthetic estimate Higher Risk drinking of drinkers only synthetic estimate Binge drinking synthetic estimate Employees in bars of all employees 21 User Guide Local Alcohol Profiles for England 2014 6 1 Mortality and months of life lost due to alcohol Months of life lost due to alcohol males Months of life lost due to alcohol females Alcohol specific mortality males Alcohol specific mortality females Mortality from chronic liver disease males Mortality from chronic liver disease females Alcohol related mortality males Alcohol related mortality females o N D 0 eS O N Mortality data for the months of life lost due to alcohol alcohol specific and alcohol related mortality indicators were extracted from the Office for National Statistics annual deaths extract by the Knowledge and Intelligence Team North West using the underlying cause of death corresponding to the International Classification of Diseases version 10 codes in Appendix 1 The corresponding mid year population estimates were obtained from the Office for National Statistics Alcohol specific and alcohol related deaths were assigned the alcohol attributable fractions described in Appendix 1 Months of life lost due to alcohol is based on three consecutive years of mortality
49. dicator details binge drinking by adults synthetic estimates ID Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition Numerator source 25 Binge drinking synthetic estimate Prevalence of adult binge drinking Persons aged 16 years and over 2007 2008 Prevalence of binge drinking percentage of resident population 2007 2008 persons aged 16 years and over Originally produced by National Centre for Social Research Updated by East Midlands Public Health Observatory now the Knowledge and Intelligence Team East Midlands March 2011 Updated on an ad hoc basis England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts The data download also provides data for government office regions England and former government office regions Proportion of adult men who drank eight or more units of alcohol on the heaviest drinking day in the previous seven days at time of survey and adult women who drank six or more units of alcohol on the heaviest drinking day in the previous seven days at time of survey 2007 2008 Local authority Model estimates by East Midlands Public Health Observatory now the Knowledge and Intelligence Team East Midlands using data from a number of sources including Health Survey for England 2007 2008
50. dised rate per 100 000 population definition European standard population Produced annually by the Knowledge and Intelligence Team North West Hospital episode statistics publish Timeliness annual extracts around August of each year The Office for National Statistics publishes mid year population estimates around July September England 2009 local authority districts non Geographical metropolitan districts unitary authorities London coverage boroughs and metropolitan districts and PHE centres The data download also provides data for government office regions Broad measure Admissions to hospital where the primary diagnosis or any of the secondary diagnoses are an alcohol attributable code Appendix 1 for the year 2012 13 Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable Numerator fractions were not available for children definition Narrow measure Admissions to hospital where the primary diagnosis is an alcohol attributable code Appendix 1 or a secondary diagnosis is an alcohol attributable external cause code Appendix 1 for the year 2012 13 Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable 53 User Guide Local Alcohol Profiles for England 2014 Numerator source Denominator definition
51. e or former government office region for indicators which have not been updated this year average for all indicators 17 User Guide Local Alcohol Profiles for England 2014 The Footnotes tab provides definitions of data indicators LAPE Local Alcohol Profiles for England Public Health England centre area Cheshire and Merseyside Return to the map to choose another profile Change Profile Area You are viewing prote data for Liverpool To change the area please choose an option from the dropdown menu below Liverpool io Chart Trend Charts Footnotes Data 1 Months of lite lost males 2 ths of life lost females Alcohol specitic mortality males 4 Alcohol specific mortality females 5 Mortality from chronic liver disease males 6 Mortality from chronic liver disease females 7 _Alcohol related mortality males 8 Alcohol related mortality females 9 Alcohol specific hospital admission under 18s 10 Alcohol specific hospital admission mates Alcohol specific hospital admission females Click on individual indicators for graphs 2 Alcohol related hospital admission Broad males Alcohol related hospital admission Broad females displaying all areas LAPE Local Alcohol Profiles for England Months of life lost males Liverpool Limitto selected region ShO all England LAs Return to profile Lo 851 212 13 19 31 06 6 een 1097 57
52. e European standard population Knowledge and Intelligence Team North West from hospital episode statistics 2012 13 Office for National Statistics mid year population estimates 2012 Does not include attendance at Accident and Emergency departments 46 User Guide Local Alcohol Profiles for England 2014 Indicator details alcohol related hospital admissions broad and narrow measures males and females IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition 12 13 14 and 15 Alcohol related hospital admission males and females broad and narrow measures Individual in year persons admitted to hospital due to alcohol related conditions Males and females all ages Financial year 2012 13 Trends are available for years 2008 09 2009 10 2010 11 and 2011 12 Persons admitted to hospital due to alcohol related conditions males and females all ages directly age standardised rate per 100 000 population European standard population Produced annually by the Knowledge and Intelligence Team North West Hospital episode statistics publish annual extracts around August of each year The Office for National Statistics publishes mid year population estimates around July September England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and m
53. e Office for National Statistics produces annual interim life tables around October England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts and PHE centres The data download also provides data for former government office regions Deaths from alcohol related conditions Appendix 1 based on underlying cause of death registered in the calendar years 2010 2012 for males and females aged less than 75 years Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable fractions were not available for children Annual death extracts from the Office for National Statistics Mid year population estimates 2010 2011 and 2012 for 0 74 year olds age bands lt 1 1 44 45 54 55 64 and 65 74 years males and females Estimates are aggregated from single year age bands The three 23 User Guide Local Alcohol Profiles for England 2014 Denominator source Confidence interval methodology Caveats Method used to create this indicator years of data are pooled The Office for National Statistics Confidence intervals have not been generated for this indicator Mortality data are considered to be complete and robust Records without a valid area code are excluded the number of these is negligible There is the potential for the underlying cause
54. each local authority is compared to the national average For the Local Alcohol Profiles for England 2014 the data download also provides data for the former government office region geographies Figure 2 Figure 1 Current geographical structure of England regions and centres Centre North East Cumbria and Lancashire Yorkshire and the Humber Greater Manchester Cheshire and Merseyside North of England East Midlands West Midlands Anglia and Essex South Midlands and Hertfordshire Midlands and East of England London integrated region and centre Kent Surrey and Sussex Thames Valley Wessex Devon Cornwall and Somerset Avon Gloucestershire and Wiltshire South of England User Guide Local Alcohol Profiles for England 2014 Figure 2 Former geographical structure of England government office regions East of England 2 4 Changes to the European standard population Comparing crude rates across populations can be misleading if the age structures of the populations differ Age standardisation is an important method which is used to account for the differences in the age structure of different populations in order to ensure that comparisons are valid The Local Alcohol Profiles for England use the European standard population for this purpose The European standard population is effectively a hypothetical population structure which is used to weight data in order to produce directly
55. ect population The standard population used is the European standard population The age groups used are 0 4 5 9 85 90 90 years The rate for 2010 2012 has been calculated as the simple average of the individual annual rates The rate is expressed per 100 000 population Comparability ratios were used in the calculation of trend data see section 2 5 of this report for more details Deaths from alcohol specific conditions all ages males females directly age standardised rate per 100 000 population standardised to the European standard population Knowledge and Intelligence Team North West from the Public Health Mortality File for 2010 2012 and Office for National Statistics mid year population estimates for 2010 2012 28 User Guide Local Alcohol Profiles for England 2014 Indicator details mortality from chronic liver disease males and females IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition Numerator source Denominator definition Denominator source Confidence interval methodology 5 and 6 Mortality from chronic liver disease males and females Mortality rate form chronic liver disease Males and females all ages Calendar years 2010 2012 three year moving average Trends are available for years 2006 2008 2007 2009 2008 2010 and 2009 2011 Mortality
