Elsevier

Social Science & Medicine

Volume 91, August 2013, Pages 162-167
Social Science & Medicine

The spatial and temporal development of binge drinking in England 2001–2009: An observational study

https://doi.org/10.1016/j.socscimed.2013.03.023Get rights and content

Highlights

  • There are pronounced regional disparities in binge drinking across England reflecting a north south divide.

  • Disparities were consistent between 2001 and 2009 using a standard and an alternative definition of binge drinking.

  • Women are more likely to concentrate their binge drinking on just one day in each week.

  • Place-based deprivation gradients in binge drinking may be artefactual.

Abstract

Binge drinking has been linked to escalating costs of hospitalisation and to premature mortality, and implicated in a range of acute and chronic health problems as well as crime, violence and other negative aspects of the wider well-being agenda. Variously defined, it can be characterised as brief periods of heavy drinking (across one day or evening) within a longer time-frame of lower consumption or even abstinence (across a week or several weeks). In England the current binge drinking epidemic has become particularly salient in the past decade and has been seen largely in terms of excessive consumption by younger people, particularly women in urban centres. It has also been linked to the liberalisation of licencing laws and the promotion of 24 h club cultures. This paper presents an observational study of the regional development of binge drinking between 2001 and 2009 as evidenced in the Health Survey for England. We innovate by using two different definitions of binge drinking within a multivariate multilevel modelling framework, with a focus on the random effects attributable to the year of study and region. We control for age, sex, ethnicity, marital status and individual socio-economic status, and confounding by neighbourhood deprivation and urbanisation. The paper identifies pronounced regional geographies that persist in the face of controls and vary little over time, and strong spatio-temporal gender differences which reflect the definition of binge drinking.

Introduction

Problem drinking is a global challenge to health. Levels of problem drinking in the UK are among the highest in Europe and the implications for society and for policy are considerable (see RGS/IBG, 2010 for a summary of current debates). In 2008, it was estimated that the financial burden of alcohol misuse for the UK was around £25.1 billion, with £2.7 billion of those costs relating to NHS services in England (National Audit Office, 2008). Research on drinking behaviour has given particular attention to binge drinking: concentrated bouts of heavy drinking within defined periods of time.

Evidence suggests that this binge drinking is highest among younger people and declines with age (Smith & Foxcroft, 2009). An association between binge drinking and particular places is also long established, drawing generally on cross-sectional surveys or case studies conducted at a single point in time. Whether at a local neighbourhood or at a larger regional or even national scale, particular places have reputations for excess alcohol consumption. These reputations are an outcome of a diverse range of factors including licencing laws, alcohol pricing, drinking cultures, hedonism, holidays or other forms of social release as well as the compositional socio-demographic make-up of local populations (see for example Jane, Valentine and Holloway, 2008a; Jayne, Holloway, & Valentine, 2006; Twigg, Moon, Duncan, & Jones, 2000).

Our aim in this paper is to assess whether the relationship between binge drinking and socio-demographic factors in England changed over the first decade of the current century. To this end, we extend existing knowledge of binge drinking in England by moving beyond a single temporal snapshot to a consideration of the interplay between time, space and binge drinking behaviour. Drawing on a statistical analysis of data on binge drinking behaviour in England between 2001 and 2009, we also consider how different definitions of binge drinking influence conclusions about the changing geography of the topic and affect associations between place and drinking behaviour.

Section snippets

Background

Social science research on binge drinking has focused on the geographies of excessive alcohol consumption associated with ‘spring break’ in the US, youth cultures, ‘stag’ and ‘hen’ destinations in Europe and the development of night-time economies (Bell, 2008; Courtney & Polich, 2009; Grucza, Norberg, & Bierut, 2009; Jayne, Valentine, & Holloway, 2008b; Measham & Brain, 2005; Naimi et al., 2003).

Quantitative studies in health geography have considered variations in levels of drinking and

Methods

We measured binge drinking using the standard UK Government definition: drinking eight units or more for men and six or more for women on the heaviest drinking day of the past week (Herring et al., 2008; Parliamentary Office of Science and Technology, 2005). We term this ‘standard binge drinking’. Standard binge drinkers may also drink heavily on other days of the week; the measure does not consider the variability of behaviour over the week. Consequently we also developed a measure capturing

Results

Table 1 shows the regional variations in binge drinking across all regions and across all time periods in the raw HSfE data for the two definitions of binge drinking. There appears to be a strong north-south divide with highest rates reported in the North East for both definitions. The lowest rate for the standard definition is reported in the South West, whereas London records the lowest rate for the episodic definition. The table also shows that the prevalence of standard binge drinking is

Conclusions

The short report has identified pronounced regional geographies that persist in the face of controls and vary little over time and can be summarized as an English north versus south divide in binge drinking. These persistent regional disparities are evident for the standard definition of binge drinking and for an episodic definition that focuses on a concentrated period of drinking on only one day of the week. The paper shows strong temporal differences according to deprivation and gender which

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