{
  "abstract": "Background Socioeconomically disadvantaged groups experience more alcohol-related harm than more advantaged groups, despite drinking the same amount or even less alcohol on average – known as the alcohol harm paradox. In part, this may be explained by social factors such as nutrition, housing and lifestyle. Plymouth is a coastal city in southwest England with areas of high deprivation, served by a single acute NHS Trust. We aimed to investigate whether wider social determinants of health, specifically number and type of food and drink outlets, was associated with alcohol-specific hospital admissions.Methods The Office of Public Health at Plymouth City Council provided data on the number of alcohol-specific admissions/10,000 population to University Hospitals Plymouth NHS Trust by electoral ward in 2022–23. Index of multiple deprivation (IMD) for each ward was determined using open access data. The number of food and drink outlets (supermarkets, convenience stores, off-licences, pubs and takeaways) in each Plymouth City ward were independently counted by two researchers using Google Maps. Disagreement resulted in a recount until an agreed number was reached. Numbers of outlets were normalised to the ward population. Correlations between the number of outlets and alcohol-specific admissions were determined using Pearson’s coefficient.Results During 2022–23 there were 1369 alcohol-specific admissions in the City of Plymouth (54.2/10,000 population). The number of admissions per ward did not significantly correlate with IMD (r=-0.42; p=0.07). There were 544 food and drink outlets in Plymouth: 181 convenience stores and off-licences, 222 takeaways, 26 supermarkets and 115 pubs. The number of alcohol-specific admissions was strongly associated with the number of outlets per ward (r=0.69; p=0.007), with strong correlations for convenience stores/off-licences (r=0.70; p=0.001), takeaways (r=0.62; p=0.003) and pubs (r=0.76; p<0.0001).Discussion These data indicate that alcohol-specific hospital admissions in the City of Plymouth are associated with the density of food and drink outlets, but not social deprivation itself. Although not causative, these data provide evidence that the built environment contributes to the alcohol harm paradox. Wider determinants of health should be considered when licencing commercial premises in areas with a high alcohol-related health burden.",
  "authors": [
    {
      "affiliations": [
        "University Of Plymouth, Plymouth, UK"
      ],
      "name": "Amber Short"
    },
    {
      "affiliations": [
        "University Of Plymouth, Plymouth, UK"
      ],
      "name": "Anes Harid"
    },
    {
      "affiliations": [
        "Plymouth City Council, Plymouth, UK"
      ],
      "name": "Emily Crowley"
    },
    {
      "affiliations": [
        "University Of Plymouth, Plymouth, UK",
        "University Hospitals Plymouth NHS Trust, Plymouth, UK"
      ],
      "name": "Ashwin Dhanda"
    }
  ],
  "title": "P121 Alcohol-specific hospital admissions are associated with wider determinants of health: a citywide case study",
  "uid": "380766d1-af73-5a8d-8dfe-a5fd594da9fd"
}