56. end date ep end falls within the financial year an alcohol attributable International Classification of Diseases version 10 code Appendix 1 appears in the primary diagnosis field diag_07 or an alcohol related external cause code Appendix 1 appears in one of the secondary codes diag 02 to diag_20 For each episode identified in step 1 above attach the appropriate alcohol attributable fraction to the alcohol attributable diagnoses using the International Classification of Diseases version 10 code age group and sex of the patient Appendix 1 3 Select a single diagnosis to create a person based indicator by identifying all alcohol attributable diagnosis codes for each individual using hospital episode statistics Identification code within the financial year select the code s with the largest attributable fraction in the event of there being two or more episodes with the same high alcohol attributable fraction select the one from the earliest episode using start date 51 User Guide Local Alcohol Profiles for England 2014 Summary footnote epistart in the event of there being two or more diagnoses with the same high alcohol attributable fraction within the same episode select the one from the lowest diagnostic position diag_nn Diagnostic position takes an integer value between 1 and 20 corresponding to the 20 diagnosis fields diag_07 to diag_20 4 Calculate directly age standardised rate by
57. eographical coverage Numerator definition Numerator source Denominator definition Denominator source Confidence interval methodology 3 and 4 Alcohol specific mortality males and females Mortality from alcohol specific conditions Males and females all ages Calendar years 2010 2012 three year moving average Trends are available for years 2006 2008 2007 2009 2008 2010 and 2009 2011 Mortality from alcohol specific conditions directly age standardised rate males and females all ages per 100 000 European standard population Produced annually by the Knowledge and Intelligence Team North West The Office for National Statistics provides Knowledge and Intelligence Teams with the annual extract and mid year population estimates around July September England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts and PHE centres The data download also provides data for former government office regions Deaths from alcohol specific conditions Appendix 1 based on underlying cause of death registered in the calendar years 2010 2012 for males and females of all ages Annual death extracts from the Office for National Statistics Mid year population estimates 2010 2011 and 2012 by five year age bands males and females The Office for National Statistics Byar s methodology was used to generate 95 confidence intervals
58. ere being two or more episodes with the same high alcohol attributable fraction select the one from the earliest episode using start date epistart in the event of there being two or more diagnoses with the same high alcohol attributable fraction within the same episode select the one from the lowest diagnostic position diag_nn Diagnostic position takes an integer value between 1 and 20 corresponding to the 20 diagnosis fields diag_07 to 50 User Guide Local Alcohol Profiles for England 2014 diag_20 4 Calculate directly age standardised rate by aggregating alcohol related admissions above by age group 5 year age bands to age 89 and 90 years and over sex and area of residence using mid year population estimates to derive age group and sex specific rates for each area calculating directly age standardised rate per 100 000 population standardised to the European standard population Narrow measure Male female alcohol related hospital admission are calculated as follows Select hospital episode statistics records where the admission is a finished episode epistat 3 the admission is an ordinary admission day case or maternity classpat 1 2 or 5 the sex of the patient is valid sex 1 or 2 there is a valid age at start of episode startage between 0 120 or between 7001 7007 the region of residence is one of the English regions no fixed abode or unknown resgor lt K or U or Y the episode
59. ers increasing risk as a percentage of drinkers and higher risk as a percentage of drinkers 81 User Guide Local Alcohol Profiles for England 2014 drinkers in local authority populations The Local Alcohol Profiles for England 2012 refresh for this indicator and included in subsequent refreshes of data was generated using an enhanced methodology see metadata for details and care should be taken when comparing these with previous estimates Higher risk drinking as a percentage of drinkers Mid 2009 synthetic estimate of the percentage of drinkers in the population aged 16 years and over who report engaging in higher risk drinking consuming more than 50 units of alcohol per week for males and more than 35 units of alcohol per week for females Estimates were derived from a statistical model developed to estimate the percentage of abstainers lower risk as a percentage of drinkers increasing risk as a percentage of drinkers and higher risk drinkers as a percentage of drinkers in local authority populations The Local Alcohol Profiles for England 2012 refresh for this indicator and subsequent refreshes of data was generated using an enhanced methodology see metadata for details and care should be taken when comparing these with previous estimates Please see this publication for further information www lape org uk downloads alcoholestimates201 1 pdf 82 User Guide Local Alcohol Profiles for England 2014 In
60. es H Peopleandplaces l Peopleandplaces J Peopleandplaces k Peopleandplaces L Peopleandplaces M Peopleandplaces U The reference category is Abstain This parameter is set to zero because it is redundant 78 User Guide Local Alcohol Profiles for England 2014 Table 7 Estimated model parameters for drinkers consuming 36 to 50 units with respect to the base category abstainers 95 Confidence Interval for Exp B Lower Upper NewDrinkCat ig Bound Bound 36 to 50 Intercept AS_Adm_3yr_Qtle 1 AS_Adm_ 3yr_Qtle 2 AS_Adm_ 3yr_Qtle 3 AS_Adm_ 3yr_Qtle 4 AS_Adm_ 3yr_Qtle 5 male female White Black Asian AG15 AG20 AG25 AG30 AG35 AG40 AG45 AG50 AG55 AG60 AG65 AG70 AG75 IMD_LSOA_Qtile 1 IMD_LSOA_Qtile 2 IMD_LSOA_Qtile 3 o j ojojojojojojojojojojloj IMD_LSOA_Qtile 4 IMD_LSOA_Qtile 5 Peopleandplaces A Peopleandplaces B Peopleandplaces C Peopleandplaces D Peopleandplaces E Peopleandplaces F Peopleandplaces G Peopleandplaces H Peopleandplaces l Peopleandplaces J Peopleandplaces k Peopleandplaces L Peopleandplaces M Peopleandplaces U The reference category is Abstain This parameter is set to zero because it is redundant 79 User Guide Local Alcohol Profiles for England 2014 Table 8 Estimated model parameters for drinkers consuming gt 50 units with respect to the base category abstainers 9
61. es the patient has no fixed abode These cases are included in the England total but not in the local authority or PHE centre figures Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable fractions were not available for children Conditions where low levels of alcohol consumption are protective have a negative alcohol attributable fraction are not included in the calculation of the indicator 55 User Guide Local Alcohol Profiles for England 2014 Method used to create this indicator Alcohol related hospital admission is calculated as follows Broad measure 1 Select hospital episode statistics records where the admission is a finished episode epistat 3 the admission is an ordinary admission day case or maternity classpat 1 2 or 5 it is an admission episode epiorder 1 the sex of the patient is valid sex 1 or 2 there is a valid age at start of episode startage between 0 120 or between 7001 7007 the region of residence is one of the English regions no fixed abode or unknown resgor lt K or U or Y the episode end date epiend falls within the financial year an alcohol attributable International Classification of Diseases version 10 code Appendix 1 appears in any diagnosis field diag_nn 2 For each episode identified in step 1 above an alcohol attributable fraction is applied base
62. etropolitan districts and PHE centres The data download also provides data for government office regions Broad measure Persons admitted to hospital where the primary diagnosis or any of the secondary diagnoses are an alcohol attributable code Appendix 1 males females for the year 2012 13 Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable fractions were not available for children Narrow measure Persons admitted to hospital where the primary diagnosis is an alcohol attributable code Appendix 1 or one of the secondary codes is an external alcohol attributable code Appendix 1 males females for the year 2012 13 Children aged less than 16 years were 47 User Guide Local Alcohol Profiles for England 2014 Numerator source Denominator definition Denominator source Confidence interval methodology only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable fractions were not available for children For a more information on the broad and narrow measures see section 2 2 The Health and Social Care Information Centre HSCIC Mid year population estimates 2012 by five year age bands males and females The Office for National Statistics Byar s methodology was used to generate 95 confidence intervals as detailed in APHO Tech
63. for the observed number of events are given by 3 O ower 0 a T gt in 90 3O 3 O per o 1 x 1 where si 9 0 1 344 041 z is the 100 1 a 2 th percentile value from the standard normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the standard normal distribution The Excel formulae available at www apho org uk resource item aspx RID 48617 were used to calculate confidence intervals The spreadsheet uses Excel s built in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Hospital admission data can be coded differently in different parts of the country In some cases details of 40 User Guide Local Alcohol Profiles for England 2014 Method used to create this indicator the patient s residence are insufficient to allocate the patient to a particular area and in other cases the patient has no fixed abode These cases are included in the England total but not in the local authority or PHE centre figures Alcohol specific hospital admission for people aged less than 18 years are calculated as follows text in square brackets refers to terms in hos
