The distribution of alcohol-attributable healthcare encounters across the population of alcohol users in Ontario, Canada
Date
2023
Authors
Andreacchi, Alessandra T.
Smith, Brendan T.
Rehm, Jürgen
Crépault, Jean-François
Sherk, Adam
Hobin, Erin
Journal Title
Journal ISSN
Volume Title
Publisher
Preventive Medicine Reports
Abstract
Recent evidence suggests there may be no safe level of alcohol use as even low levels are associated with increased risk for harm. However, the magnitude of the population-level health burden from lower levels of alcohol use is poorly understood. The objective was to estimate the distribution of alcohol-attributable healthcare encounters (emergency department (ED) visits and hospitalizations) across the population of alcohol users aged 15+ in Ontario, Canada. Using the International Model of Alcohol Harms and Policies (InterMAHP) tool, wholly and partially alcohol-attributable healthcare encounters were estimated across alcohol users: (1) former (no past-year use); (2) low volume (≤67.3 g ethanol/week); (3) medium volume (>67.3–134.5 g ethanol/week for women and >67.3–201.8 g ethanol/week for men); and (4) high volume (>134.5 g ethanol/week for women and >201.8 g ethanol/week for men). The alcohol-attributable healthcare burden was distributed across the population of alcohol users. A small population of high volume users (23% of men, 13% of women) were estimated to have contributed to the greatest proportion of alcohol-attributable healthcare encounters, particularly among men (men: 65% of ED visits and 71% of hospitalizations, women: 49% of ED visits and 50% of hospitalizations). The 71% of women low and medium volumes users were estimated to have contributed to a substantial proportion of alcohol-attributable healthcare encounters (47% of ED visits and 34% of hospitalizations). Findings provide support for universal alcohol policies (i.e., delivered to the entire population) for reducing population-level alcohol-attributable harm in addition to targeted policies for high-risk users.
Description
The authors gratefully acknowledge the contributions of Nicole Schoer for conducting the manuscript’s initial analyses.
Keywords
Alcohol use, Universal policies, Prevention paradox, Substance use, Geoffrey Rose, Canada
Citation
Andreacchi, A. T., Smith, B. T., Rehm, J., Crépault, J-F., Sherk, A., & Hobin, E. (2023). The distribution of alcohol-attributable healthcare encounters across the population of alcohol users in Ontario, Canada. Preventive Medicine Reports, 35, 102388. https://doi.org/10.1016/j.pmedr.2023.102388