Professor of Behavioural Epidemiology
areas of expertise
Alcohol’s harms to others: the harms from other people’s alcohol consumption in Wales
Internationally, there is growing recognition of the harms that an individual’s alcohol consumption can cause to those around them (referred to as alcohol’s harms to others). Consequently, research into this issue has started to emerge highlighting the nature, extent and costs of alcohol’s harms to others across various populations. This report looks at the harms from other people’s alcohol consumption in Wales.
Niwed Alcohol I Eraill: y niwed oherwydd defnydd pobl eraill o alcohol yng Nghymru
Yn rhyngwladol, mae cydnabyddiaeth gynyddol o’r niwed y gall defnydd unigolyn o alcohol ei achosi i’r rheiny o’u hamgylch (cyfeirir at hyn fel niwed alcohol i eraill). O ganlyniad, mae ymchwil i’r mater hwn wedi dechrau dod i’r amlwg gan amlygu natur, graddau a chostau niwed alcohol i eraill ar draws poblogaethau amrywiol.
Adverse Childhood Experiences (ACEs) in Hertfordshire, Luton and Northamptonshire
Adverse childhood experiences (ACEs) include a range of stressful events that children may be exposed to growing up, including: physical, sexual or emotional childhood abuse; family breakdown; exposure to domestic violence; or living in a household affected by substance misuse, mental illness or where someone is incarcerated. A growing body of research has identified that individuals’ childhood experiences are fundamental in determining their future health and social prospects, with ACEs being one of the strongest predictors of poor health and social outcomes in adults.
A cross-sectional survey of 5,454 adults, aged 18-69 years resident in Hertfordshire, Luton and Northamptonshire identified that a substantial proportion of the adult population suffered abuse, neglect or other household dysfunction during their childhood. At least four in ten (44.4%) adults have experienced one or more ACEs and almost one in ten (9.1%) have suffered four or more. The prevalence of individual ACEs ranges from 3.1% of residents reporting living with someone who was incarcerated, to 22.9% experiencing verbal abuse by a parent or adult in their home during their childhood.
The findings of this research support existing international evidence on ACEs, which reveal a cumulative impact of ACEs; an increasing risk of poor health and social outcomes with increasing number of ACEs suffered. Exposure to ACEs has had a major impact on the development of health-harming behaviours (e.g. smoking and binge drinking), health service use (e.g. staying a night in hospital), health outcomes (such as being diagnosed with a sexually transmitted infection [STI] or chronic disease), as well as low mental wellbeing and life satisfaction. The findings of this report indicate that ACEs had a clear impact on low mental wellbeing and life satisfaction in the study population. Low mental wellbeing and life satisfaction are linked to increased uptake in health-harming behaviour which are in turn, associated with the development of disease and contribute towards increased risk of premature morbidity, combating ACEs should therefore form a significant investment for the study areas.
The availability of local data on ACEs and their impacts on multi-agency priorities allows partnerships to work together to obtain the greatest benefits from shared resources. The findings from this study can make a substantial contribution to supporting practice in Hertfordshire, Luton and Northamptonshire, helping partners break cycles of adversity and improve public health.
Individual infographics relating to this report can be accessed below:
Broxbourne, Corby, Dacorum, Daventry, East Hertfordshire, East Northamptonshire, Herstmere, Hertfordshire, Kettering, Luton, North Hertfordshire, Northampton, Northamptonshire, South Northamptonshire, St Albans, Stevenage, Three Rivers, Watford, Wellingborough, Welwyn Hatfield
Optimising the use of NHS intelligence in local violence prevention and measuring its impact on violence: Project research findings
Over the past decade there has been increasing awareness of the importance of health service data in understanding violence, driving national and local action to establish data sharing pathways and incorporate health data into local violence prevention planning. Optimising the use of NHS intelligence in local violence prevention and measuring its impact on violence, aimed to provide evidence around the use of health data in local violence prevention, determine how health data can best be used for local violence prevention, and support local areas in understanding and using these data sources. Findings from the study show that most areas can access a range of health data sources which could be used within local violence prevention activity (e.g. hospital admissions; A&E attendances; ambulance service call-outs). From these data sources it is possible to explore the extent and nature of violence, along with violence hotspots, at-risk populations and communities, and long-term trends. Despite some good examples of the use of health intelligence in violence prevention, health data remained underutilised across many of the research study sites. Common barriers to, and factors that facilitated, A&E data sharing and use were identified. Our study found no specific relationship between A&E data sharing and use, and local levels of violence in our study sites. Findings may have been different if our study covered a longer period, and health data had played a greater role in informing local violence prevention activity.