64. from chronic liver disease directly age standardised rate males and females all ages per 100 000 European standard population Produced annually by the Knowledge and Intelligence Team North West The Office for National Statistics provides Knowledge and Intelligence Teams with the annual extract and mid year population estimates around July September England and 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts The data download also provides data for former government office regions Deaths from chronic liver disease including cirrhosis classified by underlying cause of death International Classification of Disease version 10 K70 K73 K74 registered in the calendar years 2010 2012 for males and females of all ages Annual death extracts from the Office for National Statistics Mid year population estimates 2010 2011 and 2012 by five year age bands males and females The Office for National Statistics Byar s methodology was used to generate 95 confidence intervals as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available 29 User Guide Local Alcohol Profiles for England 2014 from www apho org uk resource item aspx RID 48457 An accompanying Excel spreadsheet replicating all formulae is also available f
65. g uk resource item aspx RID 103520 These estimates include data from 2007 and 2008 only and cannot be compared with earlier years data due to changes in the way alcohol units are calculated Health Survey for England data are based on observed self reported drinking behaviour Self reported consumption may be prone to respondent bias Health Survey for England under samples younger people people in employment ethnic minorities women and those who are healthier but exhibit less healthy behaviour England and former government office regions These data have not been age standardised and therefore variation between area values may be a result of differences in population structure Local authority These are modelled estimates based on national survey data The model is non aetiological not based on known casual factors The estimates do not take into account additional local factors that 84 User Guide Local Alcohol Profiles for England 2014 may impact on the true prevalence of binge drinking in an area and may not match with local lifestyle survey results or modelled estimates which use known risk factors such as socio economic status age sex and ethnicity These estimates are modelled and the model used is not intended to be explanatory They should therefore be used and interpreted with caution see above and not used to measure performance or change over time The use of statistical models for prediction involves
66. ge of those who abstain from drinking lower risk drinking as a percentage of drinkers increasing risk drinking as a percentage of drinkers and higher risk drinking as a percentage of drinkers of resident drinking population 2008 09 persons aged 16 years and over Produced by the former North West Public Health Observatory now the Knowledge and Intelligence Team North West in 2011 for the Department of Health Updated estimates could be provided in the future England government office regions 2009 local authority local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts The data download also provides data for government office regions 2009 synthetic estimate of the percentage of the total adult population who report abstaining and the proportion of the adult drinking population who report engaging in lower risk increasing risk higher risk drinking where e lower risk drinking is defined as usual consumption of fewer than 22 units of alcohol per week for males and fewer than 15 units of alcohol per week for females e increasing risk drinking is defined as usual 68 User Guide Local Alcohol Profiles for England 2014 Numerator source Denominator definition Denominator source Confidence interval methodology consumption of between 22 and 50 units of alcohol per week for males and between 15 and 35 units of alcohol per week for females e
67. graphies Profiles are available online through the dynamic PDF and with a range of download options through www lape org uk The Knowledge and Intelligence Team North West has reviewed and revised the methods used to derive population measures of alcohol related harm in order to ensure the approaches used reflect current knowledge and understanding The profiles continue to reflect the wide range of domains that are affected by alcohol use There have been a number of methodological changes to the indicators presented in Local Alcohol Profiles for England 2014 a description of these changes and an assessment of their implications are given in section 2 The Knowledge and Intelligence Team North West includes staff from the former North West Public Health Observatory and the Cancer Intelligence Team 4 User Guide Local Alcohol Profiles for England 2014 2 0 Key changes to the Local Alcohol Profiles for England 2014 There have been a number of changes to the methodologies used to calculate certain indicators presented in the Local Alcohol Profiles for England 2014 The main changes are summarised here more detailed descriptions of the methodologies used to create individual indicators are presented by indicator in section 6 A number of methodological changes have occurred since the Local Alcohol Profiles for England 2012 were released The data presented in the Local Alcohol Profiles for England 2014 should not be compared with da
68. higher risk drinking is defined as usual consumption of more than 50 units of alcohol per week for males and more than 35 units of alcohol per week for females Modelled estimates produced by the former North West Public Health Observatory now the Knowledge and Intelligence Team North West using data from multiple sources including e the General Lifestyle Survey 2008 and 2009 e alcohol specific hospital admission 2007 08 to 2009 10 e Index of Multiple Deprivation 2010 Department for Communities and Local Government e Beacon and Dodsworth P People and Places classification People and Places Trees Mid year 2010 population estimates estimated resident population by ethnic group proportions of mid 2009 population estimates by ethnic group applied to mid 2010 population estimates age bands 16 19 20 25 70 74 75 and sex May 2011 release the Office for National Statistics Bespoke request for the former North West Public Health Observatory now the Knowledge and Intelligence Team North West from Office for National Statistics date file produced February 2012 Using Monte Carlo methods estimates of 95 confidence intervals for each local authority were calculated using the variation in the coefficients for each covariate in Tables 1 to 6 sampling from the distribution N B _ 88 5 where N is the normal distribution i are the covariates j are the model states gt 0 to 9 units 10 to 14 units 15 69
69. idence limits for the directly age standardised rate are given by DSR pwer DSR Var DSR O Var O DSR DSR 5 x o Var DSR gt r _ O where upper Var O x upper O is the total observed count of events in the local or subject population Ojower and Oupper are the lower and upper confidence limits for the observed count of events Var O is the variance of the total observed count O DSR is the directly age standardised rate Var DSR is the variance of the directly age standardised rate lower Using Byar s method the 100 1 c confidence limits for the observed number of events are given by 1 z e E 1s 6 25 lower 90 3 z 3 0 0 1 d ty zar where 90 1 3 0 1 z is the 100 1 ca 2 th percentile value from the Standard Normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the Standard Normal distribution The variances of the observed count O and the DSR are estimated by Var O 90 Var DSR x where i O is the observed number of events in the local or subject population in age group n is the number of individuals in the local or subject 44 User Guide Local Alcohol Profiles for England 2014 Caveats Method used to create this indicator denominator population in age group or the population x period at risk e g person years w is the number or proportion
70. ifferent set of data Wider confidence intervals equate to greater uncertainty in the estimate Confidence intervals are given with a stated probability level In Local Alcohol Profiles for England this is 95 and so we say that there is a 95 probability that the interval includes the true value The use of 95 is arbitrary but is conventional practice in medicine and public health The confidence intervals have also been used to make comparisons against the national value in the local area summary charts for an example screen shot see section 5 3 Statistical testing is undertaken by comparing the confidence intervals of the estimates to see if they overlap non overlapping confidence intervals are considered as statistically significantly different and the value is shown on the summary chart with a red or green circle depending on whether it is worse or better than the national value respectively 14 User Guide Local Alcohol Profiles for England 2014 5 0 Local Alcohol Profiles for England online tool In this section we explain how to e Access the tool e Select a profile from the launch page e View local area profile charts and data e Download data e Access associated reports and maps e Use the InstantAtlas functions 5 1 Accessing the Local Alcohol Profiles for England tool The tool is available online at www lape org uk 5 2 Selecting a profile from the launch page The Profiles tab allows you to select profiles for ea
71. ime grouping England Homicide Violence against the person Violence with injury Violence without injury Sexual offences Sexual offences Robbery Robbery Burglary Domestic burglary Theft of a motor vehicle Vehicle offences also including Theft from a motor vehicle Interfering with a motor vehicle offences The sexual offences group no longer includes the categories of Exploitation of prostitution and Soliciting for the purposes of prostitution offences Therefore figures for these offences are now not part of the dataset used to calculate the LAPE 2014 indicators Interfering with a motor vehicle offences were not previously included as part of the calculations for LAPE and for consistency these were also omitted this year Numerators were multiplied by the relevant alcohol attributable fraction to obtain the number of alcohol related recorded crimes and results presented as crude rates 61 User Guide Local Alcohol Profiles for England 2014 Indicator details alcohol related recorded crimes recorded crimes violent crimes and sexual offences IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition 9 As already noted this indicator is an aggregate based on the Home Office s former key offence categories 18 19 and 20 Alcohol related recorded crimes a
