RT Journal Article
SR Electronic
T1 The intervention effect of local alcohol licensing policies on hospital admission and crime: a natural experiment using a novel Bayesian synthetic time-series method
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP jech-2017-208931
DO 10.1136/jech-2017-208931
A1 Frank de Vocht
A1 Kate Tilling
A1 Triantafyllos Pliakas
A1 Colin Angus
A1 Matt Egan
A1 Alan Brennan
A1 Rona Campbell
A1 Matthew Hickman
YR 2017
UL http://jech.bmj.com/content/early/2017/07/05/jech-2017-208931.abstract
AB Background Control of alcohol licensing at local government level is a key component of alcohol policy in England. There is, however, only weak evidence of any public health improvement. We used a novel natural experiment design to estimate the impact of new local alcohol licensing policies on hospital admissions and crime.Methods We used Home Office licensing data (2007–2012) to identify (1) interventions: local areas where both a cumulative impact zone and increased licensing enforcement were introduced in 2011; and (2) controls: local areas with neither. Outcomes were 2009–2015 alcohol-related hospital admissions, violent and sexual crimes, and antisocial behaviour. Bayesian structural time series were used to create postintervention synthetic time series (counterfactuals) based on weighted time series in control areas. Intervention effects were calculated from differences between measured and expected trends. Validation analyses were conducted using randomly selected controls.Results 5 intervention and 86 control areas were identified. Intervention was associated with an average reduction in alcohol-related hospital admissions of 6.3% (95% credible intervals (CI) −12.8% to 0.2%) and to lesser extent with a reduced in violent crimes, especially up to 2013 (–4.6%, 95% CI −10.7% to 1.4%). There was weak evidence of an effect on sexual crimes up 2013 (–8.4%, 95% CI −21.4% to 4.6%) and insufficient evidence of an effect on antisocial behaviour as a result of a change in reporting.Conclusion Moderate reductions in alcohol-related hospital admissions and violent and sexual crimes were associated with introduction of local alcohol licensing policies. This novel methodology holds promise for use in other natural experiments in public health.