Evaluation of the South Wales Know the Score #DrinkLessEnjoyMore intervention (Phase 2)
Nightlife environments are key settings for alcohol consumption and are typified as areas where excessive drunkenness and related harms are the norm. As part of a broader long-term programme of work to address violence and alcohol-related harms in South Wales, in 2015 the Police and Crime Commissioner for South Wales and South Wales Police developed and piloted the Know the Score #DrinkLessEnjoyMore intervention (phase one). The intervention aimed to: increase awareness of the law around serving alcohol to, and purchasing alcohol for, people who are drunk; help support bar staff in refusing service of alcohol to people who are drunk; deter sales of alcohol to drunks; and promote responsible drinking in South Wales.
Evaluation of phase one of the intervention found an increase in nightlife user knowledge of the law around the service of alcohol to drunks and decreases in nightlife user acceptability of drunkenness, reported levels of preloading and reduced levels of police-recorded violence. Following study recommendations the intervention was further refined and implemented as a second phase in 2015/16. This report presents an overall evaluation of the intervention incorporating phases one and two.
Evaluation of the Liverpool Drink Less Enjoy More intervention
In the UK, nightlife environments are key settings for alcohol consumption and have for many years been typified as areas where excessive drunkenness and related harms are the norm.
This is despite the fact that it is an offence to knowingly sell alcohol to, or purchase alcohol for, a drunk person. To address the sale of alcohol to drunks in Liverpool’s nightlife, local partners developed and implemented the Drink Less Enjoy More intervention. The intervention aimed to: increase awareness of legislation preventing sales of alcohol to, and purchasing of alcohol for, drunks; support bar staff compliance with the law; provide a strong deterrence to selling alcohol to drunks; and promote responsible drinking amongst nightlife users. This report presents an evaluation of the intervention.
Adverse Childhood Experiences and their impact on health-harming behaviours in the Welsh adult population
This report is one in a series of reports examining the prevalence of Adverse Childhood Experiences (ACEs) in the Welsh adult population and their impact on health and well-being across the life course. Substantial proportions of the Welsh population reported suffering abuse, neglect and other ACEs during their childhood with 47% reporting having experienced at least one ACE and 14% experiencing four or more ACEs. This report focuses on: alcohol use, drug use, violence, sexual behaviour, incarceration, smoking and poor diet.
Implementing Child Maltreatment Prevention Programmes: What the experts say
Child maltreatment can result in mental and physical harm to the child as well as long-term negative consequences for the individual across their life-course. Delivering measurable reductions in child maltreatment requires action at political, practitioner and public levels. Internationally, some groups and individuals have successfully pioneered programmes to prevent child maltreatment, or been instrumental in changing strategy or policy to protect the rights of the child. Although many of these successes are captured in academic papers, these can omit key learning points on how to establish and sustain successful interventions. Based on a series of interviews reflecting on the experiences of world-leading experts in child maltreatment prevention, this handbook aims to fill this gap by providing practical information to policy-makers, commissioners and practitioners on implementing prevention programmes. After outlining the wider political and cultural landscape needed to drive and sustain interventions, the handbook describes key principles for selecting and delivering programmes, and important practical considerations, resources and technical support. Expert contributors provide insights into important first steps, key questions to consider, and how to address some common challenges and barriers to successful implementation. This handbook is intended for use alongside other resources developed by WHO Regional Office for Europe and has been developed to assist countries to implement Investing in children: the European child maltreatment prevention action plan.
- Published 16 October 2015
- Tagged Violence and unintentional injury
- AuthorsKatie Hardcastle, Professor Mark Bellis, Professor Karen Hughes, Dinesh Sethi
Evaluation of the South Wales Know the Score Intervention
Drunkenness is associated with a wide range of health and social harms, including alcohol poisoning, unintentional injury, violence, sexual assault and public disorder. Whilst the sale of alcohol to people who are drunk is illegal under UK law, public awareness of this legislation and bar server compliance with it appears to be low. In 2015, to address the sale of alcohol to drunks, the Police and Crime Commissioner for South Wales and South Wales Police developed and implemented the Know the Score #drinklessenjoymore pilot intervention. The intervention aimed to increase bar staff and public awareness of the law and promote responsible drinking behaviours in nightlife environments. This report presents an evaluation of the Know The Score intervention which was undertaken to inform the development of the intervention and provide a baseline for evaluating future work.
A case study to demonstrate the use of health data in violence prevention within the voluntary and community sector: Local Solutions
The purpose of the Local Solutions case study is to provide an example of how health intelligence can be used at a local level in violence prevention within the voluntary and community sector. The case study demonstrates how Local Solutions, a charity based in the North West of England were able to use health data to identify where their violence prevention and victim support activities could best be targeted, and allowed the service to increase referrals to the service.
- Published 6 February 2015
- Tagged Violence and unintentional injury