72. ital due to alcohol specific conditions males and females all ages directly age standardised rate per 100 000 population European standard population Produced annually by the Knowledge and Intelligence Team North West Hospital episode statistics publish annual extracts around August of each year The Office for National Statistics publishes mid year population estimates around July September England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts and PHE centres The data download also provides data for former government office regions Persons admitted to hospital where the primary diagnosis or any of the secondary diagnoses are an alcohol specific code Appendix 1 males females for the financial year 2012 13 The Health and Social Care Information Centre HSCIC Mid year population estimates 2012 by five year age bands males and females The Office for National Statistics Byar s methodology was used to generate 95 confidence intervals as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available from 43 User Guide Local Alcohol Profiles for England 2014 www apho org uk resource item aspx RID 48457 An accompanying Excel spreadsheet replicating all formulae is also available from this website The conf
73. l episode statistics data An alcohol attributable fraction is the proportion of a condition caused by alcohol An alcohol attributable fraction of 1 0 100 of cases are caused by alcohol An alcohol attributable fraction of 0 25 25 of cases are caused by alcohol 3 4 Alcohol attributable fractions for children Alcohol attributable fractions for children aged under 16 years are included for alcohol specific diagnoses where the alcohol attributable fraction is 1 0 and for low birth weight where the alcohol attributable fraction is 0 05 Appendix 1 For other conditions alcohol attributable fractions were not available for children 3 5 Alcohol attributable fractions used to calculate alcohol related crime Local Alcohol Profiles for England indicators use attributable fractions to estimate the number of crimes that are related to alcohol consumption Alcohol attributable fractions from the former UK Prime Ministers Strategy Unit were used in the production of the alcohol related crime indicators Table 1 These alcohol attributable fractions estimate the statistical association between measures of alcohol and crime and not necessarily the causal association and should therefore be distinguished from the disease specific alcohol attributable fractions used for the hospital admission and mortality indicators 12 User Guide Local Alcohol Profiles for England 2014 Table 1 Alcohol attributable fractions for crime Crime categ
74. l or subject population Ojower ANd Oupper are the lower and upper confidence limits for the observed count of events Var O is the variance of the total observed count O DSR is the directly age standardised rate Var DSR is the variance of the directly age standardised rate lower Using Byar s method the 100 1 c confidence limits for the observed number of events are given by 1 Z n O x 1 a low 90 is 3 Cpa o 1 x 1 where 9 0 1 3 4 0 1 z is the 100 1 a 2 th percentile value from the Standard Normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the Standard Normal distribution The variances of the observed count O and the DSR are estimated by Var O 910 1 0 Var DSR xy Ha where i O is the observed number of events in the local or subject population in age group i n is the number of individuals in the local or subject 33 User Guide Local Alcohol Profiles for England 2014 Caveats Method used to create this indicator denominator population in age group or the population x period at risk e g person years w is the number or proportion of individuals in the reference or standard population in age group The Excel formulae available at www apho org uk resource item aspx RID 48617 were used to calculate confidence intervals The spreadsheet uses Excel s buil
75. lassification of Diseases codes These changes mean that unrevised data are not comparable across years The main change relates to the rules that govern which cause of death detailed on the death certificate is selected as the underlying cause In general the impact of these changes can be quantified and the data can be adjusted through the use of comparability ratios which are used to adjust the number of deaths and to calculate adjusted mortality rates Comparability ratios have been used in all the mortality indicators included in the Local Alcohol Profiles for England 2014 in order to ensure that indicators across years within this refresh are comparable comparability ratios have been applied to mortality data for years up to and including 2010 For more details on compatibility ratios see PHE guidance available at www apho org uk resource item aspx RID 126646 2 6 Changes to the denominator populations 2011 census The Local Alcohol Profiles for England 2014 present data generated using 2011 census based populations All trend data for earlier years have been recalculated using revised population estimates based on the 2011 census Rates for trend data in the Local Alcohol Profiles for England 2014 will not match those in Local Alcohol Profiles for England 2012 for the same time periods For more details on the 2011 census see 2011 Census Guidance and Methodology available at www ons gov uk ons guide method census 201 1 index html
76. lcohol related violent crimes and alcohol related sexual offences Recorded crime for selected key offences related to alcohol All persons all ages Financial year 2012 13 Trends are available for years 2008 09 2009 10 2010 11 and 2011 12 Alcohol related recorded crimes alcohol related violent crimes and alcohol related sexual offences crude rate per 1 000 population all ages persons Produced annually by the Knowledge and Intelligence Team North West Office for National Statistics recorded crime data are now published quarterly England 2009 local authority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts and PHE centres The data download also provides data for government office regions Annual counts of the following recorded crime offences by location of incident in 2012 13 multiplied by the relevant alcohol attributable fraction Table 1 Alcohol related recorded crimes an aggregate of six offences violence against the person sexual offences robbery burglary dwelling theft of a motor vehicle and theft from a motor vehicle Violence against the person Sexual offences Crimes are recorded using the practice governed by Home Office Counting Rules for Recorded Crime and the National Crime Recording Standard Please see the following for more details www ons gov uk ons guide method method quality specific crime statistics methodology user 62 User G
77. nd beverage serving activities is part of the accommodation and food services group it is arguably one of the categories least affected by any changes 2 8 Changes to the alcohol related crime indicators The Office for National Statistics has redesigned the classifications used to present police recorded crime statistics These changes have been made to improve the understanding of crime statistics and to align police recorded crime with other crime datasets such as the British Crime Survey now the Crime Survey for England and Wales As a result of these changes data are no longer available in the seven key Further information is available at www ons gov uk ons guide method method quality specific crime statistics methodology user guide to crime statistics pdf 9 User Guide Local Alcohol Profiles for England 2014 offence crime groupings formerly released by the Home Office and used to produce the alcohol related recorded crime indicators for which attributable fractions are available Table 1 For example these changes require that crimes be classified in terms of whether they have a victim or not and as such selected offences are now transferred into different groups to better reflect the nature of the offences For example possession of weapon and public fear alarm or distress have now moved out of the violence against person without injury category to the sub categories of possessions
78. nical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available from www apho org uk resource item aspx RID 48457 An accompanying Excel spreadsheet replicating all formulae is also available from this website The confidence limits for the directly age standardised rate are given by SR SR oa x Ower o Var O DSR ye DSR pee One O where Var O O is the total observed count of events in the local or subject population Ojower ANd Oupper are the lower and upper confidence limits for the observed count of events Var O is the variance of the total observed count O DSR is the directly age standardised rate Var DSR is the variance of the directly age standardised rate lower D Using Byar s method the 100 1 a confidence limits for the observed number of events are given by 3 1 z O a0 aljen low i 90 is 3 I Z O O 4 1 x 1 a upper Pe 9 0 1 3 on User Guide Local Alcohol Profiles for England 2014 Caveats where z is the 100 1 ca 2 th percentile value from the Standard Normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the Standard Normal distribution The variances of the observed count O and the DSR are estimated by Var O 90 Var DSR 2 ge 7 where i O is the observed num
79. of death to be incorrectly attributed on the death certificate and the cause of death misclassified Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable fractions were not available for children Conditions where low levels of alcohol consumption are protective have a negative alcohol attributable fraction are not included in the calculation of the indicator 1 Select deaths under 75 2 Assemble three consecutive years of data for locality deaths in England 3 Assemble corresponding three consecutive years of locality mid year population estimates age bands lt 1 1 44 45 54 55 64 and 65 74 years 4 Reduce each observed death by the corresponding alcohol attributable fraction based on underlying cause of death 5 Attach national England and Wales three year aggregates years of life lost values to each fractional observed death from Office for National Statistics interim life tables www ons gov uk ons rel lifetables interim life tables 2010 2012 index html deaths in first year counted as life expectancy at birth deaths in years one to four counted as life expectancy at age two deaths in years five to nine counted as life expectancy at age seven and so on deaths at 70 74 counted as life expectancy at 72 6 Sum attributable years of life lost in age groups lt 1 1 44 45 54 55 64 65 74 by sex and
