Who is holding back progress on liver disease?

Date: 22/10/2014 Written by: Kelly 5 minutes to read.
Comment and case example

Liver disease is a public health priority and there has been an alarming rise in liver disease related deaths, with males in the north being more likely to die from the disease than those in the south. Knowing this allows first steps to be taken in order to reduce it, but these need to focus on the long-term rather than providing a fix for the short-term. Too much focus is placed on keeping people happy, when the real focus should be on keeping them healthy.

Earlier this week, Public Health England (PHE) reported an alarming 40% rise in liver disease related deaths - over 90% due to risk factors that could be treated and avoided such as alcohol, hepatitis B and C, and obesity. 

Liver disease is a public health priority according to PHE. In a depressing speech last week Prof Julia Verne said that all the preventable causes are on the rise, with alcohol accounting for 37% of liver disease deaths. 

In 62 local authority areas, alcohol is a public health priority and PHE are promising to do more to raise awareness, nationally and locally, and Julia is calling on the public - and public health professionals to understand their local picture.

Looking at the figures in more detail there is a stark divide between the south and the north of England with more than four times as many male adults dying from the disease in Blackpool (58.4 per 100,000) than central Bedfordshire (13 per 100,000). The results reveal significant variations in mortality across the country from liver disease – the only major cause of death and sickness which is on the rise in England while falling in the rest of Europe. 

Having these profiles is good news. It means we can start to do something about it. But often when figures like these are released, panic strikes and pressure is forced on local areas to do something quick. What results is often a short term fix - or in some cases - no fix at all. Taking on this issue is going to take more than a few billboard posters and some shock tactics. Understanding people, understanding the environment and understanding who or what influences excessive drinking AND putting in place effective programmes of support or restructuring our environment is key to turning the tide on these statistics. This might be an occasion where we start to reflect on why England has this problem and learn a little something from our European neighbours...Ok, we can't be like the French, but surely looking beyond our borders can help identify some realistic solutions? 

But the biggest barrier to solving this issue is likely to be the very organisations now in charge of solving this problem. Local authorities. Not all, but some for sure. For those of you who are unaware, public health now sit within local authorities and teams have to present their plans to our local politicians before steaming ahead. I have spoken with a number of public health professionals who have worked on alcohol strategies for their local area, proposing changes and coming up with solutions only to be told by councillors that they can't do it. Why? Because they might upset their electorate with 'nanny state' tactics or telling people not to drink is not 'popular'. Popular for who? You or the people dying from liver disease? Some have even been told to 'water down' their strategies. How ironic. 

What we need is strong leadership -local authorities who are prepared to take some drastic steps and lead the way on this issue. It might not be popular,  but if it means lives could be saved from this appauling disease let's do it. But with an election looming and public health strategies not getting off the starting line, I fear the long road to recovery will not be a sober one. 

Kelly Evans is a Director at Social Change UK, a social research and campaign company based in Lincoln but working across the UK and in Europe. 

Our work on alcohol reduction in the home

Earlier this year, we worked with a local authority keen to take on alcohol harm in their city. We carried out research and piloted solutions in Derby on behalf of the public health team at Derby City Council, examining alcohol related arrests, alcohol related admissions to hospital and drinking in the home. The project examined attitudes and behaviours and uncovered some interesting insights that have since been embedded in the city alcohol plan. 

One piece of insight discovered during research was that many people do not measure their drinks at home and hugely underestimate the units consumed.  We were asked to test whether information alone, or information with a tool  - in this case a measuring cup - would change attitudes and behaviours. 150 Participants were given a booklet with information on drinking responsibly, with stories and information on units. Another 150 participants were given a measuring cup alongside the booklet.

Interestingly, participants that were provided with a measuring cup were more likely to find the information on the book more useful, as opposed to those without the measuring cup. Findings also highlighted that participants with a measuring cup were more likely to find information on cutting down on alcohol consumption more useful, rather than those that were only provided with the booklet. This suggests that providing individuals with information is more useful if there is also a tool that will allow them to put into practice the advice and information they have been given.

For more information on this project contact Ammar at Social Change UK.

Research: At Social Change UK, we are able to carry out research that could generate insight into behaviour and attitudes around drinking that could be transformed into a campaign to help reduce alcohol related harm. For more information on the services we offer and the previous work we have carried out, please visit our social research page and our campaigns page on previous behavioural change campaigns.

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