80. ons in England and Wales only offences with sample sizes of more than 50 arrestees have been included Intoxicated arrestees were not interviewed which suggests that some figures are likely to be underestimates and explains why drunkenness offences are not included The proportions of arrestees testing positive for alcohol and thus the associated attributable fractions are shown in Table 1 The most recent recorded crime data Table 2 for all local authorities in England were obtained from the Office for National Statistics and used to create crime groups to which an attributable fraction could be applied Table 2 lists the current referred to as New Office for National Statistics recorded crime categories and outlines given recent changes in the presentation of crime data how these relate to the crime data provided by the Home Office previously used to produce Local Alcohol Profiles for England indicators For further details see section 2 8 f Please note that the alcohol related recorded crimes only include those crimes for which an attributable fraction is available see Table 2 for details and it is an aggregate based upon the key offence categories formerly released by the Home Office 60 User Guide Local Alcohol Profiles for England 2014 Table 2 Offence groupings for alcohol related recorded crimes indicator Offence groupings used in New Office for National Statistics Local Alcohol Profiles for cr
81. ontents 3 1 0 Background 4 2 0 Key changes to the Local Alcohol Profiles for England 2014 5 5 2 1 Changes to the alcohol attributable fractions 2 2 Changes to the alcohol related hospital admission and admission episodes for alcohol related conditions indicators 5 2 3 Geographical changes 6 2 4 Changes to the European standard population 7 2 5 Changes to the recording of mortality data 8 2 6 Changes to the denominator populations 2011 census 8 2 7 Changes to the employees in bars indicator 8 2 8 Changes to the alcohol related crime indicators 9 3 0 Alcohol attributable fractions 11 3 1 Alcohol attributable fractions used to calculate alcohol related mortality and hospital admissions 3 2 Alcohol specific conditions 11 3 3 Alcohol related conditions 11 3 4 Alcohol attributable fractions for children 12 3 5 Alcohol attributable fractions used to calculate alcohol related crime 12 4 0 Confidence intervals 14 5 0 Local Alcohol Profiles for England online tool 15 5 1 Accessing the Local Alcohol Profiles for England tool 15 5 2 Selecting a profile from the launch page 15 5 3 Viewing local area profile charts and data 16 5 4 Downloading data 19 5 5 Associated reports and maps 20 5 6 Using the InstantAtlas functions 20 6 0 Indicator overview and metadata 21 6 1 Mortality and months of life lost due to alcohol 22 6 2 Number of people and number of admissions to hospital for alcohol related conditions 36 6 3 Alcohol related crime 60 6 4 Alcohol
82. ork Association of Public Health Observatories 91 Local Alcohol Profiles for England 2014 Appendix 1 Updated alcohol attributable fractions used to calculate alcohol specific and alcohol related hospital admission and mortality E ICD10 0 15 16 24 25 34 35 44 45 54 55 64 65 74 75 Condition code s m F M F M F M F M F M F M F M F Wholly attributable conditions Alcohol induced pseudo Cushing s E24 4 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 syndrome Mental and behavioural disorders due F10 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 to use of alcohol Degeneration of nervous system due to G31 2 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 alcohol i Alcoholic polyneuropathy G62 1 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Alcoholic myopathy G72 1 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Alcoholic cardiomyopathy 142 6 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Alcoholic gastritis K29 2 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 1 00 Alcoholic liver disease K70 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1 00 1 00 Alcohol induced acute pancreatitis K85 2 1 00 1 00 1 00 1 00 100 1 00 1 00 1 00 1 00 1
83. ory Alcohol attributable fraction Violence against the person 0 37 Sexual offences 0 13 Robbery 0 12 Burglary 0 17 Theft of motor vehicle 0 13 Theft from a motor vehicle 0 13 13 User Guide Local Alcohol Profiles for England 2014 4 0 Confidence intervals The majority of estimates presented within the Local Alcohol Profiles for England are accompanied by confidence intervals The following definition of a confidence interval is taken from the following briefing Commonly Used Public Health Statistics and their Confidence Intervals available at www apho org uk resource item aspx RID 48457 A confidence interval is a range of values that is normally used to describe the uncertainty around a point estimate of a quantity This uncertainty arises as factors influencing the indicator are subject to chance occurrences that are inherent in the world around us These occurrences result in random fluctuations in the indicator value between different areas and time periods In the case of indicators based on a sample of the population uncertainty also arises from random differences between the sample and the population itself The stated value should therefore be considered as only an estimate of the true or underlying value Confidence intervals quantify the uncertainty in this estimate and generally speaking describe how different the point estimate could have been if the underlying conditions stayed the same but chance had led to a d
84. pital episode statistics dataset fields Select hospital episode statistics records where the admission is a finished episode epistat 3 the admission is an ordinary admission day case or maternity classpat 1 2 or 5 the sex of the patient is valid sex 1 or 2 there is a valid age under 18 at start of episode startage between 0 17 or between 7001 7007 the region of residence is one of the English regions resgor lt K or U or Y the episode end date epiend falls within the specified period an alcohol specific International Classification of Diseases version 10 code Appendix 1 appears in any diagnosis field diag_nn Select a single diagnosis to create a person based indicator by identifying all alcohol specific diagnosis codes for each individual using hospital episode statistics identification code within each financial year in the event of there being two or more episodes with an alcohol specific diagnosis select the one from the earliest episode using start date epistart in the event of there being two or more alcohol specific diagnoses within the same episode select the one from the lowest diagnostic position diag_nn Diagnostic position takes an integer value between 1 and 20 corresponding to the 20 diagnosis fields diag_01 to diag_20 Calculate crude rates by aggregating alcohol specific admissions above by area of residence aggregating under 18 year olds mid year population e
85. populations were multiplied by the predicted probabilities for each of the seven consumption groupings in the respective age sex ethnicity group to obtain predicted numbers These 2001 Lower Super Output Area level predicted numbers were aggregated to Local Authority level Overall prevalence estimates were obtained by summing the predicted numbers of abstainers and lower risk increasing risk and higher risk drinkers over all sex age ethnicity groups in each local authority 74 User Guide Local Alcohol Profiles for England 2014 Table 3 Estimated model parameters for drinkers consuming gt 0 to 9 units with respect to the base category abstainers 95 Confidence Interval for Exp B Lower Upper NewDrinkCat ig Bound Bound gt 0to9 Intercept AS_Adm_3yr_Qtle 1 AS_Adm_ 3yr_Qtle 2 AS_Adm_ 3yr_Qtle 3 AS_Adm_ 3yr_Qtle 4 AS_Adm_ 3yr_Qtle 5 male female White Black Asian AG15 AG20 AG25 AG30 AG35 AG40 AG45 AG50 AG55 AG60 AG65 AG70 AG75 IMD_LSOA_Qtile 1 IMD_LSOA_Qtile 2 IMD_LSOA_Qtile 3 ooo oo 0c 0000 IMD_LSOA Qtile 4 IMD_LSOA_Qtile 5 Peopleandplaces A Peopleandplaces B Peopleandplaces C Peopleandplaces D Peopleandplaces E Peopleandplaces F Peopleandplaces G Peopleandplaces H Peopleandplaces l Peopleandplaces J Peopleandplaces k Peopleandplaces L Peopleandplaces M Peopleandplaces U The reference category is Abstain This pa
86. rameter is set to zero because it is redundant 15 User Guide Local Alcohol Profiles for England 2014 Table 4 Estimated model parameters for drinkers consuming 10 to 14 units with respect to the base category abstainers 95 Confidence Interval for Exp B Lower Upper NewDrinkCat ig Bound Bound 10 to 14 Intercept AS_Adm_3yr_Qtle 1 AS_Adm_ 3yr_Qtle 2 AS_Adm_ 3yr_Qtle 3 AS_Adm_ 3yr_Qtle 4 AS_Adm_ 3yr_Qtle 5 male female White Black Asian AG15 AG20 AG25 AG30 AG35 AG40 AG45 AG50 AG55 AG60 AG65 AG70 AG75 IMD_LSOA_Qtile 1 IMD_LSOA_Qtile 2 IMD_LSOA_Qtile 3 ooo oo 0c00 0 0 IMD_LSOA Qtile 4 IMD_LSOA_Qtile 5 Peopleandplaces A Peopleandplaces B Peopleandplaces C Peopleandplaces D Peopleandplaces E Peopleandplaces F Peopleandplaces G Peopleandplaces H Peopleandplaces l Peopleandplaces J Peopleandplaces k Peopleandplaces L Peopleandplaces M Peopleandplaces U The reference category is Abstain This parameter is set to zero because it is redundant 76 User Guide Local Alcohol Profiles for England 2014 Table 5 Estimated model parameters for drinkers consuming 15 to 21 units with respect to the base category abstainers 95 Confidence Interval for Exp B Lower Upper NewDrinkCat ig Bound Bound 15 to 21 Intercept AS_Adm_ 3yr_Qtle 1 AS_Adm_ 3yr_Qtle 2 AS_Adm_ 3yr_Qtle 3 AS_Adm_3yr_Qtle 4 AS_Adm_
87. raphies The Wilson Score method was used to generate 95 confidence intervals as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available from www apho org uk apho techbrief htm An accompanying Excel spreadsheet replicating all formulae is also available from the link above The proportion p is given by P 2 where O is the numerator observed number of individuals in the sample population having the specified characteristics n is the denominator total number of individuals in the sample population Using the Wilson Score method the 100 1 a confidence limits for the proportion p are given by bo 2 fz 404 Prower An z E korz z 7404 Pare nz where qis 1 p z is the 100 1 ca 2 th percentile value from the standard normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the standard normal distribution BRES is based on a sample survey so estimates are subject to sampling errors which need to be taken into account when 89 User Guide Local Alcohol Profiles for England 2014 Method used to create this indicator Summary footnote interpreting the data For further details see www ons gov uk ons guide method method quality specific labour market business register and employment survey
88. re generated ethnicity populations had not been shown to meet the quality criteria for the Office for National Statistics but were published to involve users in the development of the methodology and to help build quality at an early stage Estimates for abstainers and lower risk increasing risk and higher risk drinking as a percentage of the drinking population were derived from a statistical model developed to estimate the percentage of males and females who abstain consume gt 0 to 9 units 10 to 14 units 15 to 21 units 22 to 35 units 36 to 50 units and gt 50 units per week in Lower Super Output Areas The overall process of producing these prevalence estimates for abstainers and lower risk increasing risk 71 User Guide Local Alcohol Profiles for England 2014 and higher risk drinking as a percentage of the drinking population involved a number of steps 1 The probability of abstaining or being a lower increasing or higher risk drinker was modelled using multinomial regression as a function of variables measured at the individual age sex ethnicity and area Index of Multiple Deprivation 2010 quintiles P People and Places classification and alcohol specific hospital admission 2007 08 to 2009 10 quintiles 2 The model was used to generate estimated probabilities for seven categories abstainers and each consumption group by age group sex and ethnicity for all Lower Super Output Areas 3 Age sex ethnici
89. rom this website The confidence limits for the directly age standardised rate are given by DSR DSR power DSR ase x rover o Var O DSR DSR TOS 0 0 here Var O O is the total observed count of events in the local or subject population Olower and Oupper are the lower and upper confidence limits for the observed count of events Var O is the variance of the total observed count O DSR is the directly age standardised rate Var DSR is the variance of the directly age standardised rate Using Byar s method the 100 1 a confidence limits for the observed number of events are given by 3 i Z e E low 90 is 3 1 Zz O 0 1 x 1 upper 9 0 1 3 in where z is the 100 1 a 2 th percentile value from the standard normal distribution For example for a 95 confidence interval a 0 05 and z 1 96 i e the 97 5th percentile value from the standard normal distribution The variances of the observed count O and the DSR are estimated by Var O 910 O 1 0 Var DSR xy 2 gt w iki where i O is the observed number of events in the local or subject population in age group i n is the number of individuals in the local or subject 30 User Guide Local Alcohol Profiles for England 2014 Caveats Method used to create this indicator Summary footnote denominator population in age group or the population x period at risk e g person
90. ry footnote n is the number of individuals in the subject population in age sex group Admission episodes for alcohol related conditions broad measure primary diagnosis or any secondary diagnosis and narrow measure primary diagnosis or any secondary diagnosis with an external cause all ages directly age standardised rate per 100 000 population standardised to the European standard population Knowledge and Intelligence Team North West from hospital episode statistics 2012 13 Office for National Statistics mid year population estimates 2012 Does not include attendance at Accident and Emergency departments 59 User Guide Local Alcohol Profiles for England 2014 6 3 Alcohol related crime 18 Alcohol related recorded crimes 19 Alcohol related violent crimes 20 Alcohol related sexual offences Recorded crime related to alcohol is calculated using the former UK Prime Minister s Strategy Unit s alcohol attributable fractions available at webarchive nationalarchives gov uk 20100407182953 http www cabinetoffic e gov uk media cabinetoffice strategy assets econ_annexes pdf and applying them to specific groups of recorded crimes The alcohol attributable fractions were taken from the Home Office New English and Welsh Arrestee Drug Abuse Monitoring System arrestee survey NEW ADAM 1999 2001 and were based on urine tests of arrestees One in five arrestees tested positive for alcohol Data were taken from 16 police stati
91. s Female Alcohol specific hospital admissions Male Alcohol specific hospital admissions Female Alechol specific hospital admissions Under 18s Hospital admissions for alcohol related harm NBS User Guide For guidance and methods advice download our i User Guide Aequrer Adose Acrobat Reaser Alcohol E shot Sign Up E Koop in touch with the latest alcohol research avidance policy and media articles Sign up for our E shot Alcohol ettributable recorded crimes Alcohol attributable violent cimes Alcoholreteted sexual offences Claimants of incapacity benefits Working age Employees in bars percentage of all employees Abstainers synthetic estimate Lower risk drinking of drinkers only synthetic estimate Increasing risk drinking of drinkers only synthetic estimate Highoe risk drinking of drinkers only synthetic estimate 5 6 Using the InstantAtlas functions The Atlas tab allows you to select profiles for each local authority An area can be selected by clicking on the map or the area name Local Alcohol Profiles for England Profiles Maps Data Resources An area can be selected by clicking on the map or the se uee Months of Life Lost Months of life lost due to alcohol Males aged less than 75 years 2010 2012 name Indicator area name a aau 12 Q Allertate 1147 q amde os Adan iht Ashfield ahtord o 9 Q Aylesbury Vi 9 86 Q nebergh 46 arkong and
92. s week If this was greater than zero information on the heaviest drinking day was collected on the types of alcoholic drink e g beer spirits wine and so on and amount to allow a calculation of units drunk From these questions an estimated weekly consumption expressed in terms of units of alcohol was derived Respondents whose information on drinking was missing were excluded England and former government office regions the former government office region and England estimates are taken directly from the Health Survey for England reported results for 2007 2008 Local authority The methodology for the Middle Super Output Area level estimates is available at www apho org uk resource view aspx RID 96790 The estimates for local authorities unitary authorities and counties are calculated by aggregating the estimates and populations for their constituent Middle Super Output Areas The Middle Super Output Area populations were the average of the mid year estimates for the relevant years available at September 2010 Synthetic estimate of the percentage of adults who consume at least twice the daily recommended amount of alcohol in a single drinking session that is eight or more units for men and six or more units for women Estimates produced for the former Association of Public Health Observatories 2007 2008 Revised dataset published March 2011 and updated to Local Alcohol Profiles for England resources in April 2012 Please see
93. s where the primary code is an alcohol related condition listed in Appendix 1 or episodes where the primary code is not an alcohol related condition but one of the secondary codes is an external cause with an j Previously National Indicator 39 NI39 36 User Guide Local Alcohol Profiles for England 2014 alcohol attributable fraction listed in Appendix 1 For more information on this new narrow indicator and how it differs from the old broad indicator see section 2 2 As with the broad indicator of alcohol related hospital admissions rules are produced in order to avoid double counting of people and these are described below Rules to allocate individuals to a single International Classification of Diseases version 10 code for person based analysis narrow indicator For each individual 1 Identify all alcohol attributable diagnosis codes from their hospital episode statistics records 2 Select the code s for which the primary diagnosis code is an alcohol attributable diagnosis code or an alcohol attributable external cause code appears in one of the secondary codes 3 Select the code s with the largest attributable fraction 4 In the event of there being two or more episodes with the same high attributable fraction select the one from the earliest episode using start date Person specific admissions were originally adopted by the former North West Public Health Observatory now the Knowledge and Intelligence Team North
94. s within the specified period an alcohol specific International Classification of Diseases version 10 code Appendix 1 appears in any diagnosis field diag_nn Select a single diagnosis to create a person based indicator by identifying all alcohol specific diagnosis codes for each individual using hospital episode statistics Identification code within the financial year 45 User Guide Local Alcohol Profiles for England 2014 Summary footnote in the event of there being two or more episodes with an alcohol specific diagnosis select the one from the earliest episode using start date epistart in the event of there being two or more alcohol specific diagnoses within the same episode select the one from the lowest diagnostic position diag_nn Diagnostic position takes an integer value between 1 and 20 corresponding to the 20 diagnosis fields diag_01 to diag_20 Calculate directly age standardised rate by aggregating alcohol specific admissions above by age group 5 year age bands to age 89 and 90 years and over sex and area of residence using mid year population estimates to derive age group and sex specific rates for each area calculating directly age standardised rate per 100 000 population standardised to the European standard population Persons admitted to hospital due to alcohol specific conditions all ages males females directly age standardised rate per 100 000 population standardised to th
95. stats crime statistics period ending march 2013 supplementary tables rft recorded crime data at community safety partnership local authority level from 2002 03 zip Recent crime trend data suggest that rates of crime overall are falling for further details see www ons gov uk ons rel crime stats crime statistics period ending september 201 3 index html Conversely there is some evidence of increasing reports of sexual offences for further details see www ons gov uk ons rel crime stats crime statistics period ending june 2013 index html This could arguably be due to a number of factors for example improvements in the recording of such offences as well as the increased awareness of such crimes given numerous high profile sex related cases in the media during recent months in turn leading to increased reporting for sexual crimes including those that might have happened a number of years ago The alcohol attributable fractions in Table 1 were applied to the recorded crime offences for 1 alcohol related recorded crimes 2 violence against the person and 3 sexual offences Please note that the alcohol related recorded crime indicator is a sum of the following recorded offences violence against the person sexual offences robbery burglary dwelling theft of a motor vehicle and theft from a motor vehicle Crude rates were calculated using mid year Office for National Statistics populations Crude rates per 1 000 were calculated
96. stimates for each area Crude rates per 100 000 were calculated using the 41 User Guide Local Alcohol Profiles for England 2014 Summary footnote following formula a b x 100 000 where a is the number of alcohol specific person based admissions for under 18 year olds b is the Office for National Statistic s population estimates for under 18 year olds Persons admitted to hospital due to alcohol specific conditions under 18 year olds crude rate per 100 000 population Knowledge and Intelligence Team North West from hospital episode statistics 2010 11 to 2012 13 Office for National Statistics mid year population estimates 2010 2011 and 2012 Does not include attendance at Accident and Emergency departments 42 User Guide Local Alcohol Profiles for England 2014 Indicator details alcohol specific hospital admission males and females IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition Numerator source Denominator definition Denominator source Confidence interval methodology 10 and 11 Alcohol specific hospital admission males and females Individual persons admitted to hospital due to alcohol specific conditions Males and females all ages Financial year 2012 13 Trends are available for years 2008 09 2009 10 2010 11 and 2011 12 Persons admitted to hosp
97. t in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Mortality data are considered to be complete and robust Records without a valid area code are excluded the number of these is negligible There is the potential for the underlying cause of death to be incorrectly attributed on the death certificate and the cause of death misclassified Children aged less than 16 years were only included for alcohol specific conditions and for low birth weight Appendix 1 For other conditions alcohol attributable fractions were not available for children Conditions where low levels of alcohol consumption are protective have a negative alcohol attributable fraction are not included in the calculation of the indicator Each alcohol related death is assigned an alcohol attributable fraction Appendix 1 based on underlying cause of death The alcohol attributable fractions are then aggregated by age group 0 4 5 8 85 90 90 sex and area of residence Mid year population estimates are used to calculate directly age standardised rates The directly age standardised rate is the rate of events that would occur in a population with a standard age structure if
98. ta published in previous versions The Knowledge and Intelligence Team North West have recalculated data for previous years in line with recent changes in order to ensure comparisons across years are valid 2 1 Changes to the alcohol attributable fractions Section 3 describes what alcohol attributable fractions are and how they are derived In 2014 the alcohol attributable fractions that are applied to mortality and hospital admission data were updated to take into account new epidemiological evidence for the association between alcohol consumption and health related outcomes This exercise resulted in some important changes to the number of health conditions and external causes that are identified as being alcohol related and also a recalculation of the attributable fractions for some of the existing health measures For more information about this update see Jones et al 2014 For more information on the previous alcohol attributable fractions see Jones et al 2008 The updated alcohol attributable fractions are presented in Appendix 1 2 2 Changes to the alcohol related hospital admission and admission episodes for alcohol related conditions indicators In 2013 following a stakeholder consultation PHE announced that the current indicator for admission episodes for alcohol related conditions previously National Indicator 39 would be supplemented by a new indicator The Local Alcohol Profiles for England 2014 includes both the old
99. that population were to experience the age specific rates of the subject population The standard population used is the European standard population The age groups used are 0 4 5 9 85 90 90 years The rate is expressed per 100 000 population Comparability ratios were used in the calculation of trend data see section 2 5 for more details 34 User Guide Local Alcohol Profiles for England 2014 Summary footnote Deaths from alcohol related conditions all ages males females directly age standardised rate per 100 000 population standardised to the European standard population Knowledge and Intelligence Team North West from the Office for National Statistics Public Health Mortality File for 2012 and mid year population estimates for 2012 35 User Guide Local Alcohol Profiles for England 2014 6 2 Number of people and number of admissions to hospital for alcohol related conditions 9 Alcohol specific hospital admission under 18 year olds 10 Alcohol specific hospital admission males 11 Alcohol specific hospital admission females 12 and 14 Alcohol related hospital admission broad and narrow measures males 13 and 15 Alcohol related hospital admission broad and narrow measures females 16 and 17 Admission episodes for alcohol related conditions broad and narrow measures To calculate the broad indicators of alcohol related hospital admissions the list of International Classifi
100. the crude age sex specific rate in the subject poptlation in age sex group given by n where O is the observed number of events in the subject population in age sex group i ni is the number of individuals in the subject population in age sex group Narrow measure 1 Select hospital episode statistics records where the admission is a finished episode epistat 3 the admission is an ordinary admission day case or maternity classpat 1 2 or 5 it is an admission episode epiorder 1 the sex of the patient is valid sex 1 or 2 there is a valid age at start of episode startage between 0 120 or between 7001 7007 the region of residence is one of the English regions no fixed abode or unknown resgor lt K or U or Y the episode end date epiend falls within the financial year an alcohol attributable International Classification of Diseases version 10 code Appendix 1 appears in any diagnosis field diag_nn 2 For each episode identified in step 1 above an alcohol attributable fraction is applied to the primary diagnosis field 57 User Guide Local Alcohol Profiles for England 2014 diag_01 or an alcohol attributable external cause code Appendix 1 appears in one of the secondary codes diag_02 to diag_20 based on the diagnostic codes age group and sex of the patient Appendix 1 Where there is more than one alcohol related International Classification of Diseases version 10 code among the 2
101. this report for more details Deaths from chronic liver disease including cirrhosis International Classification of Diseases version 10 K70 K73 K74 all ages males females directly age standardised rate per 100 000 population standardised to the European standard population Knowledge and Intelligence Team North West from the Public Health Mortality File for 2010 2012 and Office for National Statistics mid year population estimates for 2010 2012 31 User Guide Local Alcohol Profiles for England 2014 Indicator details alcohol related mortality males and females IDs Indicator name What is being measured Who does it measure When does it measure Indicator definition Timeliness Geographical coverage Numerator definition Numerator source Denominator definition Denominator source Confidence interval methodology 7 and 8 Alcohol related mortality males and females Mortality from alcohol related conditions Males and females all ages Calendar year 2012 Trends are available for 2008 2009 2010 and 2011 Mortality from alcohol related conditions directly age standardised rate males and females all ages per 100 000 European standard population Produced annually by the Knowledge and Intelligence Team North West The Office for National Statistics provides Knowledge and Intelligence Teams with the annual extract and mid year population estimates around July September
102. ty Index of Multiple Deprivation 2010 P People and Places and alcohol specific hospital admission quintile probabilities were applied to the age sex and ethnicity specific population estimates for each 2001 Lower Super Output Area to provide an estimate of the overall number in each of the consumption categories 4 The consumption categories were transformed to abstaining and lower increasing and higher risk drinking groups based on the specific male and female thresholds 5 2001 Lower Super Output Areas were aggregated to local authority former government office regions England level Predictive modelling in detail To compile the predictive model individual level data from the General Lifestyle Survey 2008 and 2009 along with a number of 2001 Lower Super Output Area level covariates were used to determine the relationship between abstainers consumers of gt 0 to 9 units 10 to 14 units 15 to 21 units 22 to 35 units 36 to 50 units and gt 50 units per week The variables used in the final model included e Three individual level variables o age bands 16 19 20 24 70 74 75 years O sex o ethnic groups white Asian and black other e Two 2001 Lower Super Output Areas level 72 User Guide Local Alcohol Profiles for England 2014 covariates transformed to quintiles o Index of Multiple Deprivation 2010 o Alcohol specific hospital admission 2007 08 to 2009 10 persons A further geographic identifier P
103. uide Local Alcohol Profiles for England 2014 Numerator source Denominator definition Denominator source Confidence interval methodology guide to crime statistics pdf Numerator data have been used exactly as published in the Home Office supplied data Where new unitary authorities created as part of the 2009 boundary changes are exactly coterminous with pre existing counties Cornwall Durham Northumberland Shropshire and Wiltshire the numerator data have been drawn from the relevant county figures Where new unitary authorities represent only part of existing counties numerator data have been aggregated from the relevant published figures for the constituent districts Office for National Statistics www ons gov uk ons rel crime stats crime statistics period ending september 201 3 index html Mid year population estimates 2011 Office for National Statistics Byar s methodology was used to generate 95 confidence intervals as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available from www apho org uk apho techbrief htm An accompanying Excel spreadsheet replicating all formulae is also available from the link above The rate of events ris given by where E O is the numerator number of observed events n is the denominator population years at risk The confidence limits for
104. using the following formula a x b c x 1 000 where a alcohol attributable fraction 65 User Guide Local Alcohol Profiles for England 2014 Summary footnote b number of offences c Office for National Statistics population estimate all ages The following formula was used to calculate the sum of the six offences included in the alcohol related crime rate indicator a x b a x b a x b af x b a x b af x b c x 1 000 Alcohol related recorded crimes based on the Home Office s former key offence categories all ages persons crude rate per 1 000 population Knowledge and Intelligence Team North West from Office for National Statistics recorded crime statistics 2012 13 Office for National Statistics 2011 mid year populations Attributable fractions for alcohol for each crime category were applied based on survey data on arrestees who tested positive for alcohol by the UK Prime Minister s Strategy Unit 66 User Guide Local Alcohol Profiles for England 2014 6 4 Alcohol consumption by adults 21 22 23 24 25 Abstainers synthetic estimate Lower risk drinking as a percentage of drinkers synthetic estimate Increasing risk drinking as a percentage of drinkers synthetic estimate Higher risk drinking as a percentage of drinkers synthetic estimate Binge drinking synthetic estimate Five synthetic drinking estimates are included in Local Alcohol
105. uthority districts non metropolitan districts unitary authorities London boroughs and metropolitan districts and PHE centres The data download also provides data for former government office regions Persons aged less than 18 years admitted to hospital where the primary diagnosis or any of the secondary diagnoses are an alcohol specific code Appendix 1 for years 2010 11 to 2012 13 The Health and Social Care Information Centre HSCIC Mid year population estimates 2010 2011 and 2012 for 0 17 year olds The Office for National Statistics Byar s methodology was used to generate 95 confidence intervals as detailed in APHO Technical Briefing 3 Commonly Used Public Health Statistics and their Confidence Intervals The formula numbers below correspond to those in the briefing available 39 User Guide Local Alcohol Profiles for England 2014 Caveats from www apho org uk resource item aspx RID 48457 An accompanying Excel spreadsheet replicating all formulae is also available from the link above The rate of events ris given by O r n where O is the numerator number of observed events n is the denominator population years at risk The copfidence limits for the rate r are given by lower Power Ia O n upper r upper n where Ojower ANd Oupper are the lower and upper confidence limits for the observed count of events Using Byar s method the 100 1 c confidence limits
106. vailable for children Conditions where low levels of alcohol consumption are protective have a negative alcohol attributable fraction are not included in the calculation of the indicator Broad measure Male female alcohol related hospital admission are calculated as follows Select hospital episode statistics records where the admission is a finished episode epistat 3 the admission is an ordinary admission day case or maternity classpat 1 2 or 5 the sex of the patient is valid sex 1 or 2 there is a valid age at start of episode startage between 0 120 or between 7001 7007 the region of residence is one of the English regions no fixed abode or unknown resgor lt K or U or Y the episode end date epiend falls within the financial year an alcohol related International Classification of Diseases version 10 code Appendix 1 appears in any diagnosis field diag_nn For each episode identified in step 1 above attach the appropriate alcohol attributable fraction to the alcohol attributable diagnoses using the International Classification of Diseases version 10 code age group and sex of the patient Appendix 1 3 Select a single diagnosis to create a person based indicator by identifying all alcohol attributable diagnosis codes for each individual using hospital episode statistics Identification code within the financial year select the code s with the largest attributable fraction in the event of th
107. ve attributable fraction where low levels of alcohol consumption were found to have a protective effect such as diabetes mellitus type II Appendix 1 Outcomes where alcohol has a protective effect are not included when the alcohol attributable fractions are applied to mortality and hospital episode statistics data 3 2 Alcohol specific conditions Alcohol specific conditions include those conditions where alcohol is causally implicated in all cases of the condition for example alcohol induced behavioural disorders and alcohol related liver cirrhosis The alcohol attributable fraction is 1 0 because all cases 100 are caused by alcohol 3 3 Alcohol related conditions Alcohol related conditions include all alcohol specific conditions plus those where alcohol is causally implicated in some but not all cases of the outcome for example 11 User Guide Local Alcohol Profiles for England 2014 hypertensive diseases various cancers and falls The attributable fractions for alcohol related outcomes used here range from between 0 and less than 1 0 For example the alcohol attributable fraction for mortality from pneumonia among men aged 75 and over is 0 10 because the latest epidemiological data suggest that 10 of pneumonia cases among this population are due to alcohol Outcomes where alcohol has a protective effect i e the fraction is less than 0 are not included when the alcohol attributable fractions are applied to mortality and hospita
108. y femates e o Alconhot specific hospital admission under 18s c Alcohol specific hosptal admission mates e The interquartile range is the distance between the 75th percentile and the 25th percentile The Trend charts tab displays local trends over five time periods for 12 selected indicators 16 User Guide Local Alcohol Profiles for England 2014 LAPE 3 Local Alcohol Profiles for England Maps Atlas Data Resources Public Health England centre area Cheshire and Merseyside Return to the map to choose another profile Change Profile Area Area profile summary You are viewing profile data for Liverpool i To change the area please choose an option from the dropdown menu below Download this profile as a PDF Liverpool a Chart Data Footnotes Aechol related mortahty lemales Mortality from chrome liver disease Mortaiity trom chrorsc liver disease males femates kad zanu a Sao s ae i 0 j Es me E E l i f r 4 z 3 g PES ES H s 0 o Hospital Admission Alcobol relates hosptal s vsaon Alcchel related hospital smau Alcohol related hosptal s meson Alcohol related hosptal s meaon Broad males Broad females Narrow males Narrow termales gans DSN pur 10000 papatan sugg DSA por 100000 papatan Dp 10000 ppt s g oag DSN pur 100000 papadatian ots eeaa8 wader 12s The Data tab displays the local values the measure national rank and PHE centr
109. years w is the number or proportion of individuals in the reference or standard population in age group The Excel formulae available at www apho org uk resource item aspx RID 48617 were used to calculate confidence intervals The spreadsheet uses Excel s built in functions for exact probabilities for all cases based on numerators under 389 in order to give the most accurate results For higher numerators Excel s statistical functions fail intermittently and while macros are available to calculate exact Poisson probabilities it is simpler to use Byar s method and extremely accurate to do so Mortality data are considered to be complete and robust Records without a valid area code are excluded the number of these is negligible There is the potential for the underlying cause of death to be incorrectly attributed on the death certificate and the cause of death misclassified The directly age standardised rate is the rate of events that would occur in a population with a standard age structure if that population were to experience the age specific rates of the subject population The standard population used is the European standard population The age groups used are 0 4 5 9 85 90 90 years The rate for 2010 2012 has been calculated as the simple average of the individual annual rates The rate is expressed per 100 000 population Comparability ratios were used in the calculation of trend data see section 2 5 of

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